Computer-assisted medical system and method

Abstract

The invention relates to computer-aided medical systems and methods, and describes systems and methods for computer-aided instrument motion. For example, the present disclosure provides mechanisms and techniques for gripping an instrument with a computer-assisted manipulator assembly, as well as methods for actuating computer-assisted instrument motion.

Description

[0001] This application is a divisional application of Chinese patent application 202111268463.2, with the application date of June 29, 2017, entitled “Computer-assisted medical systems and methods”. The aforementioned application is a divisional application of Chinese patent application 201780045919.4, with the application date of June 29, 2017, entitled “Computer-assisted medical systems and methods”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims the benefit of U.S. Provisional Application No. 62 / 357,678, filed on July 1, 2016. The disclosure of the prior application is considered part of the disclosure of the present application and is incorporated by reference into the disclosure of the present application. Technical Field

[0004] The present disclosure relates to systems and methods for computer-assisted surgery, such as minimally invasive surgery, teleoperated surgery, and minimally invasive computer-assisted teleoperated surgery. For example, the present disclosure relates to mechanisms for gripping surgical instruments at the end of a robotic manipulator and methods for actuating computer-assisted insertion motions of surgical instruments. Background Art

[0005] Robotic systems and computer-assisted devices typically include a robot or an articulating arm that manipulates an instrument to perform a task at a work site, and at least one robot or articulating arm that supports an image acquisition device that acquires images of the work site. The robotic arm includes a plurality of links coupled together by one or more actively controlled joints. In various embodiments, a plurality of actively controlled joints may be provided. The robotic arm may also include one or more passive joints that are not actively controlled but follow the movement of the actively controlled joints. Such active and passive joints may be revolute or prismatic joints. The configuration of the robotic arm may be determined by knowledge of the joint orientations and the structure and coupling of the links.

[0006] Minimally invasive telesurgery systems for use in surgical procedures are being developed to improve the dexterity of surgeons and to allow surgeons to operate on patients from a remote location. Telesurgery is a general term for surgical systems in which surgeons use some form of remote control, such as servomechanisms, etc., to manipulate the movement of surgical instruments rather than directly holding and moving instruments by hand. In such telesurgery systems, images of the surgical site are provided to the surgeon at a remote location. When the surgeon typically views a three-dimensional image of the surgical site on a suitable viewer or display, the surgeon controls the movement of the robotic instrument by manipulating the main control input device, thereby performing a surgical procedure on the patient. Robotic surgical instruments can be inserted through a small minimally invasive surgical orifice to treat tissue at the surgical site in the patient's body, usually avoiding trauma associated with entering the surgical work site through open surgical techniques. These robotic systems can move the working end of the surgical instrument dexterously enough to perform fairly complex surgical tasks, usually by pivoting the shaft of the instrument at the minimally invasive orifice, sliding the shaft axially through the orifice, rotating the shaft in the orifice, and / or other similar actions. Summary of the invention

[0007] The present disclosure provides systems and methods for computer-assisted medical procedures. Example procedures include surgical procedures, such as minimally invasive surgery, teleoperated surgery, and minimally invasive computer-assisted teleoperated surgery using computer-assisted teleoperated medical devices. Other example procedures include various medical treatment and diagnostic procedures. For example, the present disclosure provides a mechanism for clamping a medical instrument at the end of a robotic manipulator assembly and a method for actuating an axial translation or insertion motion of an instrument.

[0008] In the context of minimally invasive computer-assisted medical procedures, the movement of a robotic manipulator assembly can be controlled by a system processor so that a shaft or intermediate portion of a surgical instrument is constrained to safe motion when passing through a minimally invasive surgical access site, a natural orifice (including oral and anal), or other orifice. For example, such motion can include axial insertion of the shaft through the orifice site, rotation of the shaft about its axis, and pivotal motion of the shaft about a pivot point adjacent to the access site, but excessive lateral motion of the shaft is generally prevented, which may inadvertently tear tissue adjacent to the orifice or enlarge the access site. Some or all of these constraints on the motion of the robotic manipulator assembly at the access site can be applied by partially or fully utilizing robotic data processing and control technology. Such concepts for constraining the motion of a robotic manipulator assembly may be referred to herein as a software-constrained remote center of motion.

[0009] In one aspect, the present disclosure is directed to a minimally invasive computer-assisted surgical method, the method comprising moving a computer-assisted surgical manipulator arm to cause an elongated surgical instrument coupled to the computer-assisted manipulator arm to move along a fixed line in space, the fixed line in space being defined by a longitudinal axis of the surgical instrument, and moving the surgical instrument along the fixed line in space independently of the movement of the computer-assisted surgical manipulator arm. The computer-assisted surgical manipulator arm may be remotely operated.

[0010] Such a minimally invasive computer-assisted surgical method may optionally include one or more of the following features. At least the distal portion of the surgical instrument may be disposed within the patient's body during each movement operation. The movement operations may occur simultaneously, at least to a certain extent. The movement operations may not occur simultaneously. The movement of the surgical instrument independently of the movement of the computer-assisted surgical manipulator arm may include moving an instrument holder bracket to which the surgical instrument is releasably coupled. Moving the computer-assisted surgical manipulator arm may be used for long, slow movements, while moving the surgical instrument may be used for shorter, faster movements. The long, slow movements may be distinguished from the shorter, faster movements by a frequency cutoff filtering operation. Moving the computer-assisted surgical manipulator arm in conjunction with the moving the surgical instrument may be performed in response to receiving a motion input of a surgical instrument command. Moving the computer-assisted surgical manipulator arm may further include pivoting a surgical instrument holder relative to the computer-assisted surgical manipulator arm.

[0011] In another aspect, the present disclosure relates to a computer-assisted surgical system comprising: (a) an instrument holder configured for pivotable attachment to a computer-assisted surgical manipulator arm; (b) an instrument holder bracket movably coupled to the instrument holder; (c) a surgical instrument coupleable to the instrument holder bracket, the surgical instrument comprising an elongated shaft and an end effector disposed at the end of the elongated shaft; and (d) a tubular sleeve defining a first lumen for slidably receiving the elongated shaft, wherein the tubular sleeve is configured for removal from the instrument holder for use.

[0012] Such a computer-assisted surgical system may optionally include one or more of the following features. The instrument holder may define a second lumen for slidably engaging the elongated shaft. The instrument holder bracket may translate linearly along the instrument holder. The system may also include the computer-assisted surgical manipulator arm coupled to a base.

[0013] In another aspect, a computer-assisted surgical system includes an instrument holder coupleable to a computer-assisted surgical manipulator arm, an instrument holder bracket movably coupled to the instrument holder, and a cannula holder coupled to the instrument holder. When the instrument holder is coupled to the computer-assisted surgical manipulator arm, the instrument holder bracket is movable independently of the computer-assisted surgical manipulator arm, and the cannula holder is movable independently of the computer-assisted surgical manipulator arm and independently of the instrument holder bracket.

[0014] Such a computer-assisted surgical system may optionally include one or more of the following features. The system may also include a cannula releasably coupled to the cannula holder, wherein the cannula defines a lumen. The system may also include a surgical instrument releasably coupled to the instrument holder bracket (wherein the surgical instrument is slidably coupled within the lumen of the cannula). The instrument holder bracket may be linearly translatable along the instrument holder. The system may also include the computer-assisted surgical manipulator arm coupled to a base.

[0015] In another aspect, the present disclosure relates to a computer-assisted surgical system comprising: (a) an instrument holder configured for pivotable attachment to a computer-assisted surgical manipulator arm; (b) an instrument holder bracket movably coupled to the instrument holder; (c) a surgical instrument coupleable to the instrument holder bracket (the surgical instrument comprising an elongated shaft and an end effector disposed at the end of the elongated shaft); (d) a cannula holder movably coupled to the instrument holder; and (e) a tubular cannula coupleable to the cannula holder (the tubular cannula defines a lumen for slidably receiving the elongated shaft).

[0016] Such a computer-assisted surgical system may optionally include one or more of the following features. The instrument holder carriage may be linearly translatable along the instrument holder. The system may also include the computer-assisted surgical manipulator arm coupled to a base. The cannula holder may be linearly translatable relative to the instrument holder.

[0017] In another aspect, the present disclosure relates to a computer-assisted surgical system, comprising: (a) an instrument holder configured to be attached to a computer-assisted surgical manipulator arm at a pivotable joint (wherein the pivotable joint can translate along the instrument holder); (b) an instrument holder bracket movably coupled to the instrument holder; (c) a tubular sleeve that can be coupled to the instrument holder (wherein the tubular sleeve defines a lumen); and (d) a surgical instrument that can be coupled to the instrument holder bracket. The surgical instrument includes an elongated shaft and an end effector disposed at the end of the elongated shaft. The elongated shaft is slidably coupled within the lumen.

[0018] Such a computer-assisted surgical system may optionally include one or more of the following features: The instrument holder carriage may be linearly translatable along the instrument holder. The system may also include the computer-assisted surgical manipulator arm coupled to a base.

[0019] Some or all of the embodiments described herein may provide one or more of the following advantages. For example, some of the robotic manipulator assembly embodiments described herein are configured to be more compact than conventional robotic manipulator assemblies. This compact design can reduce the likelihood of physical interference between robotic manipulator assemblies of a robotic surgical system. In addition, this compact design can reduce the weight and inertia of the robotic manipulator assembly. Therefore, the size and power of the actuators of the robotic surgical system can be reduced. The structural size and weight of the mechanical linkage can also be reduced by using the robotic manipulator assembly embodiments described herein. This lighter mechanical linkage can facilitate a robotic surgical system that is better responsive to user input. In addition, some of the methods provided herein also facilitate smaller and more responsive robotic manipulator assemblies.

[0020] The details of one or more embodiments are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1is a perspective view of an example patient side cart for a robotic surgical system.

[0022] Figure 2 is a front view of an example surgeon's console for a robotic surgical system.

[0023] Figure 3 is a side view of an example robotic manipulator arm assembly of a robotic surgical system.

