Robot-assisted fulcrum effect correction apparatus and method

Abstract

Devices and methods for switching between a fulcrum effect mode and a fulcrum effect correction mode are described herein. In a fulcrum effect mode, the method includes receiving a first input at a handle coupled to a medical device. The first input causes manual reverse movement of the medical device about a pivot point. In a fulcrum correction mode, the method includes activating a control device at the handle to engage a sensor assembly and a powered actuation unit in communication with the medical instrument, monitoring a position of one or more sensorized joints of the handle, and in response to a change in the position detected by the sensor assembly, activating the control device at the handle to engage the sensor assembly and the powered actuation unit. The distal portion of the medical device is caused to translate using the powered actuation unit.

Description

[0001] Cross-references to related applications This application claims priority to U.S. Provisional Patent Application Serial No. 63 / 485,715, filed February 17, 2023, the contents of which are incorporated herein by reference in their entirety.

[0002] By incorporating via reference All publications and patent applications mentioned in this specification are incorporated herein by reference in their entirety, as specifically and individually indicated that each individual publication or patent application is incorporated herein by reference in its entirety. Technical Field

[0003] This disclosure generally pertains to the field of minimally invasive surgery, and more specifically to the field of robot-assisted minimally invasive surgery. This document describes robot-assisted devices and methods for performing minimally invasive surgery. Background Technology

[0004] Surgical procedures can be performed using either an open approach (where a large incision is made to access the surgical site) or a minimally invasive (MIS) approach (where multiple smaller incisions are made and thin instruments are used to manipulate tissue at the surgical site). MIS, also known as keyhole surgery or laparoscopic surgery, offers patients numerous advantages, such as reduced blood loss, less scarring, and shorter hospital stays. However, in many cases, the MIS approach is extremely difficult to perform, and the open approach is used instead.

[0005] There are many reasons for the challenges in surgical instrument control (MIS), but the main difficulty stems from the limitations of the instrument control system (e.g., the interface). While many control systems have been developed to address some of these challenges, traditional control systems still have shortcomings. Another limitation that increases the difficulty of traditional MIS procedures is the fulcrum formed at the incision site around which the surgical instrument rotates within the patient's body. Manipulating the instrument at this fulcrum introduces reverse control of the movement of the instrument tip relative to the instrument handle or other control interface. Reverse control (i.e., moving upwards moves the tip downwards, or moving to the right moves the tip to the left) is counterintuitive for surgeons and reduces the effectiveness of MIS instruments.

[0006] Therefore, there is a need to develop new control mechanisms that allow for improved control over both the orientation and position of surgical instruments, while providing surgeons with a comfortable and ergonomic control interface. Summary of the Invention

[0007] In some aspects, the technology described herein relates to a system for performing minimally invasive surgery, comprising: a stabilizing device that can switch between an unlocked state and a locked state; a control assembly including: a handle pivotally coupled to the stabilizing device and including one or more sensorized joints; and an instrument actuator interface configured to be reversibly coupled to the handle; and a medical device coupled to and operable by the handle, the medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints; and an end effector coupled to the distal portion; wherein, in a first mode, the stabilizing device is configured to be in an unlocked state, such that the medical device can be operated by the handle about a pivot point or in a first three-dimensional space; wherein, in a second mode, the handle is configured to operate the end effector of the medical device; and wherein, in a third mode, the stabilizing device is configured to be in a locked state, and such that the handle can cause movement of one or more sensorized joints, such that movement of one or more sensorized joints causes corresponding distal movement of one or more distal joints of the medical device about a pivot point.

[0008] In some aspects, the technology described herein relates to a system for performing minimally invasive surgery, comprising: an elongated body including a distal end having an end effector and one or more distal joints, and a proximal end opposite the distal end; a handle configured to receive the proximal end of the elongated body, wherein the handle includes a cannula including one or more sensorized joints; a sensor assembly configured to monitor the position of each of the one or more sensorized joints; and an instrument actuator interface coupled to the cannula of the handle, and including: a power actuation unit; and a controller communicatively connected to the sensor assembly and the power actuation unit, wherein: the sensor assembly is configured to monitor at least a first position of one or more sensorized joints and generate a corresponding sensor signal, wherein the first position is based on proximal movement of the handle; the controller is configured to receive the corresponding sensor signal and generate a corresponding control signal; and the power actuation unit is configured to receive the corresponding control signal and actuate one or more distal joints based on the first position of one or more sensorized joints to cause translation of one or more distal joints.

[0009] In some aspects, the technology described herein relates to a system for minimally invasive surgery, comprising: a medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints, and an end effector; and a control assembly including: a handle configured to be coupled to the proximal portion of the medical device and to manipulate the medical device, wherein the handle includes one or more sensorized joints, and a device actuator interface configured to be reversibly coupled to the handle, wherein the system is configured to selectively operate in a first control mode or a second control mode, and wherein selecting between the first and second control modes includes modifying the range of motion associated with the one or more sensorized joints.

[0010] In some aspects, the technology described herein relates to a system for performing minimally invasive surgery, comprising: a control assembly including: a handle pivotally coupled to a bedside device, wherein the handle includes one or more sensorized joints, and an instrument actuator interface; and a medical device coupled to and operable by the handle, the medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints, wherein, in a fulcrum effect mode, mechanical movement of the handle coupled to the proximal portion of the medical device causes movement of the medical device about a pivot point, and wherein, in a fulcrum correction mode: the pivot point is between one or more sensorized joints of the handle and one or more distal joints of the medical device, and actuation of the handle causes movement of one or more sensorized joints, thereby causing the instrument actuator interface to map the movement to a corresponding distal movement of one or more distal joints at least about the pivot point.

[0011] In some aspects, the technology described herein relates to a method for performing minimally invasive surgery, comprising: in a fulcrum effect mode: receiving a first input at a handle coupled to a medical device, wherein the first input causes manual movement of the medical device about a pivot point, wherein the pivot point is between a distal portion and a proximal portion of the medical device; and in a fulcrum correction mode: activating a control device at the handle, the control device being configured to engage a sensor assembly and a power actuation unit in communication with the medical device for electronically assisted movement; using the sensor assembly communicatively coupled to the controller to monitor the position of one or more sensorized joints of the handle; and in response to a change in position detected by the sensor assembly, using the power actuation unit to cause translation of the distal portion of the medical device, wherein the translation of the distal portion of the medical device is based on the position of one or more sensorized joints.