[0024] Figure 4 is a perspective view of a distal portion of an example surgical instrument in a first configuration.

[0025] Figure 5 It is in the second configuration Figure 4 A perspective view of a distal portion of a surgical instrument.

[0026] Figure 6 It is in the third configuration Figure 4 A perspective view of a distal portion of a surgical instrument.

[0027] Figures 7 to 9 are bottom, side, and back views of an exemplary robotic manipulator assembly having a range of joint states for a given end effector orientation.

[0028] Fig.10 The diagram is illustrated by Figures 7 to 9 Schematic representation of the degrees of freedom provided by the robotic manipulator components.

[0029] Fig.11 is a schematic diagram illustrating a robotic manipulator assembly inserted through a surgical orifice.

[0030] Fig.12 Schematic diagram of manually Fig.11 Some of the challenges of repositioning a highly configurable manipulator assembly to a new orifice location.

[0031] Fig.13 Schematically illustrates the Fig.11 The arm is reconfigured to enhance range of motion or the like during manual repositioning of the manipulator to a new orifice location.

[0032] Fig.14 and 15 Automatic reconfiguration of the joints of the manipulator assembly within a series of alternative joint configurations during manual movement of the arm is schematically illustrated.

[0033] Fig.16 is a simplified block diagram schematically illustrating a fully constrained inverse Jacobian master / slave speed controller.

[0034] Fig.17 is a simplified block diagram of a modified master / slave controller in which an inverse Jacobi controller module is combined with a second module having a configuration-dependent subspace filter to allow control of a manipulator assembly.

[0035] Fig.18 The diagram illustrates the Fig.17 A refinement of the simplified master-slave control illustrated in .

[0036] Fig.19 An exemplary inverse Jacobian controller for a fully constrained master / slave robotic surgical system is schematically illustrated.

[0037] Fig. 20 Schematically illustrates Fig.11 FIG. 4 is a modified portion of the controller in which the inverse Jacobi controller has been modified by a configuration-dependent filter so that the controller takes into account the priorities of different levels of system constraints and / or objectives.

[0038] Fig.21 is a side view of a distal portion of an example patient-side robotic manipulator assembly in accordance with some embodiments. The robotic manipulator assembly is in a first arrangement relative to a surgical site.

[0039] Fig. 22 yes Fig.21 Another side view of an example patient-side robotic manipulator assembly of FIG. The robotic manipulator assembly is in a second arrangement relative to the surgical site.

[0040] Fig.23 is a flow chart of a two-step method for controlling insertion of a surgical instrument, according to some embodiments.

[0041] Fig.24 is a side view of a distal portion of another example patient-side robotic manipulator assembly, according to some embodiments.

[0042] Fig.25 is a side view of a distal portion of another example patient-side robotic manipulator assembly, according to some embodiments.

[0043] Fig.26 is a side view of a distal portion of another example patient-side robotic manipulator assembly, according to some embodiments.

[0044] Fig. 27 is a side view of a distal portion of another example patient-side robotic manipulator assembly, according to some embodiments.

[0045] Fig.28 is a side view of a distal portion of another example patient-side robotic manipulator assembly, according to some embodiments.

[0046] Like reference symbols in the various drawings indicate like elements. DETAILED DESCRIPTION

[0047] The present specification and drawings illustrating inventive aspects, embodiments, implementations, or applications should not be construed as limiting—rather, the claims define the protected invention. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of the present specification and claims. In some cases, well-known circuits, structures, or techniques are not shown or described in detail to avoid obscuring the present invention. The same number in two or more drawings represents the same or similar elements.

[0048] In addition, the specific words selected to describe one or more embodiments and optional elements or features are not intended to limit the present invention.For example, spatial relative terms, such as, "below ... ", "below ... ", "lower part", "above ... ", "upper part", "near side", "distal side" and similar expressions, can be used to describe the relationship between an element or feature and another element or feature as illustrated in the figure. In addition to the position and orientation shown in the figure, these spatial relative terms are intended to cover the different orientations (i.e., translation placement) and orientations (i.e., rotation placement) of the device in use or operation. For example, if the device in the figure is flipped, the element described as "below" other elements or features or "below" other elements or features will become "above" other elements or features or "above" other elements or features. Therefore, the exemplary term "below ... " can cover both the position and orientation above and below. The device can be oriented in other ways (e.g., rotated 90 degrees or in other orientations), and the spatial relative descriptors used herein are interpreted accordingly. Likewise, descriptions of movement along various axes (translation) and about various axes (rotation) include various specific device positions and orientations.The combination of the position and orientation of the body defines the posture of the body.

[0049] Similarly, unless the context indicates otherwise, geometric terms (e.g., "parallel," "perpendicular," "circular," or "square") are not intended to require absolute mathematical precision. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "circular" or "substantially circular," the specification still encompasses components that are not precisely annular (e.g., slightly oblong or multi-sided polygonal in shape). The words "including" or "having" mean including, but not limited to, including.

[0050] It should be understood that although the description is sufficiently clear, concise and accurate, rigorous and exhaustive linguistic precision is not always possible or desirable because the description should be kept to a reasonable length and a skilled reader should understand the background and associated technology. For example, with respect to video signals, a skilled reader should understand that an oscilloscope described as displaying a signal does not display the signal itself but a representation of the signal, and a video monitor described as displaying a signal does not display the signal itself but the video information carried by the signal.

[0051] In addition, unless the context indicates otherwise, the singular forms "a", "an", and "said / the" are also intended to include the plural forms. Furthermore, the terms "comprise", "include", "have", and similar expressions specify the presence of stated features, steps, operations, elements, and / or parts but do not exclude the presence or addition of one or more other features, steps, operations, elements, parts, and / or groups. Furthermore, the one or more individually listed terms or each of the one or more individually listed terms should be considered optional unless otherwise specified, so that various combinations of terms are described without exhaustively listing every possible combination. The auxiliary verb "may" also means that the feature, step, operation, element, or part is optional.

[0052] As long as feasible, the elements described in detail about one embodiment, implementation or application can be optionally included in other embodiments, implementations or applications that are not specifically shown or described. For example, if an element is described in detail about one embodiment and is not described about a second embodiment, the element can nevertheless be required to be included in the second embodiment. Therefore, to avoid unnecessary repetition in the following description, unless specifically described otherwise, unless one or more elements will make an embodiment or implementation inoperative, or unless two or more of the elements provide conflicting functions, one or more elements shown and described in association with an embodiment, implementation or application can be incorporated into other embodiments, implementations or aspects.

[0053] Elements described as being coupled may be directly electrically or mechanically coupled, or they may be indirectly coupled via one or more intermediate components.

[0054] The term "flexible" in connection with a part such as a mechanical structure, component, or assembly of components should be understood broadly. Essentially, the term means that the part is able to bend repeatedly and return to its original shape without damaging the part. Many "rigid" objects have a small inherent elastic "bend" due to the properties of the material, but such objects are not considered "flexible" when the term is used in this article. Flexible parts can have infinite degrees of freedom (DOF). Examples of such parts include closed, bendable tubes (made of, for example, NITINOL, polymers, soft rubber, and the like), helical coil springs, etc., which can be bent into a variety of simple and complex curves, usually without significant cross-sectional deformation. Other flexible parts can approximate such infinite DOF parts by using a series of closely spaced components similar to a serpentine arrangement of series-connected "vertebrae." In such vertebral arrangements, each component is a short link in a kinematic chain, and a movable mechanical constraint (e.g., pin hinge, cup and ball, living hinge, and the like) between each link can allow one (e.g., pitch) or two (e.g., pitch and yaw) DOF of relative movement between the links. A short flexible part can be used and modeled as a single mechanical constraint (joint) that provides one or more DOF between two links of a kinematic chain, even though the flexible part itself can be a kinematic chain composed of several coupled links. It will be understood by those skilled in the art that the flexibility of a part can be represented by its stiffness.

[0055] Unless otherwise stated in this specification, a flexible part, such as a mechanical structure, component, or component assembly, may be actively or passively flexible. An active flexible part may be bent by using forces inherently associated with the part itself. For example, one or more tendons may be routed lengthwise along the part and offset from the longitudinal axis of the part so that tension on one or more tendons causes the part or a portion of the part to bend. Other ways of actively bending active flexible parts include, but are not limited to, using pneumatic or hydraulic power, gears, electroactive polymers (more generally, "artificial muscles"), and the like. Passive flexible parts are bent by using forces external to the part (e.g., applied mechanical or electromagnetic forces). A passive flexible part may remain in its bent shape until bent again, or it may have an intrinsic property that tends to restore the part to its original shape. Examples of passive flexible parts with intrinsic stiffness are plastic rods or elastic rubber tubes. Active flexible parts may be passively flexible when not actuated by forces inherently associated with them. A single part may be made of one or more active and passive flexible parts in series.

[0056] The results were based primarily on the use of the da Aspects of the present invention are described in detail with reference to implementations of surgical systems. An example of such a surgical system is a Xi TM Surgical system (model IS4000) and da Si TM HD TM Surgical System (Model IS3000). However, those skilled in the art will appreciate that the inventive aspects disclosed herein may be embodied and implemented in different ways, including computer-assisted, non-computer-assisted, and hybrid combinations of manual and computer-assisted embodiments and implementations. The implementation of the surgical system (e.g., Model IS4000, Model IS3000, Model IS2000, Model IS1200) is exemplary only and is not to be considered as limiting the scope of the inventive aspects disclosed herein. If applicable, the inventive aspects may be embodied and implemented in relatively smaller, handheld, manually operated devices, and in relatively larger systems with additional mechanical support, as well as in other embodiments of computer-assisted devices (including non-teleoperated and teleoperated medical devices used in all types of medical procedures (such as procedures for diagnosis, nonsurgical procedures, minimally invasive surgical procedures, and non-minimally invasive surgical procedures). If applicable, the inventive aspects may be embodied and implemented in non-medical systems, such as industrial robots and other robotic systems.

[0057] It should be understood that the small scale of the disclosed structures and mechanisms creates unique mechanical conditions and challenges in the construction of these structures and mechanisms, which are unlike those found in similar structures and mechanisms built at larger scales, because forces and material strengths do not scale in proportion to the size of the mechanism at the same rate. For example, a surgical instrument with an 8 mm shaft diameter cannot be simply scaled in size to a 5 mm shaft diameter due to mechanical, material properties, and manufacturing considerations. Likewise, a 5 mm shaft diameter device cannot be simply scaled in size to a 3 mm shaft diameter device. Significant mechanical / mechanical problems exist when physical size is reduced.

[0058] A computer is a machine that follows programmed instructions to perform mathematical or logical functions on input information to produce processed output information. A computer includes logic units that perform mathematical or logical functions, and memory that stores programmed instructions, input information, and output information. The term "computer" and similar terms (such as "processor" or "controller") encompass both single location and distributed implementations.

[0059] The present disclosure provides improved medical and robotic devices, systems and methods. The inventive concept can be used with a computer-assisted medical system such as a medical robotic system, in which multiple surgical tools or instruments will be mounted thereon and moved by associated multiple robotic manipulators during a medical procedure. The robotic system will typically include a minimally invasive, non-teleoperated, telerobotic, telesurgery and / or telepresence system, which includes a processor configured as a master-slave controller. By providing a robotic system using a processor appropriately configured to move the manipulator assembly with an articulated linkage having a relatively large number of degrees of freedom, the movement of the linkage can be customized to adapt to working through minimally invasive, natural orifices or other entry sites. The large number of degrees of freedom also enables the processor to position the manipulator to suppress interference or collisions or similar problems between these moving structures.

[0060] The robotic manipulator assembly described herein will typically include a robotic manipulator and a tool mounted thereon (in surgical applications, the tool typically includes a surgical instrument), although the term "robotic assembly" may also encompass a manipulator without a tool mounted thereon. The term "tool" not only covers general or industrial robotic tools, but also includes dedicated robotic surgical instruments, wherein the dedicated robotic surgical instrument structure typically includes an end effector suitable for tissue manipulation, tissue processing, tissue imaging, or similar actions. The tool / manipulator interface will typically be a tool holder or coupling that can be quickly detached so that the tool can be quickly removed and replaced with a replaceable tool. The manipulator assembly will typically have a base that is fixed in space during at least a portion of the robotic procedure, and the manipulator assembly may include many degrees of freedom between the base and the end effector of the tool. The actuation of the end effector (such as opening or closing the jaws of the clamping device, energizing the electrosurgical paddle, or similar actions) will typically be independent of these manipulator assembly degrees of freedom, and will additionally increase these manipulator assembly degrees of freedom in addition to the manipulator assembly degrees of freedom.

[0061] The end effector typically moves within the workspace with 2 to 6 degrees of freedom. As used herein, the term "position" includes both position and orientation. Thus, for example, a change in the position of an end effector may involve a translation of the end effector from a first position to a second position, a rotation of the end effector from a first orientation to a second orientation, or a combination of both.

[0062] When used in minimally invasive robotic surgery or other medical procedures, the movement of the manipulator assembly can be controlled by the system processor so that the shaft or intermediate portion of the tool or instrument is constrained to safe movement when passing through the minimally invasive surgical access site or other orifice. For example, such movement can include axial insertion of the shaft through the orifice site, rotation of the shaft about its axis, and pivotal movement of the shaft about a pivot point adjacent to the access site, but excessive lateral movement of the shaft is generally prevented, which may inadvertently tear tissue adjacent to the orifice or enlarge the access site. Some or all of this constraint on manipulator movement at the access site is applied by utilizing a mechanical manipulator joint linkage that inhibits inappropriate movement, or is partially or fully applied by utilizing robotic data processing and control techniques. Therefore, this minimally invasive orifice constrained movement of the manipulator assembly can be used with between 0 and 3 degrees of freedom of the manipulator assembly.

[0063] Many of the exemplary manipulator assemblies described herein will have more degrees of freedom than those required to position and move the end effector within the surgical site. For example, a surgical end effector that can be positioned with 6 degrees of freedom at an internal surgical site through a minimally invasive orifice may have 9 degrees of freedom in some embodiments (6 degrees of freedom for the end effector - 3 for position, 3 for orientation - plus 3 degrees of freedom to comply with the constraints of the entry site), but it generally has 10 or more degrees of freedom. A highly configurable manipulator assembly with more degrees of freedom than those required for a given end effector orientation can be described as having or providing sufficient degrees of freedom to allow a series of joint states for the end effector orientation in the workspace. For example, for a given end effector orientation, the manipulator assembly can occupy (and be driven between) any of a series of alternative manipulator linkage orientations. Similarly, for a given end effector velocity vector, the manipulator assembly can have a series of different joint movement velocities for various joints of the manipulator assembly.

[0064] refer to Figure 1 and Figure 2, a system for minimally invasive telesurgery can include a patient-side cart 100 and a surgeon's console 40. Telesurgery is a general term for surgical systems in which the surgeon uses some form of remote control (e.g., servomechanism or the like) to manipulate the movement of surgical instruments rather than directly holding and moving the instruments by hand. For example, controlling the patient-side cart 100 using the surgeon's console 40 is a type of telesurgery. In contrast, directly controlling the patient-side cart by manually pushing or pulling the manipulator or instrument into a desired configuration includes non-remotely operated controls. Robotic manipulable surgical instruments can be inserted through small minimally invasive surgical orifices to treat tissue at a surgical site in a patient's body, avoiding trauma associated with access for open surgery. These robotic systems can move the working end of surgical instruments deftly enough to perform fairly complex surgical tasks, typically accomplished by pivoting the shaft of the instrument at the minimally invasive orifice, sliding the shaft axially through the orifice, rotating the shaft in the orifice, and / or other similar actions.

[0065] In the depicted embodiment, the patient side cart 100 includes a base 110, a first robotic manipulator arm assembly 120, a second robotic manipulator arm assembly 130, a third robotic manipulator arm assembly 140, and a fourth robotic manipulator arm assembly 150. Each robotic manipulator arm assembly 120, 130, 140, and 150 is pivotably coupled to the base 110. In some embodiments, fewer than four or more than four robotic manipulator arm assemblies may be included as part of the patient side cart 100. Although in the depicted embodiment the base 110 includes casters to allow for ease of mobility, in some embodiments the patient side cart 100 is fixedly mounted to a floor, a roof, an operating table, a structural frame, or the like.

[0066] In a typical application, two of the robotic manipulator arm assemblies 120, 130, 140, or 150 hold surgical instruments, and the third holds a stereo endoscope. The remaining robotic manipulator arm assembly is available so that another instrument can be introduced at the working site. Alternatively, the remaining robotic manipulator arm assembly can be used to introduce a second endoscope or another image capture device (such as an ultrasound transducer) to the working site.

[0067] Each of the robotic manipulator arm assemblies 120, 130, 140, and 150 is generally formed of links that are coupled together and manipulated by actuatable joints. Each of the robotic manipulator arm assemblies 120, 130, 140, and 150 includes an assembly arm and a device manipulator. The assembly arm positions its gripping device so that the pivot point occurs at the assembly arm entry aperture into the patient. The device manipulator can then manipulate its gripping device so that it can be pivoted about the pivot point, inserted into and retracted from the entry aperture, and rotated about its shaft axis.

[0068] In the depicted embodiment, the surgeon console 40 includes a stereoscopic vision display 45 so that the user can view the surgical working site in stereoscopic form from the images captured by the stereoscopic camera of the patient side cart 100. Left eyepiece 46 and right eyepiece 47 are provided in the stereoscopic vision display 45 so that the user can view the left and right display screens within the display 45 with the user's left and right eyes, respectively. The surgeon typically performs a surgical procedure on the patient by manipulating a master control input device, which in turn controls the movement of the robotic instrument, while viewing the image of the surgical site on a suitable viewer or display.

[0069] The surgeon console 40 also includes left and right input devices 41, 42, which the user grasps with his / her left and right hands, respectively, to manipulate devices (e.g., surgical instruments) being held by the robotic manipulator arm assemblies 120, 130, 140, and 150 of the patient side cart 100, preferably with six degrees of freedom (“DOF”). A foot pedal 44 with toe control and heel control is provided on the surgeon console 40 so that the user can control the movement and / or actuation of the device associated with the foot pedal.

[0070] A processor 43 is provided in the surgeon console 40 for control and other purposes. The processor 43 performs various functions in the medical robotic system. One function performed by the processor 43 is to convert and transmit the mechanical motion of the input devices 41, 42 to actuate their respective joints in their associated robotic manipulator arm assemblies 120, 130, 140 and 150 so that the surgeon can effectively manipulate the devices, such as surgical instruments. Another function of the processor 43 is to implement the methods, cross-coupling control logic and controllers described herein.

[0071] Although described as a processor, it should be appreciated that processor 43 may be implemented by any combination of hardware, software, and firmware. Moreover, its functions as described herein may be performed by one unit or distributed among a number of subunits, each of which may in turn be implemented by any combination of hardware, software, and firmware. Further, although shown as part of or physically adjacent to surgeon's console 40, processor 43 may also be distributed throughout the telesurgery system as a subunit.

[0072] Also refer to Figure 3 , the robotic manipulator arm assemblies 120, 130, 140, and 150 are capable of manipulating devices, such as surgical instruments, to perform minimally invasive surgical procedures. For example, in the depicted arrangement, the robotic manipulator arm assembly 120 is pivotally coupled to the instrument holder 122. The cannula 180 and the surgical instrument 200 are in turn releasably coupled to the instrument holder 122. The cannula 180 is a tubular member that is positioned at a patient interface site during a surgical procedure. The cannula 180 defines a lumen in which an elongated shaft 220 of the surgical instrument 200 is slidably disposed.

[0073] The instrument holder 122 is pivotably coupled to the distal end of the robotic manipulator arm assembly 120. In some embodiments, the pivotable coupling between the instrument holder 122 and the distal end of the robotic manipulator arm assembly 120 is a motorized joint actuatable by the surgeon console 40 and processor 43.