[0012] In some aspects, the technology described herein relates to a handle configured for mounting at the bedside of a patient support device and for performing minimally invasive surgery, the handle comprising: a first input mechanism configured to select a fulcrum effect mode, wherein the handle is configured to be attached to a medical device mechanically movable about a pivot point; and a second input mechanism configured to select a fulcrum correction mode, wherein selection of the second input mechanism is configured to activate a sensor assembly, a power actuation unit, and a controller communicatively coupled to the power actuation unit and the sensor assembly. Attached Figure Description

[0013] The foregoing is an overview and therefore necessarily limited in detail. The following description, in conjunction with various embodiments and with reference to the accompanying drawings, describes the foregoing aspects, as well as other aspects, features, and advantages of the invention.

[0014] Figure 1A A perspective view of an embodiment of the fulcrum effect correction device is shown.

[0015] Figure 1B A schematic diagram of an embodiment of the control system of the fulcrum effect correction device is shown.

[0016] Figure 1C A schematic diagram of an embodiment of the control system of the fulcrum effect correction device is shown.

[0017] Figure 2 It shows Figure 1A A perspective view of an embodiment in which a medical device is installed.

[0018] Figure 3A It shows about Figure 1A The first joint of the stabilizing device in the embodiment is adjusted.

[0019] Figure 3B It shows about Figure 1A The first joint of the stabilizing device in the embodiment Figure 3A The reverse adjustment.

[0020] Figure 4A It shows Figure 1A Adjustment of the stabilizing device in the embodiment.

[0021] Figure 4B It shows Figure 1A Stabilizing device of the embodiment Figure 4A The reverse adjustment.

[0022] Figure 5A It shows Figure 1A The axial movement of the medical device in the embodiment.

[0023] Figure 5B It shows Figure 1A The medical device of the embodiment Figure 5A The opposite axial movement.

[0024] Figure 6 It shows the basis Figure 1A The embodiment of the handle input mechanism manipulates the rolling motion of the medical device.

[0025] Figure 7 It shows the basis Figure 1A The embodiment of the handle input mechanism manipulates the movement of the wrist assembly of the medical device.

[0026] Figure 8 This shows the switching to fulcrum effect correction mode. Figure 1A Examples of implementations.

[0027] Figure 9 This shows the state of being in the fulcrum effect correction mode. Figure 8 The embodiment describes the configuration of the handle and the corresponding configuration of the medical device.

[0028] Figure 10A An embodiment of a fulcrum effect correction device in fulcrum effect mode is shown.

[0029] Figure 10B The cross-section of the linear guide rail of the fulcrum effect correction device is shown.

[0030] Figure 11 This shows the switching to fulcrum effect correction mode. Figure 10A Examples of implementations.

[0031] Figure 12 This shows the state of being in the fulcrum effect correction mode. Figure 10A The embodiment describes the configuration of the handle and the corresponding configuration of the medical device.

[0032] Figure 13 An embodiment of a fulcrum effect correction device in fulcrum effect mode is shown.

[0033] Figure 14 This shows the state of being in the fulcrum effect correction mode. Figure 13 Configuration of an embodiment.

[0034] Figure 15 This shows the state of being in the fulcrum effect correction mode. Figure 13 Another configuration of the embodiment.

[0035] Figure 16 An embodiment of a fulcrum effect correction device in fulcrum effect mode is shown.

[0036] Figure 17 This shows the switching to fulcrum effect correction mode. Figure 16 Examples of implementations.

[0037] Figure 18 This shows the state of being in the fulcrum effect correction mode. Figure 17 Configuration of an embodiment.

[0038] Figure 19 It shows the basis Figure 17 The embodiments of the medical device have multiple degrees of freedom of one or more input mechanisms of the handle.

[0039] Figure 20 It shows Figure 16 A detailed perspective view of the control components in an embodiment.

[0040] Figure 21A It shows Figure 20 The control component's handle rotates counterclockwise.

[0041] Figure 21B It shows Figure 20 The control component's handle rotates clockwise.

[0042] Figure 22A It shows the manipulation of the unactuated state. Figure 20 The control input of the end effector in the embodiment.

[0043] Figure 22B It shows the manipulation of the actuated state. Figure 20 The control input of the end effector in the embodiment.

[0044] Figure 23A A medical device is shown in its mounting position in an embodiment with the handle.

[0045] Figure 23B It shows the installation Figure 23A The medical device in the handle of the embodiment.

[0046] Figure 24A An embodiment of the control handle in the neutral position is shown.

[0047] Figure 24B An embodiment of the control handle in yaw adjustment configuration is shown.

[0048] Figure 24C An embodiment of the control handle in yaw and pitch adjustment configuration is shown.

[0049] Figure 25 A linear guide is shown that allows axial movement of one or more sensorized joints of the handle to disable or enable fulcrum effect correction modes, such as... Figure 16 and Figure 17 As shown respectively.

[0050] Figure 26An embodiment of a fulcrum effect correction device in fulcrum effect correction mode is shown.

[0051] Figure 27 This shows the state of being in the fulcrum effect correction mode. Figure 26 Another configuration of an embodiment of the fulcrum effect correction device.

[0052] Figure 28 This shows the state of being in the fulcrum effect correction mode. Figure 26 The internal components of the linear guide rail in an embodiment of the fulcrum effect correction device.

[0053] Figure 29 An embodiment of a fulcrum effect correction device with two control input handles is shown.

[0054] Figure 30 A method for performing fulcrum effect surgery using a fulcrum effect correction device is shown.

[0055] Figure 31 A method for performing fulcrum effect correction surgery using a fulcrum effect correction device is shown.

[0056] The embodiments shown are merely examples and are not intended to limit this disclosure. The schematic diagrams are for illustrating features and concepts and are not necessarily drawn to scale. Detailed Implementation

[0057] The foregoing is an overview and therefore necessarily limited in detail. The aspects mentioned above, as well as other aspects, features, and advantages of the invention, will now be described in conjunction with various embodiments. The inclusion of the following embodiments is not intended to limit this disclosure to these embodiments, but rather to allow those skilled in the art to make and use the contemplated invention. Other embodiments may be utilized and modifications may be made without departing from the spirit or scope of the subject matter presented herein. The aspects of this disclosure as described and illustrated herein can be arranged, combined, modified, and designed in a variety of different conceptual forms, all of which are expressly contemplated and form part of this disclosure.