[0074] The instrument holder 122 includes an instrument holder frame 124, a cannula clamp 126, and an instrument holder carriage 128. In the depicted embodiment, the cannula clamp 126 is fixed to the distal end of the instrument holder frame 124. The cannula clamp 126 can be actuated to couple or decouple with the cannula 180. The instrument holder carriage 128 is movably coupled to the instrument holder frame 124. More specifically, the instrument holder carriage 128 is linearly translatable along the instrument holder frame 124. In some embodiments, the movement of the instrument holder carriage 128 along the instrument holder frame 124 is a motorized translational movement that is actuable / controllable by the processor 43.

[0075] The surgical instrument 200 includes a transmission assembly 210, an elongated shaft 220, and an end effector 230. The transmission assembly 210 is releasably coupled to the instrument holder bracket 128. The shaft 220 extends distally from the transmission assembly 210. The end effector 230 is disposed at the distal end of the shaft 220.

[0076] The shaft 220 defines a longitudinal axis 222 that coincides with the longitudinal axis of the cannula 180. As the instrument holder carriage 128 translates along the instrument holder frame 124, the elongated shaft 220 of the surgical instrument 200 is moved along the longitudinal axis 222. In this manner, the end effector 230 can be inserted into and / or retracted from a surgical workspace within a patient's body.

[0077] Also refer to Figures 4 to 6 , a variety of different types of alternative robotic surgical instruments and different end effectors 230 can be used, wherein at least some of the instruments of the manipulators are removed and replaced during the surgical procedure. Several of these end effectors (including, for example, DeBakey forceps 56i, microsurgical forceps 56ii, and Potts scissors 56iii) include a first end effector unit 56a and a second end effector unit 56b that pivot relative to each other to define a pair of end effector clips. Other end effectors (including scalpels and electrocautery probes) have a single end effector unit. For instruments having end effector clips, the clips are typically actuated by squeezing the clamping members of the input devices 41, 42.

[0078] The elongated shaft 220 allows the end effector 230 and the distal end of the shaft 220 to be inserted distally (via the cannula 180) through a minimally invasive orifice (typically through the abdominal wall or the like) into a surgical working site. The surgical site can be insufflated with gas, and movement of the end effector 230 within the patient's body is typically affected, at least in part, by pivoting the instrument 200 about a location where the shaft 220 passes through the minimally invasive orifice. In other words, the robotic manipulator arm assemblies 120, 130, 140, and 150 move the transmission assembly 210 outside the patient's body so that the shaft 220 extends through the minimally invasive orifice location to help provide the desired movement of the end effector 230. Therefore, the robotic manipulator arm assemblies 120, 130, 140, and 150 are typically moved significantly outside the patient's body during a surgical procedure.

[0079] refer to Figures 7 to 10 , the example robotic manipulator arm assembly 304 is capable of coupling with a surgical instrument 306 to affect movement of the instrument 306 relative to the base 302. Since many different surgical instruments with different end effectors may be sequentially mounted on each robotic manipulator arm assembly 304 (generally with the aid of a surgical assistant) during a surgical procedure, the instrument holder 320 will preferably allow for rapid removal and replacement of the mounted surgical instruments 306. It should be understood that the example robotic manipulator arm assembly 304 is merely one non-limiting example of various types of robotic manipulator arm assemblies contemplated within the scope of the present disclosure.

[0080] The example robotic manipulator arm assembly 304 is mounted to the base 302 via a pivot mounting joint 322, thereby allowing the remainder of the robotic manipulator arm assembly 304 to rotate about a first joint axis J1, wherein in the exemplary embodiment the first joint 322 provides rotation about a vertical axis. The base 302 and the first joint 322 generally comprise a proximal portion of the robotic manipulator arm assembly 304, wherein the manipulator extends distally from the base toward the instrument holder 320 and the end effector 50.

[0081] By describing Figures 7 to 9 The various links of the illustrated robotic manipulator arm assembly 304 and the Fig.10 The illustrated rotation axes of the joints connecting these links, the first link 324 extends distally from the base 302 and rotates about the first pivot joint axis J1 at the joint 322. Many other joints can be connected by Fig.10 324 is identified by the axis of rotation associated therewith. For example, the distal end of the first link 324 is coupled to the proximal end of the second link 326 at a joint that provides a horizontal pivot axis J2. The proximal end of the third link 328 is coupled to the distal end of the second link 326 at a roll joint so that the third link generally rotates or rolls at a joint J3 about an axis extending along (and ideally aligned with) the axes of both the second and third links. Further extending distally, behind another pivot joint J4, the distal end of the fourth link 330 is coupled to the instrument holder 320 by a pair of pivot joints J5, J6, wherein the pivot joints J5, J6 together define an instrument holder wrist 332. The translational or prismatic joint J7 of the robotic manipulator arm assembly 304 facilitates axial movement of the instrument 306 through the minimally invasive orifice and also facilitates attachment of the instrument holder 320 to the cannula 306 through which the instrument 306 is slidably inserted.

[0082] Distal to the instrument holder 320, the surgical instrument 306 may have additional degrees of freedom. The actuation of these degrees of freedom of the surgical instrument 306 would typically be driven by the motors of the robotic manipulator arm assembly 304. Alternative embodiments may separate the surgical instrument 306 from the supporting manipulator arm structure at the quick-detachable instrument holder / instrument interface so that one or more joints shown here being on the surgical instrument 306 are replaced on the interface, and vice versa. In other words, the interface between the surgical instrument 306 and the robotic manipulator arm assembly 304 may be disposed more proximally or distally along the kinematic chain of the manipulator arm assembly 304 (which may include the surgical instrument and the manipulator arm assembly 304). In an exemplary embodiment, the surgical instrument 306 includes a revolute joint J8 proximal to the pivot point PP, which is generally disposed at the minimally invasive orifice site. The distal wrist of the surgical instrument 306 allows the end effector 50 to pivot about the instrument wrist joint axes J9, J10. The angle α between the end effector jaw elements may be controlled independently of the position and orientation of the end effector 50 .

[0083] Reference now Figure 11 to Figure 13 , the example robotic manipulator arm assembly 502 includes a manipulator arm assembly 504 and a surgical instrument 506 having an end effector 508. The term "manipulator assembly" as used herein may also include a manipulator arm without a surgical instrument mounted thereon in some cases. The illustrated robotic manipulator arm assembly 502 generally extends distally from a proximal base 510 to an end effector 508, wherein the end effector 508 and the distal portion of the surgical instrument 506 are configured for insertion into an internal surgical site 512 via a minimally invasive surgical portal 514. The joint structure of the robotic manipulator arm assembly 502 is similar to that described above with respect to Fig.10 , and includes sufficient degrees of freedom to allow the manipulator assembly to be in any of a range of different joint states for a given end effector orientation, even when the surgical instrument 506 is constrained from passing through the minimally invasive orifice 514.

[0084] When the access site for a minimally invasive surgical procedure is to be changed from a first port position 514a to a second port position 514b, it is often desirable to be able to manually reposition some or all of the links of the robotic manipulator arm assembly 502. Similarly, when initially assembling the robotic manipulator assembly 502 for a surgical procedure, the manipulator assembly 502 can be manually moved to a desired orientation aligned with a port position through which an associated surgical instrument 506 can access the surgical site 512. However, in view of the highly configurable manipulator arm structure, wherein the highly configurable manipulator arm structure is configured between, for example, a base 510 and an instrument / manipulator interface (see Fig.10) between the robot manipulator assembly 502 and the robot manipulator assembly 502, such manual positioning of the links is challenging. Even when the robot manipulator assembly 502 structure is balanced to avoid the effects of gravity, attempting to align each joint in a proper arrangement is difficult for an individual, is time consuming, and may involve extensive training and / or skill. These challenges may be greater when the links of the robot manipulator assembly 502 are unbalanced relative to the joints, because positioning such a highly configurable structure in a proper configuration to begin a surgical procedure is difficult due to the length of the manipulator's arm and its passive and soft design.

[0085] To facilitate setting up the robotic manipulator assembly 502 for a surgical procedure (or to facilitate reconfiguring the manipulator assembly 502 to access different tissues of a patient), the processor 43 (see Figure 2 ) can actively drive the joints of manipulator assembly 502. In some cases, such actuation can be in response to manual movement of at least one joint of manipulator assembly 502. Fig.13 , a hand H of a system operator (optionally a surgeon, assistant, technician, or the like) manually moves a linkage or surgical instrument 506 of a robotic manipulator arm assembly 502 to align with a desired minimally invasive orifice 514b. During this movement, the processor drives the joints proximal to the hand / manipulator interface. Because the robotic manipulator arm assembly 502 will typically have sufficient degrees of freedom to be in a range of alternative configurations, the proximal joints can be driven to the desired manipulator state without inhibiting manual positioning of the distal portion of the robotic manipulator arm assembly 502. Optionally, the joints can be driven to compensate for gravity, inhibit momentum effects, or provide a desired (and typically easily overcome) resistance to manual movement so that the hand feels plastic deformation of the manipulator structure at its joints so as to maintain the configurable linkage assembly in a desired posture, or the like. Although in Fig.13 This movement is shown as being performed by a surgical instrument 506 attached to a robotic manipulator arm assembly 504 , but the manipulator assembly is typically positioned manually prior to attaching the surgical instrument 506 to the robotic manipulator arm assembly 504 .

[0086] refer to Fig.14 and 15 , the robotic manipulator assembly 502 may be controlled by the processor 43 ( Figure 2) reconfiguration. For example, joint 526 may be driven from a downward vertex configuration to an upward vertex configuration to inhibit collision with an adjacent arm, equipment, or personnel; to enhance the range of motion of end effector 508; to respond to patient physiological movement (such as patient breathing or the like); to respond to patient repositioning such as by reorienting a surgical table; and the like. Some, but not all, of these changes in the configuration of robotic manipulator assembly 502 may be responsive to external forces applied to manipulator assembly 502, and processor 43 typically drives a different joint of manipulator assembly 502 than the joint acted upon by the external force. In other cases, processor 43 reconfigures robotic manipulator assembly 502 in response to calculations performed by processor 43. In either case, processor 43 may be different from a simple master / slave controller that drives robotic manipulator assembly 502 in response to signals to provide a preferred manipulator assembly 502 configuration. Such configuration of the robotic manipulator assembly 502 may occur during master / slave end effector movement, during manual or other reconfiguration of the manipulator assembly 502, and / or at least in part at a different time, such as after a clutch input is released.