[0058] As used herein, "distal or distal" describes the direction in which a device or system acts on an object (e.g., a patient during minimally invasive surgery). For example, the distal portion of a device or system is the part of the device or system that is closer to the object on which the device or system acts.

[0059] As used herein, "proximal or to proximal" describes the direction of a device or system towards the user. For example, the proximal portion of a device or system is the part of the device or system that is closer to the user of the device or system.

[0060] The devices and systems described herein include technological improvements for instrument delivery and manipulation during minimally invasive surgery. A traditional drawback of current technologies includes the counterintuitive nature of using conventional devices. For example, many conventional minimally invasive devices are subject to the "fulcrum effect." Disadvantageously, the fulcrum effect results in a reverse positional output relative to the positional input. For example, when using conventional devices during minimally invasive surgery, a fulcrum is created at the point where the device or cannula enters the patient, or at the point where the device or system is attached to a bedside device. If a handle or other input device on the proximal side of the fulcrum pivots about the fulcrum, a portion of the device on the distal side of the fulcrum will pivot about the fulcrum in the opposite direction. For linear movements (e.g., insertion or retraction), movement at the proximal end results in a similar movement at the distal end (e.g., insertion at the proximal end results in insertion at the distal end). This type of control operation is called the fulcrum effect pattern. The fulcrum effect pattern can render these devices cumbersome and counterintuitive in some cases. At least some of the devices and systems described herein address these technical problems by providing a control output on the distal side of the fulcrum that moves in the same direction as the control input on the proximal side of the fulcrum, referred to herein as a fulcrum effect correction (FEC) mode. Some embodiments use one or more sensorized joints on the proximal side of the fulcrum that indicate the position and orientation of the handle, and actuate one or more drive joints on the distal side of the fulcrum to simulate the movement of the handle.

[0061] The devices and systems described herein may also include fulcrum effect mode operation when needed. The technical solutions provided herein include a handle that allows switching between fulcrum effect mode and fulcrum effect correction mode (FEC) based on input at the handle. This handle can be mounted at the bedside, for example, attached to a stabilization device, a brace, or directly to the bedside. Conventional systems and devices with fulcrum effect correction mode do not offer such a simple and compact device and system, and therefore require more space in the operating area, a separate stabilization device, and / or require the surgeon to move between the bedside and a remote control console. The devices and systems described herein provide intuitive control while having a compact configuration that enables bedside positioning. Furthermore, the devices and systems described herein allow users to use and switch between multiple operating modes without removing their hands from the device's main control input device (at least in some embodiments).

[0062] The control component may include one or more input devices for selecting an operating mode (e.g., fulcrum effect mode, fulcrum effect correction mode, end effector control mode, etc.). The devices and systems described herein may include one or more controllers contained within the control component or a telecomputing device. In some embodiments, various ergonomic features allow for a variety of control inputs from a single control component.

[0063] As used in this article and as Figure 1A As shown, the "fulcrum effect" operation of the fulcrum effect correction device 100 defines the reverse control of the distal portion 112 of the medical device 106 (optionally including an end effector 114) relative to the handle 120. In other words, a leftward position change of the handle 120 (also referred to as the input position) produces a rightward position change of the distal portion 112 of the medical device 106 (also referred to as the output position). Furthermore, an upward position change of the handle 120 produces a downward position change of the distal portion 112 of the medical device 106. The ratio of the positional changes of the handle 120 to the distal portion 112 of the medical device 106 can be based on the ratio of the length of the distal portion 112 of the medical device 106 to the length of the proximal portion 110. For example, when the length of the distal portion 112 of the medical device 106 is half the length of the proximal portion 110, a positional change of about 2.00 cm (0.78 inches) to the left of the handle may produce a positional response of about 1.00 cm (0.39 inches) to the right of the distal portion 112 of the medical device 106.

[0064] As used in this article and as Figure 9 As shown, the fulcrum effect correction operation of the fulcrum effect correction device 100 defines the corresponding control of the distal portion 112 of the medical device 106 relative to the handle 120. In other words, a leftward position change of the handle 120 (also referred to as the input position) produces a leftward position change of the distal portion 112 of the medical device 106 (also referred to as the output position). Furthermore, an upward position change of the proximal portion 110 of the medical device 106 produces an upward position change of the distal portion 112 of the medical device 106. The simulated motion of the distal portion 112 of the medical device 106 relative to the handle 120 can be scaled. For example, the simulated motion of the handle 120 relative to the distal portion 112 of the medical device 106 can be approximately 10:1, 8:1, 6:1, 4:1, 2:1, 1:1, 1:2, 1:4, 1:6, 1:8, or 1:10. As described herein with respect to various embodiments, fulcrum effect correction can be achieved using electronically assisted motion, for example, using control components that include instrument actuator interfaces and sensor assemblies.

[0065] Generally, the devices and systems described herein include handles or mechanisms that enable switching between fulcrum effect mode and fulcrum effect correction (FEC) mode. For example... Figure 1BAs shown, a system 10 for performing minimally invasive surgery includes a medical device 6 with an elongated body, an optional wrist assembly 16, and an optional end effector 14. The optional end effector 14 can be coupled to the medical device 6 via the optional wrist assembly 16. The system 10 can utilize the optional wrist assembly 16 to change the position or orientation of the optional end effector 14 relative to the medical device 6. The system 10 may further include a control assembly 18, which includes a handle 20 and a device actuator interface 22, which together enable switching between a fulcrum effect correction mode and a fulcrum effect mode. As will be described elsewhere herein, the device actuator interface 22 coupled to the medical device 6 may include motors, mechanisms, etc., for manipulating the medical device 6. Additionally, in some operational embodiments, as will be described elsewhere herein, the handle 20 may be reversibly coupled to the device actuator interface 22. In some specific implementations, the control assembly 18 includes an input 23 for configuring the system 10 to a fulcrum effect mode and an input 25 for configuring the system 10 to a fulcrum effect correction mode. For example, inputs 23 and 25 can be mechanical switches (e.g., buttons, toggle switches, slide switches, etc.) or separate grip portions of handle 20 for releasing or securing handle 20 to the instrument actuator interface 22. Alternatively or additionally, inputs 23 and 25 can actuate electromechanical control mechanisms such as starter motors, sensors, processors, etc., thereby allowing the device to switch modes. In other embodiments, input 23 is used to switch between fulcrum effect mode and fulcrum effect correction mode, while input 25 is used to manipulate the end effector of the system. Inputs 23 and 25 can be mechanical switches (e.g., buttons, toggle switches, slide switches, joysticks, etc.) or separate grip portions of handle 20, respectively used for switching between modes and manipulating the end effector.

[0066] In addition, such as Figure 1B As shown, system 10 may optionally include a stabilizing device 2. The optional stabilizing device 2 may at least partially support the weight of the medical device 6, the handle 20, and / or the device actuator interface 22. In some embodiments, the optional stabilizing device 2 defines a remote center of motion (e.g., Figure 1AThe pivot point 124 in the stabilization device 2 may have a base member fixedly attached to or relative to a patient support device (e.g., bed, operating table, wall, floor, brace, etc.). The stabilization device 2 may enable the supported surgical device to move about one, two, three, or more degrees of freedom. The stabilization device may allow the user to move the surgical device in substantially the same manner as moving the surgical device without the stabilization device. In some embodiments, the stabilization device may also restrict the movement of the surgical device (when attached) to a predetermined range of motion of one or more relevant degrees of freedom, allowing the surgical device to move about a remote center of motion, as described herein. Restricting movement in this way, in addition to supporting at least a portion of the weight of the attached surgical device, may also help guide and / or limit the movement of its distal tip within a predefined range of motion. That is, the articulated configuration in the stabilization device facilitates minimally invasive surgery by restricting the movement of the attached surgical device to a pivot point for a minimally invasive approach (also known as a remote center of motion configuration). The surgeon can directly control the position and / or orientation of the end effector of the attached surgical device via any suitable user input device, such as a multi-degree-of-freedom (DOF) handle that is part of the device described in this example. The stabilizing device allows the surgeon to control the position of the distal portion or tip of the medical device via the handle in a manner substantially the same as with manual instruments, while the entire motion device is limited and supported by a remote motion center mechanism.

[0067] As used herein, a remote motion center (RCM) is understood to refer to a configuration in which a series of joints or degrees of freedom pivot about a single point, which the mechanism (e.g., the stabilizing device in this example) is not physically attached to. An RCM can be used in minimally invasive surgical approaches because it allows surgical instruments to enter the body through a fixed single point (referred to herein as the pivot point or fulcrum), while allowing the instruments to move within those constraints. This configuration helps prevent movement of the surgical instruments at the site of their entry into the patient's body (typically the abdominal wall), thereby helping to reduce damage to that location or surrounding soft tissues. An RCM can be implemented through mechanical joints or software-imposed constraints. To achieve a software-imposed RCM, the joints are typically actuated or driven. While the system described herein is illustrated with reference to one possible surgical type, it can be used in surgeries where minimally invasive approaches are feasible, and is not necessarily limited to surgeries currently performed using minimally invasive methods. Additionally, the system can also be used in situations where the remote motion center is located outside the patient's body, such as for example, transoral robotic surgery (TORS).

[0068] In alternative embodiments, and as Figure 1AAs shown, any or all of the three RCM joints 104a, 104b, and 108 may include suitable braking devices, such as electronically or mechanically controlled brakes, to enable additional functions, such as the ability to actively dampen any or all joints for finer motion control, to perform virtual fixation to prevent damage to tissues away from the surgical site, or to lock one or more joints during a given surgical task. The ability to selectively lock and unlock one or more joints can, for example, allow the surgeon to hold tissue in a specific position or enable the RCM mechanism to maintain its accurate position during instrument changes. These advanced functions, such as joint damping, joint locking, or virtual fixation, can be controlled by the surgeon via various mechanisms, such as buttons, switches, knobs, etc. These mechanisms may be contained on the surgical handle, on a touchscreen within the surgeon's reach, via foot pedals, etc. In an alternative embodiment, the advanced functions may be activated by a surgical assistant. In alternative embodiments, any or all of the RCM joints can be electrified by including actuators, such as motors, which can be integrated into each joint for direct drive or located remotely and driven via a transmission system, such as using cables, belts, or gear systems. The electrification of the RCM mechanism, combined with sensorization (i.e., adding sensors to each joint), will enable more advanced functionalities such as active haptic feedback, fully remote operation (surgeon controlling the robotic unit via a console), or semi-autonomous or fully autonomous surgical tasks.

[0069] As used herein, the stabilizing device can switch between a locked state or configuration and an unlocked state or configuration. In the unlocked state or configuration, the stabilizing device can move around each joint of the stabilizing device. In the locked state or configuration, one or more joints of the stabilizing device are locked, thereby preventing the stabilizing device from moving around one or more locked joints. Figure 1A and Figures 2 to 9 Embodiments may include a stabilizing device 102 that has RCM functionality (i.e., synchronized movement including joints 104a, 104b, 108 as described herein) during fulcrum effect mode. When stabilizing device 102 is locked to enter fulcrum effect correction mode, stabilizing device 102 may lock joints 104a, 104b, and 108. Embodiments, such as... Figures 10A to 12 , Figures 16 to 25 and Figures 26 to 28Those embodiments that include linear guides (e.g., linear guides 212, 412, and 614) may include a stabilizing device 102 with RCM functionality during fulcrum effect mode (i.e., synchronized movement including joints 104a, 104b, and 205 as described herein). When the stabilizing device 102 is locked to enter fulcrum effect correction mode, it may lock joints 104a, 104b, and 205. In some cases, stabilizing joint 108 may be selectively locked and unlocked while joints 104a and 104b remain locked to adjust the fulcrum.

[0070] Figure 1C A schematic diagram illustrating a fulcrum effect correction operation is shown, including a device actuator interface 122, a controller 182, a sensor assembly 184, and a medical device 186. The device actuator interface 122 includes a power actuation unit 180. The sensor assembly 184 may include one or more position sensors. The sensor assembly 184 measures or monitors the position of one or more joints actuated by a handle, such that the medical device 186 is actuated based on the position of the one or more joints. Sensor signals output from the sensor assembly 184 are received by the controller 182. The controller 182 may output signals to the device actuator interface 122, which includes one or more power actuation units 180. These output signals from the controller 182 actuate one or more power actuation units 180 to manipulate the medical device 186, such as a distal portion of the medical device. During the fulcrum effect correction operation, the position of the distal portion of the medical device 186 simulates the position of a handle, the handle's input mechanism, and / or one or more sensorized joints associated with the handle. Furthermore, the movement of the distal portion of the medical device 186 is a simulated movement of the position of the handle, the input mechanism of the handle, and / or one or more sensorized joints associated with the handle. Therefore, from the user's perspective, and in fulcrum effect correction mode, when the input mechanism of the handle, the handle, and / or one or more sensorized joints associated with the handle tilt or move to the left, the medical device 186 will also tilt or move to the left. As a further example, when the input mechanism, the handle, and / or one or more sensorized joints associated with the handle tilt or move to the right, the medical device 186 will also tilt or move to the right. As a further example, when the input mechanism, the handle, and / or one or more sensorized joints associated with the handle tilt or move upwards, the medical device 186 will also tilt or move upwards. As a further example, when the input mechanism, the handle, and / or one or more sensorized joints associated with the handle tilt or move downwards, the medical device 186 will also tilt or move downwards.