[0087] Reference now Fig.16 , a simplified controller schematic 530 shows a master / slave controller 532 coupling a master input device 534 to a slave manipulator 536. In this example, vector mathematical notation is used to describe the controller inputs, outputs, and calculations, where the vector x typically refers to the orientation vector in Cartesian / rectangular coordinates, and where the vector q refers to the joint articulation configuration vector of the associated linkage (most commonly the manipulator slave linkage), and sometimes the linkage orientation in joint space. Subscripts may be added to these vectors to distinguish a particular configuration when there is otherwise ambiguity, so x is . m For example, x is the position of the master input device in the associated master workspace or coordinate system, and x s represents the position of the driven device in the workspace. The velocity vector related to the position vector is indicated by adding a dot above the vector or by adding the word "dot" between the vector and the subscript, such as xdot m or represents the master velocity vector, where the velocity vector is mathematically defined as the change of the orientation vector over time (e.g., dx m / dt represents the main control speed vector).

[0088] The example controller 532 comprises an inverse Jacobian velocity controller. Here x m is the position of the master input device. For the speed of the master input device, the controller 532 calculates motor commands to transmit to the manipulator 536, thereby achieving the slave end effector movement corresponding to the input device according to the master speed. Similarly, the controller 532 can calculate the motor commands for transmission to the manipulator 536 according to the slave position x s and / or driven speed The force feedback signal applied to the master input device (and thus to the operator's hand) is calculated. Many refinements to this simple master / slave inverse Jacobian controller schematic are desirable, including Fig.19 Those illustrated and described in detail in US Pat. No. 6,424,885 ("the '885 patent"), the entire disclosure of which is incorporated herein by reference.

[0089] Reference now Fig.17 , the processor 542 (also referred to as "controller 542") can be characterized as including a first controller module 544 and a second controller module 546. The first module 544 can include a master joint controller, such as an inverse Jacobi master-slave controller. The master joint controller of the first module 544 can be configured to generate a desired manipulator assembly movement in response to input from the master input device 534. However, as can be seen from the above, for a given end effector orientation in space, many of the manipulator linkages described herein have a series of alternative configurations. Therefore, a command for causing the end effector to assume a given orientation will result in a variety of different joint movements and configurations, some of which may be more desirable than others. Therefore, the second module 546 can be configured to help drive the manipulator assembly to the desired configuration, in some embodiments driving the manipulator towards a preferred configuration during a master / slave movement. In many embodiments, the second module 546 will include a configuration-dependent filter.

[0090] In broad mathematical terms, both the master joint controller of the first module 544 and the configuration-dependent filter of the second module 546 can comprise filters used by the processor 542 to route control authority of a linear combination of joints to a server for one or more surgical objectives or tasks. If we assume that X is the space of joint motions, F(X) can be a filter that controls the joints to: i) provide the desired end effector movement, and ii) provide pivot motion of the instrument axis at the orifice location. Thus, the master joint controller of the first module 544 can comprise a filter F(X). Conceptually, (1-F - 1F(X) can describe a configuration-dependent subspace filter that provides control actuation authority to a linear combination of orthogonal joint velocities to achieve the objectives of the primary joint controller (in this example, end effector movement and pivot motion of the instrument axis). Therefore, this configuration-dependent filter can be used by the second module 546 of the controller 542 to achieve a secondary objective, such as maintaining a desired posture of the manipulator assembly, preventing collisions, or the like. Both filters can be further subdivided into more filters corresponding to achieving more specific tasks. For example, the filter F(X) can be divided into F1(X) and F2(X), which are used for control of the end effector and control of the pivot motion of the axis, respectively, either of which can be selected as the main task or highest priority task of the processor.

[0091] Although the mathematical calculations implemented by each module may be (at least partially) similar, the robot processor and control techniques described herein will generally utilize a primary joint controller configured to complete a first (sometimes referred to as a primary) controller task, while utilizing a configuration-dependent filter that utilizes the under-constrained solution produced by the primary joint controller to complete a second (also referred to as a secondary) task. In most of the following descriptions, the primary joint controller will be described with respect to the first module, while the configuration-dependent filter will be described with respect to the second module. Additional functionality (such as additional subspace filters) and / or additional modules with varying priorities may also be included.

[0092] As mentioned elsewhere herein, the hardware and / or programming code used to implement the functionality described with respect to such first and second modules may be fully integrated, partially integrated, or completely separate. The controller 542 may use the functionality of the two modules simultaneously, and / or may have multiple different modes in which one or both modules are used separately or in different ways. For example, in some embodiments, the first module 544 may be used during master-slave manipulation with little or no influence from the second module 546, while the second module 546 may play a greater role during assembly of the system when the end effector is not automatically driven, such as during port clutching or other manual articulation of the manipulator assembly. Nonetheless, in many embodiments both modules may be active most or all of the time when robot motion is enabled. For example, by setting the gain of the first module to zero, by setting x s Set to x s,actual , and / or by reducing the rank of the matrix in the inverse Jacobian controller so that it does not control as much and allowing the configuration-dependent filter to have more control authority, the influence of the first module on the state of the manipulator assembly can be reduced or eliminated in order to change the mode of the processor 542 from the tissue manipulator mode to the clutch mode.

[0093] Fig.18 The diagram illustrates Fig.17 This is a refinement of the simplified master-slave control diagram in , and shows how different modules are used in different processor modes. Fig.18 As illustrated, for example, the first module 544 may include some form of a Jacobian controller having a Jacobian correlation matrix. In the port clutch mode, the second module 546 may receive a signal from the slave manipulator 536 indicating the position or velocity of the slave device, which is generated at least in part by manual articulation of the slave manipulator linkage. In response to this input, the second module 546 may generate a motor command suitable for driving the joint of the slave device so as to allow manual articulation of the slave linkage while configuring the slave device in a desired joint configuration. During the master-slave end effector manipulation process, the controller may use the second module 546 to help derive the motor command based on the differential signal bqdot0. This selective input signal to the second module 546 of the controller 542 may be used to drive the manipulator linkage to maintain the pivot position of the minimally invasive orifice or move the pivot position of the minimally invasive orifice along the manipulator structure, thereby avoiding collisions between multiple manipulators, enhancing the range of motion of the manipulator structure and / or avoiding singularities, generating a desired manipulator posture, or similar purposes. Thus, bqdot0 may contain and / or indicate, for example, a desired set of joint velocities generally in joint space, more generally representing a secondary control objective. In other embodiments, the processor may include separate modules and / or configuration-dependent filters for clutching, secondary controller tasks, and similar functions.

[0094] Reference now Fig. 20 , local control schematic 550 illustrates the Fig.19 The control schematic 550 generally represents a modification of the controller shown in FIG. Fig.19 Modification of the controller portion 551 in order to facilitate control of a manipulator assembly having a large number of degrees of freedom. Fig. 20 In the illustrated embodiment, the first module 544 comprises an inverse Jacobian velocity controller, wherein the output of the calculation using the inverse Jacobian matrix is ​​modified according to the virtual follower path 552. First, the virtual follower path is described. Vectors associated with the virtual follower path are generally denoted by the subscript v, so that the virtual follower velocity qdot in the joint space is v is integrated to obtain q v , using the inverse kinematics module 554 to q v Processing is performed to generate a virtual slave joint orientation signal x v . Virtual slave position and master input command x mThe use of a virtual slave path (often with simplified dynamics) facilitates smooth control and force feedback when approaching hard limits of the system, when violating soft limits of the system, etc., as may be more fully understood by reference to the '885 patent, which is hereby incorporated by reference. Similarly, the computation of motor commands (such as joint torque signals or the like from a joint controller) via outputs from an appropriate joint controller in response to outputs from the inverse Jacobian matrix (which is modified or augmented by the second module 546), input and output processing, and the like are more fully described in the '885 patent.

[0095] With respect to the structures generally indicated by the first control module 544 and the second control module 546, as well as the structures of other elements of the control schematic 550 and other controllers described herein, these structures generally include data processing hardware, software and / or firmware. These structures will generally include reprogrammable software, data and the like, which can be embodied as machine-readable code and accessed through the surgeon console 40 (see Figure 2 ) is stored in a tangible medium for use by a processor 43 of the computer program product. The machine-readable code may be stored in many different configurations, including random access memory, non-volatile memory, write-once memory, magnetic recording media, optical recording media, or the like. Signals embodying the code and / or data associated therewith may be transmitted over a variety of communication links, including the Internet, an intranet, an Ethernet, wireless communication networks and links, electrical signals and conductors, optical fibers and networks, and the like. Figure 2 As shown, the processor 43 may include one or more data processors of the surgeon's console 40, and / or may include localized data processing circuits of one or more manipulators, instruments, independent and / or remote processing structures or locations, and the like, while the modules described herein may include (for example) a single common processor circuit board, multiple independent circuit boards, or one or more of these modules may be dispersed across multiple circuit boards, some of which also run some or all of the calculations in another module. Similarly, the software code for the modules may be written as a single integrated software code, each module may be separated into separate subroutines, or part of the code of one module may be combined with some or all of the code of another module. Thus, the data and processing structures may include any of a variety of centralized or distributed data processing and / or programming architectures.

[0096] To describe in more detail Fig. 20At the output of the controller, the controller typically seeks to solve for a specific manipulator joint configuration vector q, which is used to generate commands for these highly configurable slave manipulator mechanisms. As can be seen above, the manipulator linkage typically has sufficient degrees of freedom to occupy a range of joint states for a given end effector state. These structures can (but typically do not) include linkages with truly redundant degrees of freedom, that is, in which actuation of one joint can be directly replaced by a similar actuation of a different joint along the kinematic chain. Despite this, these structures are sometimes referred to as having excess, additional or redundant degrees of freedom, where these terms (in a broad sense) generally include kinematic chains in which (for example) intermediate links can be moved without changing the position (including position and orientation) of the end effector.

[0097] When using Fig. 20 When using a velocity controller to guide the movement of a highly configurable manipulator, the first module's main joint controller typically seeks to determine or solve for the virtual joint velocity vector qdot v , which can be used to drive the joints of the slave manipulator 536 in such a way that the end effector accurately follows the master command x m . However, for driven mechanisms with redundant degrees of freedom, the inverse Jacobian matrix does not generally fully define the joint vector solutions. For example, the mapping from Cartesian commands xdot to joint motions qdot in a system that occupies a range of joint states for a given end effector state is a one-to-many mapping. In other words, because the mechanism is redundant, there are mathematically infinitely many solutions, represented by the subspace for which an inverse transformation exists. The controller can embody this relationship by mapping multiple joint velocities to a relatively small number of Cartesian velocities using a Jacobian matrix that has more columns than rows. Our solution It is usually sought to eliminate this conflict of degrees of freedom of the driven mechanism within the Cartesian workspace.

[0098] Additional description related to using a processor configured by software instructions to calculate a software constrained remote center of motion for a robotic manipulator arm assembly can be found in US Pat. No. 8,004,229, which is incorporated herein by reference in its entirety.

[0099] In short, the above description (and the description in U.S. Pat. No. 8,004,229) enables the pivot point (remote motion center) to be determined / estimated through software and therefore the concept of a software-constrained remote motion center. Due to the ability to calculate software pivot points, different modes characterized by the flexibility or rigidity of the system can be selectively implemented. More specifically, after calculating the estimated pivot point, different system modes within a certain pivot point / center range (i.e., from having a passive pivot point to having a fixed / rigid pivot point) can be implemented. For example, in a fixed pivot point implementation, the estimated pivot point can be compared with the desired pivot point to generate an error output, which can be used to drive the pivot of the instrument to the desired position. On the contrary, in a passive pivot implementation, although the desired pivot position may not be the most important goal, the estimated pivot point can be used for error detection and subsequent safety protection, because changes in the estimated pivot point position can indicate that the patient has been moved or the sensor has failed, thereby giving the system the opportunity to take corrective action.

[0100] The interaction between the moving instrument and the tissue of the minimally invasive orifice can be determined at least in part by a processor that optionally allows the flexibility or rigidity of the system to vary within a range from a passive pivot point to a fixed pivot point. At the passive end of the passive / rigid range, the proximal end of the instrument can move in space when the motor of the instrument holder wrist applies little or no torque so that the instrument effectively behaves as if it is coupled to a manipulator or robotic arm through a pair of passive joints. In this mode, the interaction between the instrument axis and the tissue along the minimally invasive orifice causes the instrument to pivot about a pivot point. If the surgical instrument is not inserted into the minimally invasive orifice or otherwise constrained, it can point downward under the influence of gravity, and movement of the manipulator arm will translate the suspended instrument without pivoting about a portion along the instrument axis. For the rigid end of the passive / rigid range, the location of the minimally invasive orifice can be input or calculated as a fixed point in space. The motors associated with each joint in the kinematic chain that is disposed proximal to the pivot point can then drive the manipulators so that any lateral force against the shaft at the calculated pivot point will result in a reaction force to ensure that the shaft passes through the pivot point. In some respects, such a system can behave similarly to a mechanically constrained remote center linkage. Many embodiments will fall between these two extremes, providing a calculated motion that generally pivots at the access site and accommodates or moves the pivot center of motion within an acceptable range while moving along the tissue of the minimally invasive access site without applying excessive lateral forces to that tissue.

[0101] refer to Fig.21 and Fig. 22, an example instrument holder 620 is pivotally coupled to the distal-most link 600 of the robotic manipulator arm assembly at a joint 610 in a configuration that can be used to perform telesurgery according to the telesurgery systems and concepts described herein. A surgical instrument 640 is releasably coupled to the instrument holder 620. A cannula 660 is positioned at the minimally invasive surgical interface site 10. In the depicted embodiment, the cannula 660 is detached from the instrument holder 620. Although in the depicted embodiment, the instrument holder 620 is pivotally coupled to the distal-most link 600 of the robotic manipulator arm assembly, in some embodiments, a translation coupling or a prismatic joint coupling is used to couple the instrument holder 620 to the distal-most link 600. Such pivoting, translational, and / or prismatic joints can be included in any of the embodiments described herein.

[0102] The instrument holder 620 includes an instrument holder frame 622, and an instrument holder bracket 624, and an optional instrument shaft guide 626. The instrument holder bracket 624 is movably coupled to the instrument holder frame 622. More specifically, the instrument holder bracket 624 is linearly translatable along the instrument holder frame 622. In some embodiments, the movement of the instrument holder bracket 624 along the instrument holder frame 622 is a motorized translational movement that can be actuated / controlled by a processor of the telesurgical system. The optional instrument shaft guide 626 can be attached to or releasably coupled to the instrument holder frame 622.

[0103] The surgical instrument 640 includes a transmission assembly 642, an elongated shaft 644, and an end effector 646. The transmission assembly 642 can be releasably coupled to the instrument holder bracket 624. The shaft 644 extends distally from the transmission assembly 642. The shaft 644 is slidably coupled to a lumen defined by the cannula 660 and to a lumen defined by an optional instrument shaft guide 626. The end effector 646 is disposed at the distal end of the shaft 644 and is positioned within a surgical workspace within the patient's body during a telesurgical procedure.

[0104] The elongated shaft 644 defines an instrument axis, which is the longitudinal axis 641. By virtue of the physical engagement between the shaft 644 and the cannula 660, the longitudinal axis 641 coincides with the longitudinal axis of the cannula 660. As the instrument holder carriage 624 translates along the instrument holder frame 622, the elongated shaft 644 of the surgical instrument 640 moves along the longitudinal axis 641. As the instrument holder carriage 624 translates along the instrument holder frame 622, the longitudinal axis 641 remains fixed in space. In this way (by translating the instrument holder carriage 624 along the instrument holder frame 622), the end effector 646 can be inserted into and / or retracted from a surgical working space within a patient's body along a line that is fixed in space (defined by the longitudinal axis 641).

[0105] Furthermore, in the depicted embodiment, the end effector 646 can be inserted into and / or retracted from the surgical workspace in a second manner along a line that is fixed in space (defined by the longitudinal axis 641). That is, using the software-constrained remote center of motion techniques described herein, movement of the distal-most link 600 of the robotic manipulator arm assembly in conjunction with movement of the pivotable joint 610 can cause the surgical instrument 640 to move along the longitudinal axis 641 while the longitudinal axis 641 remains fixed in space.

[0106] In some embodiments, the cannula 660 is arcuate (compared to the linear cannula 660 shown) and the elongated shaft 644 of the surgical instrument 640 is flexible so that the elongated shaft 644 can conform to the arc of the cannula 660. In such a case, the end portion of the elongated shaft 644 extending linearly from the drive assembly 642 proximal to the arcuate cannula 660 defines the longitudinal axis 641. It should be understood that any of the embodiments described herein can alternatively include an arcuate cannula.

[0107] In some embodiments, the elongated shaft 644 of the surgical instrument 640 is curved (compared to the linear elongated shaft 644 shown). In such a case, the longitudinal axis 641 is an arc that coincides with the curved elongated shaft 644. It should be understood that any of the embodiments described herein can alternatively include a surgical instrument having a curved elongated shaft.

[0108] Fig.21 The end effector 646 is shown inserted at a first depth D1. Fig. 22 The end effector 646 is shown inserted at a second depth D2. The second depth D2 is greater than the first depth D1. In both configurations, the longitudinal axis 641 is located along the same line in space.

[0109] from Fig.21 The layout is transformed to Fig. 22 The arrangement can involve two types of movement. First, the instrument holder carriage 624 is translated along the instrument holder frame 622, resulting in a first movement of the surgical instrument 640 deeper into the patient. Second, movement of the distal-most link 600 of the robotic manipulator arm assembly combined with movement of the pivotable joint 610 results in a second movement of the surgical instrument 640 still deeper into the patient. The difference between the second depth D2 and the first depth D1 is composed of the sum of the first and second movements. Both types of movement can be performed while keeping the longitudinal axis 641 fixed (consistent) along a line in space.

[0110] Although the previous description relates to two movements that both result in moving the surgical instrument 640 deeper into the patient, it should be understood that the same principles can be applied to withdrawing the surgical instrument 640 from the patient. In addition, any combination of the first and second movements mentioned above can be performed. For example, a first movement of the instrument holder carriage 624 along the instrument holder frame 622 can be performed to withdraw the surgical instrument 640 from the patient, and a second movement of the distal-most link 600 and the pivotable joint 610 of the robotic manipulator arm can be performed to insert the surgical instrument 640 into the patient. Such movements can be performed simultaneously (synchronously) or sequentially (asynchronously).

[0111] refer to Fig.23 , presents a flow chart of a two-step method 700 for moving a surgical instrument along a line fixed in space. The method 700 uses the method described above with reference to Fig.21 and 22 Describe the idea.