[0071] The sensorized joints described herein include position sensors that measure the orientation and / or position of one or more parts of a device or system (see, for example...). Figures 3A to 4B, Figure 9 , Figures 17 to 19 , Figures 26 to 29 For example, sensorized joints can be included in stabilization devices to allow determination or actuation of joint movement about yaw, pitch, and / or roll axes (e.g., Figures 3A to 4B As a further example, sensorized joints can be actuated in a fulcrum effect correction mode, allowing the joint position to be determined and the medical device to be actuated based on the measured position. Examples of position sensors may be optical encoders, potentiometers, magnetic encoders, capacitive encoders, linear encoders, rotary encoders, or any other suitable sensors known in the art.

[0072] Driven joints, actuators, or any other mechanisms driven by one or more power actuation units described herein may also include position sensors. The included position sensors may be potentiometers, optical encoders, or any other suitable sensors known in the art. Measurement of the position of the drive joint, actuator, or mechanism may be necessary to provide control feedback at the controller to ensure proper positioning of the distal portion of the medical device.

[0073] The overall motion described herein can be defined as any motion of the device other than the motion in the fulcrum effect correction mode and the end effector control mode. For example, overall motion can include linear motion modes, fulcrum effect motion, motion of control components, and / or motion of the medical device used to position it for a procedure to be performed. Overall motion can utilize a stabilizing device in an unlocked or configured state, such that the joints of the stabilizing device are movable (see, for example...). Figures 3A to 5B ).

[0074] The medical device described herein may have an elongated body portion. This elongated body portion may terminate distally at an optional end effector. The end effector may include grasping forceps, tweezers, scissors, suturing devices, cutting tools, ablation elements, cryo-elements, cameras, needle holders, electrocautery tools, etc. Furthermore, the medical device described herein may be operatively coupled to and manipulated by a device actuator interface.

[0075] Systems and devices The general features and structure of the embodiments described herein have been compared with Figures 1B to 1C A description has been provided. Now, the following will be based on... Figure 1A and Figures 2 to 31 Describe an exemplary embodiment.

[0076] Figure 1A An embodiment of a fulcrum effect correction device 100 is depicted. Device 100 includes a stabilizing device 102, a control assembly 118, and a medical device 106.

[0077] The control assembly 118 may include a handle 120, an instrument actuator interface 122, and optionally an insertion tube, shaft, or sleeve 140. The handle 120 may have one or more control inputs, such as an input mechanism 126. The instrument actuator interface 122 is detachably coupled to the handle 120. Furthermore, the instrument actuator interface 122 may be operatively coupled to the base portion 107 of the medical device 106 (e.g., as shown in the image). Figure 2 (As shown) and / or cannula 140. The device actuator interface 122 may include a power actuation unit, for example, for transmitting power at the interface between the device actuator interface 122 and the cannula 140, and / or for transmitting power at the interface between the device actuator interface 122 and the medical device 106. The cannula 140 may include a guide rail or track on which the handle 120 can slide when disengaged from the device actuator interface 122. Figure 2 As shown, the sleeve 140 defines a recess or slot 101 within which the handle 120 interface 129 can slide, thereby locking the roll orientation of the handle 120 and the sleeve 140. The sleeve 140 may include one or more sensorized joints 160a, 160b (e.g., Figure 9 (As shown). One or more sensorized joints 160a, 160b can be locked to keep each part of the sleeve 140 concentric with each other (as shown in Figure 1). Figure 2 , Figure 6 and Figure 7 (As shown). Sensorized joints 160a and 160b can be locked until the handle 120 disengages from the instrument actuator interface 122 and slides proximally through sensorized joints 160a and 160b (as shown). Figure 8 (As shown). Input at handle 120 and / or actions that cause handle 120 to slide proximally through sensorized joints 160a, 160b can unlock sensorized joints 160a, 160b. Some embodiments may include a sleeve 140, wherein a first portion 119 is part of a stabilization device. The first portion 119 is at the distal end of the control assembly 118. In these embodiments, the sleeve 140 has a second portion 121 adjacent to the control assembly 118, and the second portion 121 may be considered part of the control assembly 118. The second portion 121 of the sleeve 140 may include sensorized joints 160a, 160b. Alternatively, in some embodiments, the sleeve 140 may be considered part of the stabilization device 102, while in other embodiments, it may be considered part of the control assembly 118 or the handle 120.

[0078] For example, the locking mechanism of sensorized joints 160a and 160b can be a directional switch mechanism that releases the sensorized joints 160a and 160b when moved in one direction and re-locks them when moved in the other direction. When the portions of sleeve 140 connected to the respective sensorized joints remain concentric, handle 120 can optionally slide distally across sensorized joints 160a and 160b. Thus, portions of sleeve 140 are positioned in an appropriate orientation to lock the sensorized joints. Control component 118 can include a controller within or near handle 120. Alternatively, the controller can be remotely positioned. The controller can include computing functions, such as a processor, and can be communicatively coupled to the control inputs of device 100 and / or handle 120.

[0079] like Figure 1A and Figure 2 As shown, device 100 includes medical device 106. Medical device 106 includes a distal portion 112, a proximal portion 110, a base portion 107, an optional end effector 114, and an optional wrist assembly 116. Figure 1A Further shown, the distal portion 112 and the proximal portion 110 are separated by a pivot point 124. The pivot point 124 can be enabled or generated at a predefined point or the point where the device 100 enters the patient. In some embodiments, the pivot point 124 may be a point near, within, or aligned with a cannula or inserter. The distal portion 112 of the medical device 106 may include one or more drive joints 162a, 162b (e.g., Figure 9 (As shown). One or more drive joints 162a, 162b, and the mechanisms described elsewhere herein, can be actuated by cables, traction lines, or other mechanisms incorporated within the medical device 106. Mechanisms for cable or traction line actuation described elsewhere herein can be incorporated within the base portion 107 of the medical device 106. Mechanisms within the end effector portion of the medical device 106 can receive actuation power at an interface with the device actuator interface 122. Both the optional end effector 114 and the optional wrist assembly 116 that connects the end effector 114 to the medical device 106 can be actuated by cables or traction lines within the medical device 106, similar to the drive joints 162a, 162b. Manipulation of the drive joints 162a, 162b and the optional wrist assembly 116 ultimately manipulates the position of the optional end effector 114. Manipulation of the optional wrist assembly 116 facilitates positioning of the optional end effector 114 during use.

[0080] like Figure 1A , Figure 3A , Figure 3B , Figure 4A and Figure 4BAs shown, the device 100 includes a stabilizing device 102. The stabilizing device 102 supports the weight of the control assembly 118 and the medical device 106. Furthermore, the stabilizing device 102 allows for overall movement to position the control assembly 118, and consequently, the medical device 106. In some variations, the stabilizing device 102 may include a first arm 103a terminating at a rotating mechanism or joint 104a (e.g., see...). Figure 3A and Figure 3B The arm 103b shown rotates about axis 130. Figure 3A The rotational motion 128 of rotating clockwise around joint 104a to the first position is shown. Figure 3B Rotational motion 128, involving counterclockwise rotation about joint 104b to a second position, is shown. The rotation of arm 103b relative to arm 103a about joint 104a and axis 130 is the first degree of freedom of stabilizing device 102. Stabilizing device 102 may further include a second arm 103b and a third arm 103c. The first arm 103b may include a first set of linkages, and the second arm 103c may include a second set of linkages, the first and second sets of linkages together constituting a parallelogram motion mechanism. Figure 4A and Figure 4B As shown, the parallelogram motion mechanism of arms 103b and 103c provides coordinated movement of the first joint 104a, the second joint 104b, and the stabilizing joint 108 about the pitch axis 137 (indicated by arrow 132). The movement about the pitch axis 137 is the second degree of freedom of the stabilizing device 102. Figure 4A The control assembly 118 and the proximal portion 110 of the medical device 106 are shown positioned in a lowered position via a stabilizing device 102 about an axis 137. Figure 4B The control assembly 118 and the proximal portion 110 of the medical device 106 are shown positioned in an elevated position about axis 137 via a stabilizing device 102. In some embodiments, the stabilizing device 102 further includes a cannula 140 (e.g., including a prismatic joint) that enables linear movement or a third degree of freedom of the stabilizing device 102, as will be described in further detail below.

[0081] As shown in the figure, the stabilizing device 102 includes a first joint 104a that connects a first arm 103a to a second arm 103b and a third arm 103c (in some embodiments, they together form a parallelogram motion mechanism). The first joint 104a can function as a rotary joint. For example, as... Figure 1A , Figure 3A and Figure 3B As shown, the second arm 103b and the third arm 103c can jointly rotate around a yaw axis 130 relative to the first arm 103a and perpendicular to the horizontal plane 94 (e.g., Figure 3A and Figure 3BAs shown, it performs a rotational motion 128 (e.g., motion about a yaw axis 130 perpendicular to the horizontal plane 94). Additionally, as... Figure 4A and Figure 4B As shown, the first joint 104a may further include a hinge mechanism that allows the second arm 103b and the third arm 103c to move together relative to the first joint 104a about a pitch axis 137 (indicated by arrow 132). As described above, the second arm 103b and the third arm 103c form a parallelogram motion mechanism such that the second arm 103b and the third arm 103c move relative to the arm 103a through the coordinated movement of joints 104a, 104b, and 108. The stabilizing joint 108 allows the medical device 106 to be pitched relative to the stabilizing device 102. Figure 1A As shown, the adjustment plane 183 for pitch adjustment at the stabilizing joint 108 is perpendicular to the horizontal plane 94.

[0082] Some embodiments include RCM functionality implemented using joints 104a, 104b, 108 of the stabilizing device 102. Embodiments with RCM functionality may include synchronously operating joints 104a, 104b, 108. Synchronous movement of joints 104a, 104b, 108 can be achieved through mechanical linkages (e.g., parallelogram motion mechanisms) or gear coupling. For embodiments of the stabilizing device 102 including electrified RCM joints 104a, 104b, 108, the synchronous movement of joints 104a, 104b, 108 may originate from the output of a controller that moves each joint 104a, 104b, 108 relative to each other to maintain a remote center of motion. Embodiments with RCM functionality, whether mechanical or electrified, include synchronized joints 104a, 104b, 108 that align during operation or positioning of the instrument to maintain a remote center of motion. Furthermore, the stabilizing device 102 can be temporarily locked in any position. When the controller receives a corresponding input signal, it can lock the stabilizing device 102. For example, the input signal can be generated by an input on the handle, and the controller, upon receiving the input signal, generates an output signal to lock the stabilizing device 102. The stabilizing device 102 can be unlocked upon the controller receiving the same input signal from the handle, or alternatively, another input signal from the handle. Figure 1A , Figures 2 to 5B , Figures 8 to 10A , Figure 11 , Figure 12 , Figures 16 to 19 and Figures 25 to 29 As shown, the stabilizing device 102 is intended to be rigidly mounted at the interface 151. The interface 151 may include a bedside, wall, bracket, floor, ceiling mount, or any other suitable fixing device.

[0083] Device 100 operates in one or more operating modes. The first mode, referred to herein as the fulcrum effect mode, defines the configuration of the device that enables the previously described adjustment of joints 104a, 104b, 108 of the stabilizing device 102, such as... Figure 1A , Figure 3A , Figure 3B , Figure 4A and Figure 4B As shown. In some embodiments, the adjustment movement of the joints 104a, 104b, 108 around the stabilizing device 102 can be manual. For example, when the device 100 is used in a minimally invasive procedure, a fulcrum, remote center of motion, or pivot point 124 can be generated at a predefined point or at the point where the device 100 enters the patient's body. The pivot point 124 (i.e., the remote center of motion) may include the yaw axis 130 of the medical device 106 (e.g., the yaw axis 130 of the medical device 106). Figure 3A and Figure 3B As shown), pitch axis 137 (as shown) Figure 4A and 4B (as shown) and longitudinal axis 150 (as shown) Figure 1A The pivot point 124 is the common intersection point (shown in the diagram). In some implementations, the pivot point 124 may be a point near or inside the cannula or aligned with the cannula. For example, when positioning the distal portion 112 of the medical device 106 or the end effector 114 of the medical device 106, movement of the medical device 106 about the pivot point 124 will result in a fulcrum effect. The fulcrum effect mode may further include actuation of the end effector 114, such as... Figures 6 to 7 As shown. The fulcrum effect mode of device 100 can be used during the program or for the overall movement of the device, for example, for positioning the program to be completed.