[0112] In operation 710, the robotic manipulator arm is moved to cause an elongated surgical instrument coupled to the robotic manipulator arm to move along a fixed line in space defined by a longitudinal axis of the surgical instrument. Such movement can be accomplished, for example, by Fig.21 and Fig. 22 The comparison between the two is illustrated in the figure. Fig. 22 In the embodiment, the most distal link 600 of the robot manipulator arm assembly is larger than that in the embodiment Fig.21As described above, when the distal-most link 600 is moved closer to the patient, the surgical instrument 640 is correspondingly moved along the longitudinal axis 641, and the longitudinal axis 641 is always maintained along a line fixed in space. In other words, using the software-constrained remote motion center technology described herein, the movement of the distal-most link 600 of the robot manipulator arm assembly can cause the surgical instrument 640 to be moved along the longitudinal axis 641, while the longitudinal axis 641 remains fixed in space. The movement of the distal-most link 600 can be carried out in conjunction with the movement of the pivotable joint 610. Alternatively, in some cases, when the robot manipulator arm is moved to cause the elongated surgical instrument to extend deeper into the surgical space, the instrument may be undergoing pitch and yaw motion about the remote center, while the instrument depth is also being controlled. The three-dimensional end effector trajectory can be composed of the pitch, yaw and insertion of the instrument. In such a case, the longitudinal axis of the surgical instrument is not necessarily fixed in space.

[0113] In operation 720, the surgical instrument is moved along a fixed line in space (as defined by longitudinal axis 641 in accordance with operation 710) independently of the movement of the robotic manipulator arm. For example, referring again to Fig.21 and Fig. 22 In comparison, the instrument holder bracket 624 can be translated along the instrument holder frame 622, resulting in the movement of the surgical instrument 640 along the longitudinal axis 641, while the longitudinal axis 641 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 600 of the robotic manipulator arm assembly.

[0114] In some cases, operation 720 can include periodically re-centering the instrument holder bracket 624 on the instrument holder frame 622. By re-centering the instrument holder bracket 624 on the instrument holder frame 622, approximately half of the full travel of the instrument holder bracket 624 relative to the instrument holder frame 622 is available for movement (insertion and retraction) in either direction. While the re-centering motion(s) are occurring, in some cases the orientation of the end effector 646 can be substantially maintained.

[0115] In some cases, limits can be established with respect to the movement of the robotic manipulator arm and / or the instrument holder carriage (with respect to operations 710 and 720). In one such example, reference Fig.21 and Fig. 22In some embodiments, the insertion of the instrument holder frame 622 is limited so that the instrument holder frame 622 does not collide with the sleeve 660. In another example, in some cases, the combined retraction of the instrument holder bracket 624 and the instrument holder frame 622 is limited so that the instrument end effector 646 is not pulled out of the sleeve 660. In another example, in some cases, the distance that the instrument holder frame 622 is allowed to be retracted from the sleeve 660 is limited, and any further retraction along the longitudinal axis 641 is performed by movement of the instrument holder bracket 624.

[0116] It should be understood that operations 710 and 720 can be performed in either order without departing from the scope of method 700. Furthermore, operations 710 and 720 can be performed simultaneously (synchronously) or sequentially (asynchronously) without departing from the scope of method 700.

[0117] The use of method 700 can provide advantages with respect to the design and operation of a telesurgery system. For example, because the movement of the instrument holder carriage 624 along the instrument holder frame 622 involves relatively low inertia, operation 720 can be particularly suitable for actuating short, rapid movements of the surgical instrument 640, while longer, slower movements can be performed by moving the robotic manipulator arm as in operation 710. With this combination of available movements according to method 700, the robotic manipulator arm and / or instrument holder 620 can be made smaller and lighter. Thus, the possibility of interference between the robotic manipulator arm assemblies of the system is reduced. In addition, the use of less powerful motors and lighter-weight links for actuating the robotic manipulator arm assemblies of the system can be made feasible by the use of method 700.

[0118] In some embodiments, by defining a frequency cutoff, slow movements (i.e., those movements designated to be performed by the robotic manipulator arm) can be distinguished from fast movements (i.e., those movements designated to be performed by the instrument holder carriage). For example, in some embodiments, the controller uses a low pass filtering operation on the desired motion of the instrument and uses the output of the filter to drive the motion of the robotic manipulator arm. The remaining high frequency motion components are used by the controller to drive the motion of the instrument holder carriage. Conversely, in some embodiments, the control system filters the desired motion of the instrument using a high pass filter and uses the output of the filter to drive the motion of the instrument holder carriage, while using the remainder of the signal to drive the motion of the robotic manipulator arm. Reference Fig.24, an example instrument holder 820 is pivotally coupled to the distal-most link 800 of the robotic manipulator arm assembly at a joint 810 in a configuration that can be used to perform telesurgery in accordance with the telesurgery systems and concepts described herein. A surgical instrument 840 is releasably coupled to the instrument holder 820. A cannula 860 is positioned at the minimally invasive surgical interface site 10.

[0119] The depicted arrangement is roughly similar to Fig.21 and Fig. 22 820, except that in the depicted arrangement the sleeve 860 is coupled to the instrument holder 820 via the linearly adjustable assembly 826 (and Fig.21 and Fig. 22 860 is detached from the instrument holder 620). The linear adjustable assembly 826 extends from the instrument holder 820. A sleeve clamp 827 can be positioned at the free end of the linear adjustable assembly 826. The sleeve clamp 827 can be used to releasably couple the sleeve 860 to the instrument holder 820 via the linear adjustable assembly 826. Such an arrangement can support lateral loads applied to the instrument shaft 844 and can help prevent the sleeve 860 from shifting relative to the surgical interface site 10.

[0120] In some embodiments, the linearly adjustable assembly 826 is active. That is, in some embodiments, the linearly adjustable assembly 826 is driven by an actuator (e.g., a motor) such that the linearly adjustable assembly 826 is extended and retracted by powered actuation. Such powered actuation can be controlled by a processor (e.g., in accordance with a controller) at the surgeon's console. Figure 2 ) to be actuated / controlled. In some embodiments, the linear adjustable assembly 826 is passive. That is, in some embodiments, the linear adjustable assembly 826 is not driven by an actuator. Alternatively, the linear adjustable assembly 826 can be extended and retracted in response to being acted upon by external forces due to contact with adjacent objects, gravity, etc. In some passive and / or active embodiments, the linear adjustable assembly 826 is braked so that it can maintain its orientation when necessary.

[0121] It should be realized that in Fig.24 The arrangement depicted in Fig.23That is, using the software-constrained remote center of motion techniques described herein, the distal-most link 800 of the robotic manipulator arm assembly can be moved to cause the surgical instrument 840 to be moved along the longitudinal axis 841 while the longitudinal axis 841 remains fixed in space. In addition, the instrument holder bracket 824 can be translated along the instrument holder frame 822, causing the surgical instrument 840 to be moved along the longitudinal axis 841 while the longitudinal axis 841 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 800 of the robotic manipulator arm assembly.

[0122] refer to Fig.25 , an example instrument holder 920 is pivotally coupled to the distal-most link 900 of the robotic manipulator arm assembly at a joint 910 in a configuration that can be used to perform telesurgery in accordance with the telesurgery systems and concepts described herein. A surgical instrument 940 is releasably coupled to the instrument holder 920. A cannula 960 is positioned at the minimally invasive surgical interface site 10.

[0123] The depicted arrangement includes a linear actuator mechanism 926 that facilitates translation of the joint 910 along the instrument holder frame 922. Thus, the instrument holder 920 is capable of pivoting and translating relative to the distal-most link 900. In some embodiments, the linear actuator mechanism 926 can be a mechanism such as, but not limited to, a lead screw assembly, a rack and pinion arrangement, a telescoping assembly, and the like.

[0124] It should be realized that in Fig.25 The arrangement depicted in Fig.23 The method 700 of the present invention is operated. That is, using the software-constrained remote center of motion technology described herein, the distal-most link 900 of the robotic manipulator arm assembly can be moved to cause the surgical instrument 940 to be moved along the longitudinal axis 941 while the longitudinal axis 941 remains fixed in space. In addition, the instrument holder bracket 924 can be translated along the instrument holder frame 922, resulting in the movement of the surgical instrument 940 along the longitudinal axis 941 while the longitudinal axis 941 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 900 of the robotic manipulator arm assembly.

[0125] refer to Fig.26, an example instrument holder 1020 is pivotally coupled to the distal-most link 1000 of the robotic manipulator arm assembly at a joint 1010 in a configuration that can be used to perform telesurgery according to the telesurgery systems and concepts described herein. A surgical instrument 1040 is releasably coupled to the instrument holder 1020. A cannula 1060 is positioned at the minimally invasive surgical interface site 10.

[0126] The instrument holder 1020 includes a linearly adjustable upper portion 1022 and a linearly adjustable lower portion 1026. The linearly adjustable upper portion 1022 and the linearly adjustable lower portion 1026 are coupled to the middle portion 1021, which is pivotally coupled to the distal-most link 1000 at the joint 1010. The linearly adjustable portions 1022 and 1026 can be extended and / or retracted relative to the middle portion 1021. In some embodiments, the linearly adjustable portions 1022 and 1026 are telescopic assemblies. In some embodiments, either or both of the linearly adjustable portions 1022 and 1026 are active (power-actuated). In some embodiments, either or both of the linearly adjustable portions 1022 and 1026 are passive (non-power-actuated).

[0127] The instrument holder bracket 1024 is coupled to the linearly adjustable upper portion 1022. Thus, the instrument holder bracket 1024 can be translated (parallel to the axis 1041) independently of the distal-most link 1000. The cannula 1060 can be releasably coupled to the linearly adjustable lower portion 1026 via the cannula clamp 1027. Thus, when the distal-most link 1000 moves, the cannula 1060 can be maintained in a substantially stationary orientation relative to the minimally invasive surgical interface site 10 (via compensating movement of the linearly adjustable lower portion 1026).

[0128] It should be realized that in Fig.26 The arrangement depicted in Fig.23 1041 . That is, using the software-constrained remote center of motion techniques described herein, the distal-most link 1000 of the robotic manipulator arm assembly can be moved to cause the surgical instrument 1040 to be moved along the longitudinal axis 1041 while the longitudinal axis 1041 remains fixed in space. In addition, the instrument holder bracket 1024 can be translated along the instrument holder 1020 (relative to the middle portion 1021), causing the surgical instrument 1040 to be moved along the longitudinal axis 1041 while the longitudinal axis 1041 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 1000 of the robotic manipulator arm assembly.