[0084] In some embodiments, the control component 118 includes an input mechanism 142 located on or near the handle 120 (such as...). Figure 6 (As shown). Although the input mechanism 142 is shown as a button, a dial, joystick, switch, etc., may also be used without departing from the scope and intent of this disclosure. The input mechanism 142 can be used for actuation of the end effector 114. For example, in an embodiment having a gripper-type end effector 114, as Figure 1A As shown, pressing or actuating the input mechanism 142 causes the end effector 114 to perform a gripping action. Furthermore, releasing the input mechanism 142 can release or open the gripping mechanism of the end effector 114. In some embodiments, the end effector 114 may include an ablation element, a freezing element, a cutting element, a suturing element, a drilling element, a milling element, an electrocautery element, etc., such that actuation of the input mechanism 142 can initiate ablation, freezing, cutting, suturing, drilling, milling, electrocautery, etc.

[0085] In some variations, any device in the apparatus described herein may perform an optional second mode or an optional portion of any mode of the modes described herein (also referred to herein as an end effector control mode). For example, when the optional end effector control mode is enabled, the wrist assembly 116 of the end effector 114 (such as...) Figure 1A (As shown) will be controlled by control component 118. In some embodiments, control component 118 includes input mechanism 126 (such as...) Figure 6 and Figure 7 As shown, this input mechanism is used to manipulate the wrist assembly 116 of the medical device 106 and the end effector 114. Although a joystick for the input mechanism 126 is shown in the figure, dials, knobs, switches, etc., may also be used without departing from the scope and intent of this application. Figure 6 As shown, the input mechanism 126 is rotatable about a roll axis 144. In some embodiments, rotating the input mechanism 126 clockwise 148 causes the medical device 106 to rotate clockwise 146 about its longitudinal axis 150 (or causes the wrist assembly 116 to rotate about its longitudinal axis 150). Furthermore, rotating the input mechanism 126 counterclockwise (opposite to clockwise 148) causes the medical device 106 to rotate counterclockwise (opposite to clockwise 146) about its longitudinal axis 150 (or causes the wrist assembly 116 to rotate about its longitudinal axis 150). Rotation of the medical device 106 (or wrist assembly 116) can ultimately change the orientation of the end effector 114. In some embodiments, the input mechanism 126 includes an electromechanical accessory of a control assembly 118 similar to a joystick known in the art.

[0086] like Figure 7 As shown, when the input mechanism 126 is pitched about a first or pitch axis 154 and / or a second or yaw axis 156, the wrist assembly 116 can pitch the end effector 114 about a first or pitch axis 152 and / or a second or yaw axis 158 of the end effector, respectively, to simulate the position of the input mechanism 126. For example, if the input mechanism 126 pitches down about the pitch axis 154, the wrist assembly 116 can cause the end effector 114 to pitch down about the pitch axis 152. Furthermore, if the input mechanism 126 yaws about the yaw axis 156, the wrist assembly 116 can cause the end effector 114 to yaw in the same direction about the yaw axis 158. The end effector control mode can optionally be used in conjunction with a fulcrum effect mode or a fulcrum effect correction mode, as described elsewhere herein.

[0087] Figure 1A and Figures 3A to 7 This shows the state of being in the fulcrum effect mode and in Figure 7The device 100 incorporates optional end effector control modes. The device 100 can further operate in a third mode, which is also described herein as a fulcrum effect correction (FEC) mode. Figure 8 As shown, device 100 can enter fulcrum effect correction mode by disengaging the handle 120 of control component 118 from instrument actuator interface 122 and translating the handle 120 backward along sleeve 140. In fulcrum effect correction mode, stabilizing device 102 can be locked. Translation of handle 120 along sleeve 140 can activate one or more sensorized joints 160a, 160b. These sensorized joints 160a, 160b may include one or more position sensors that measure the position of the respective joint 160a, 160b, which is received by the controller of instrument actuator interface 122. When device 100 is in FEC mode, instrument actuator interface 122 can adjust one or more driven joints 162a, 162b of medical device 106 to simulate the position of sensorized joints 160a, 160b and / or handle 120, such as... Figure 9 As shown. The FEC mode generates an analog control mapping in which input at handle 120 causes movement of one or more sensorized joints 160a, 160b. The position of each joint 160a, 160b is measured or monitored by a sensor assembly and received by a controller. The controller outputs actuation signals to one or more driven joints 162a, 162b respectively to position each joint 162a, 162b, simulating the position of each joint 160a, 160b. For example, the analog plane 95 used for the analog control mapping can be... Figure 1A At pivot point 124, or anywhere along the length of medical device 106. For example... Figure 1A The simulated plane 95 shown can be perpendicular to the longitudinal length of the medical device 106. The control described is more intuitive than that described for the fulcrum effect mode. For example, and referring to... Figure 9The driven joint 162b simulates the measured position of the sensorized joint 160a, and the driven joint 162a simulates the measured position of the sensorized joint 160b. Furthermore, the device responds to a measured leftward movement of the handle 120 by moving the end effector 114 to the left. Additionally, if a change in the pitch of the distal portion 112 of the medical device 106 is desired, the handle 120 can pitch in the desired pitch direction. The simulated motion of one or more driven joints 162a, 162b with respect to one or more sensorized joints 160a, 160b can be scaled. For example, the simulated motion of the sensorized joints 160a, 160b with respect to the driven joints 162a, 162b can be approximately 10:1, 8:1, 6:1, 4:1, 2:1, 1:1, 1:2, 1:4, 1:6, 1:8, or 1:10. The device 100 can be used in a fulcrum effect correction mode or in an end effector control mode. In other words, device 100 can utilize the distal portion 112 of medical device 106 to perform fulcrum effect correction motion, while simultaneously causing end effector 114 to perform pitch, yaw, and roll motions. Furthermore, when device 100 is in fulcrum effect correction mode, and when in fulcrum effect mode, propulsion ( Figure 5A ) and retraction ( Figure 5B Medical devices 106 (such as Figure 5A and Figure 5B (As indicated by arrow 123) may be useful. Medical device 106 can be coupled to device actuator interface 122, and device actuator interface 122 can be operatively coupled to cannula 140. The operative coupling of device actuator interface 122 to cannula 140 allows device actuator interface 122 to be driven along the length of cannula 140. Once coupled to medical device 106, driving device actuator interface 122 along cannula 140 causes medical device 106 to advance and retract along arrow 123, as shown. Figure 5A and Figure 5B As shown. In some embodiments, the position of the instrument actuator interface 122 along the length of the sleeve 140 is relative to the position of the handle 120 along the length of the proximal portion 170 of the sleeve 140. The proximal portion 170 of the sleeve 140 is the portion on the proximal side of the sensorized joint 160b. The proximal portion 170 of the sleeve 140 may include one or more position sensors. The position sensors measure the position of the sleeve 140 (i.e., the activated joints 160a, 160b) based on movement at the handle 120. The position signal is received by a controller, which in turn outputs a control signal to cause the instrument actuator interface 122 to drive the joints 162a, 162b to a simulated position, as described elsewhere herein.