[0129] refer to Fig. 27, an example instrument holder 1120 is pivotally coupled to the distal-most link 1100 of the robotic manipulator arm assembly at a joint 1110 in a configuration that can be used to perform telesurgery according to the telesurgery systems and concepts described herein. A surgical instrument 1140 is releasably coupled to the instrument holder 1120. A cannula 1160 is positioned at the minimally invasive surgical interface site 10.

[0130] The depicted arrangement is roughly similar to Fig.21 and Fig. 22 11, except that in the depicted arrangement the inner cannula 1162 is coupled to the instrument holder 1120 and the inner cannula 1162 extends through the cannula 1160 positioned at the minimally invasive surgical interface site 10. The inner cannula 1162 is slidably coupled to the lumen defined by the cannula 1160. The elongated instrument shaft 1144 of the surgical instrument 1140 is slidably coupled to the lumen defined by the inner cannula 1162. Such an arrangement can support lateral loads applied to the instrument shaft 1144 and can help prevent displacement of the cannula 1160 relative to the surgical interface site 10. The inner cannula 1162 is longer than the cannula 1160.

[0131] It should be realized that in Fig. 27 The arrangement depicted in Fig.23 That is, using the software-constrained remote center of motion techniques described herein, the distal-most link 1100 of the robotic manipulator arm assembly can be moved to cause the surgical instrument 1140 to be moved along the longitudinal axis 1141 while the longitudinal axis 1141 remains fixed in space. In addition, the instrument holder bracket 1124 can be translated along the instrument holder frame 1122, causing the surgical instrument 1140 to be moved along the longitudinal axis 1141 while the longitudinal axis 1141 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 1100 of the robotic manipulator arm assembly.

[0132] refer to Fig.28 , an example instrument holder 1220 is coupled to the distal-most link 1200 of the robotic manipulator arm assembly in a configuration that can be used to perform telesurgery according to the telesurgery systems and concepts described herein. A surgical instrument 1240 is releasably coupled to the instrument holder 1220. A cannula 1260 is positioned at the minimally invasive surgical interface site 10.

[0133] The instrument holder 1220 includes an instrument holder frame 1222, an instrument holder bracket 1224, and a cannula clamp 1227. The instrument holder bracket 1224 is movably coupled to the instrument holder frame 1222. More specifically, the instrument holder bracket 1224 can be linearly translated along the instrument holder frame 1222. In some embodiments, the movement of the instrument holder bracket 1224 along the instrument holder frame 1222 is a motorized translational movement that can be actuated / controllable by a processor of the telesurgical system. The cannula clamp 1227 can be attached to the instrument holder frame 1222. The cannula clamp 1227 can make the instrument holder frame 1222 suitable for releasably coupling with the cannula 1260.

[0134] The proximal portion of the instrument holder 1220 is coupled to the distal-most link 1200. The instrument holder 1220 includes an articulated portion of an instrument holder frame 1223. The articulated portion of the instrument holder frame 1223 can be manipulated relative to the distal-most link 1200. In some embodiments, the articulated portion of the instrument holder frame 1223 can be manipulated by a motorized movement that can be actuated / controllable by a processor of the telesurgical system. By manipulating the instrument holder frame 1223 relative to the distal-most link 1200, the orientation of the sleeve 1260 can be adjusted. By adjusting the orientation of the sleeve 1260, the distal portion of the surgical instrument 1240 can be physically controlled.

[0135] The surgical instrument 1240 includes a transmission assembly 1242, a flexible elongated shaft 1244, and an end effector 1246. The transmission assembly 1242 can be releasably coupled to the instrument holder bracket 1224. The flexible elongated shaft 1244 extends distally from the transmission assembly 1242. The flexible elongated shaft 1244 is slidably coupled to a lumen defined by a cannula 1260. In some embodiments, a guide member 1248 is included to facilitate lateral flexure of the flexible elongated shaft 1244 between the transmission assembly 1242 and the cannula 1260. The end effector 1246 is disposed at the distal end of the flexible elongated shaft 1244 and is positioned within a surgical workspace within the patient's body during a telesurgical procedure.

[0136] The cannula 1260 and the portion of the flexible elongated shaft 1244 extending distally from the cannula 1260 define a longitudinal axis 1241. As the instrument holder carriage 1224 translates along the instrument holder frame 1222, the portion of the flexible elongated shaft 1244 extending distally from the cannula 1260 moves along the longitudinal axis 1241. As the instrument holder carriage 1224 translates along the instrument holder frame 1222, the longitudinal axis 1241 remains fixed in space. In this manner (by translating the instrument holder carriage 1224 along the instrument holder frame 1222), the end effector 1246 can be inserted into and / or retracted from a surgical working space within the body of a patient along a line that is fixed in space (defined by the longitudinal axis 1241).

[0137] Furthermore, in the depicted embodiment, the end effector 1246 can be inserted into and / or retracted from the surgical workspace in a second manner along a line that is fixed in space (defined by the longitudinal axis 1241). That is, using the software-constrained remote center of motion techniques described herein, movement of the distal-most link 1200 of the robotic manipulator arm assembly in combination with movement of the articulatable portion of the instrument holder frame 1223 can cause the surgical instrument 1240 to move along the longitudinal axis 1241 while the longitudinal axis 1241 remains fixed in space.

[0138] It should be realized that in Fig.28 The arrangement depicted in Fig.23 That is, using the software-constrained remote center of motion techniques described herein, the distal-most link 1200 of the robotic manipulator arm assembly can be moved to cause the surgical instrument 1240 to be moved along the longitudinal axis 1241 while the longitudinal axis 1241 remains fixed in space. In addition, the instrument holder bracket 1224 can be translated along the instrument holder frame 1222, causing the surgical instrument 1240 to be moved along the longitudinal axis 1241 while the longitudinal axis 1241 remains fixed in space. Such movement can be performed independently of the movement of the distal-most link 1200 of the robotic manipulator arm assembly.

[0139] Although this specification contains many specific implementation details, these should not be interpreted as limitations on the scope of any invention or the scope of what can be claimed, but should be interpreted as descriptions of features of specific embodiments that can be dedicated to specific inventions. Certain features described in this specification in the context of separate embodiments may also be implemented in a single embodiment in combination. In contrast, various features described in the context of a single embodiment may also be implemented in multiple embodiments separately or in any suitable sub-combination. In addition, although features may be described herein as working in certain combinations and even initially claimed as such, in some cases, one or more features from the claimed combination may be deleted from the combination, and the claimed combination may involve a sub-combination or a variation of a sub-combination.

[0140] Similarly, although operations are depicted in a particular order in the accompanying drawings, this should not be construed as requiring such operations to be performed in the particular order shown or in a sequential order or requiring all shown operations to be performed to achieve the desired result. In some cases, multitasking and parallel processing can be advantageous. In addition, the separation of various system modules and components in the embodiments described herein should not be construed as requiring such separation in all embodiments, but should be construed as, described program components and systems can be generally integrated together into a separate product or packaged into a plurality of products.

[0141] Specific embodiments of the subject matter have been described. Other embodiments fall within the scope of the appended claims. For example, the actions listed in the claims can be performed in a different order and still achieve the desired results. As an example, the processes depicted in the accompanying drawings do not necessarily require the particular order or sequential order shown to achieve the desired results. In some implementations, multitasking and parallel processing can be advantageous.

Claims

1. A computer-assisted robotic method comprising: moving a computer-assisted manipulator arm to cause an elongated instrument coupled to the computer-assisted manipulator arm to move along a line in space defined by a longitudinal axis of the elongated instrument; and The instrument is moved along the line in the space independently of the computer-assisted movement of the manipulator arm.

2. A method according to claim 1, wherein the instrument is a medical instrument and wherein during said moving the computer-assisted manipulator arm to cause said slender instrument to move along a line in said space and during said moving said instrument along a line in said space independently of said movement of said computer-assisted manipulator arm, at least a distal portion of said instrument is disposed inside the patient's body.

3. A method according to claim 1, wherein the moving of the computer-assisted manipulator arm to cause the slender instrument coupled to the computer-assisted manipulator arm to move along the line in the space occurs simultaneously with the movement of the instrument along the line in the space independent of the computer-assisted manipulator arm.

4. A method according to claim 1, wherein the moving of the computer-assisted manipulator arm to cause the slender instrument coupled to the computer-assisted manipulator arm to move along the line in the space does not occur simultaneously with the movement of the instrument along the line in the space independent of the computer-assisted manipulator arm.

5. The method of claim 1, wherein said moving said instrument along a line in said space independently of said motion of said computer-assisted manipulator arm comprises: An instrument holder bracket is moved to which the instrument is releasably coupled.

6. A method according to claim 1 or any one of claims 2 to 5, wherein moving the computer-assisted manipulator arm to cause the slender instrument coupled to the computer-assisted manipulator arm to move along the line is used for a first movement, wherein the movement independent of the computer-assisted manipulator arm to move the instrument along the line in the space is used for a second movement, and wherein the first movement is longer and slower than the second movement.

7. The method according to claim 6, further comprising: A frequency cutoff filtering operation is used to distinguish between the first movement and the second movement.

8. The method according to claim 1 or any one of claims 2 to 5, further comprising: In response to receiving a motion input of an instrument command, performing a combination of: said moving said computer-assisted manipulator arm to cause said elongated instrument coupled to said computer-assisted manipulator arm to move along a line in said space, and The movement of the manipulator arm, which is independent of the computer assistance, moves the instrument along a line in the space.

9. A method according to claim 1 or any one of claims 2 to 5, wherein moving the computer-assisted manipulator arm to cause the slender instrument coupled to the computer-assisted manipulator arm to move along a line in the space further comprises: pivoting the instrument holder relative to the computer-assisted manipulator arm.

10. A computer-assisted medical system comprising: a computer-assisted manipulator arm comprising an instrument holder bracket configured to releasably couple to an elongated instrument; and A processor, the processor being configured to: moving the computer-assisted manipulator arm to cause the elongated instrument to move along a line in space defined by a longitudinal axis of the elongated instrument, and The elongate instrument is moved along the line in the space independently of the movement of the computer-assisted manipulator arm.

Images