[0088] Figure 2An embodiment of device 100 is depicted, in which a medical device 106 is being fitted into device 100. As shown, a cannula 140 is operatively coupled to a stabilizing device 102 or (in some embodiments) an element of the stabilizing device 102, the cannula defining a lumen 105 into which the elongated body of the medical device 106 can slide. A base portion 107 of the medical device 106 defines an aperture 109 that receives the cannula 140, but a portion of it is within the lumen 105 defined by the cannula 140. The medical device 106 can slide back and forth within the length of the cannula 140, but is locked within the cannula 140 to roll about the longitudinal axis 150 of the cannula 140 (see Figure 100). Figure 6 Rotation. As shown, the handle 120 defines an aperture 125 through which the base portion 107 of the medical device 106 passes. The aperture 125 of the handle 120 includes an interface 129 that mates with a slot 101 defined by the sleeve 140. In this configuration, when the handle 120 is disengaged from the device actuator interface 122, it is capable of sliding back and forth along the length of the sleeve 140, but about the roll axis 150 of the sleeve 140 (see Figure 120). Figure 6 Regarding the rotation of the sleeve 140, it is locked in the sleeve 140.

[0089] Figure 5A and Figure 5B An embodiment of device 100 is depicted, wherein propulsion ( Figure 5A ) and retraction ( Figure 5B The overall movement of medical device 106. When handle 120 is coupled to device actuator interface 122, which is further connected to medical device 106, medical device 106 can undergo overall movement. When handle 120 is coupled to device actuator interface 122, advancement or retraction of medical device 106 can occur during fulcrum effect mode. Advancement of medical device 106 (e.g., Figure 5A (as shown) and the retraction of medical device 106 (as shown) Figure 5B As shown, this can be accomplished during fulcrum effect mode by adjusting joints 104a, 104b, 108 of the stabilizing device 102. Some embodiments include a linear motion mode for sliding the handle 120 and the instrument actuator interface 122 when they are engaged and when joints 104a, 104b are locked. The linear motion mode can be entered by activating the input mechanism on the handle 120. The mechanism for sliding the handle 120 and the instrument actuator interface 122 up and down along the sleeve 140 can be implemented by placing the drive mechanism at the interface between the instrument actuator interface 122 and the sleeve 140 in a neutral position (i.e., disengaged from the power actuation unit). The stabilizing device 102 can be locked when the linear motion mode is independent of the fulcrum effect mode or the fulcrum effect correction mode.

[0090] When using a combination of linear motion mode and fulcrum effect mode, the frictional force at the actuator interface 122 and sleeve 140 (e.g., when the drive mechanism is in neutral) can be less than that at the joints 104a and 104b of the stabilizing device 102 (e.g., when the drive mechanism is in neutral). Figure 1A The frictional force at the point shown (adjusted for leverage) allows the instrument actuator interface 122, handle 120, and medical device 106 to advance and retract relative to the stabilizing device 102. To further facilitate fulcrum-effect mode movement of the stabilizing device joints 104a, 104b, the mechanism at the interface between the instrument actuator interface 122 and the sleeve 140 can have a braking mechanism controlled by an input mechanism on the handle 120. The braking mechanism at the interface between the instrument actuator interface 122 and the sleeve 140 can be normally engaged by default to facilitate independent fulcrum-effect mode movement. When the dedicated input mechanism engages, the braking mechanism disengages, thereby allowing linear motion mode movement. Alternatively, the opposite approach can be used. For example, the braking mechanism can be normally disengaged by default to facilitate linear motion mode movement, and activation of the dedicated input mechanism engages the braking mechanism, thereby canceling the linear motion mode. The braking mechanism can be a literal braking mechanism at the interface between the instrument actuator interface 122 and the sleeve 140 (e.g., those known in the art), or it can be the engagement of the mechanism at the interface between the instrument actuator interface 122 and the sleeve 140 with the power actuation unit.

[0091] The instrument actuator interface 122 may include one or more power actuation units 180, such as Figure 1C As shown. One such example of a power actuation unit can be responsible for translating the instrument actuator interface 122 along its actuation length 171 on the cannula 140. When a control signal for translating the instrument actuator interface 122 along the cannula 140 is received at the instrument actuator interface 122, an electric motor can be activated to power a linear motion mechanism to move the instrument actuator interface 122 relative to the cannula 140. For example, the linear motion mechanism can be a rack and pinion, wherein the rack is coupled to the cannula 140 and the pinion is coupled to and driven by the instrument actuator interface 122. Another example of a linear motion mechanism can be one or more wheels coupled to and driven by the instrument actuator interface 122. The one or more wheels have sufficient friction at the interface with the cannula 140 to induce linear motion when power is supplied to the one or more wheels. Additionally, when the medical device 106 is coupled to the instrument actuator interface 122, one or more drive actuators can be operatively coupled to one or more corresponding power actuation units 180 (e.g., Figure 1C(As shown). In some embodiments, such as during operation in end-effector control mode or fulcrum effect correction mode, these drive actuators housed in the base portion 107 of the medical device 106 are responsible for actuating the medical device 106. One or more drive actuators may interface with one or more corresponding power actuation units at the point where the device actuator interface 122 interfaces with the medical device 106. The transmission on this interface may be, for example, a gear-to-gear interface or a friction wheel-to-friction wheel interface.

[0092] like Figure 7 and Figure 9 As shown, the medical device 106 of the embodiments described herein can be actuated in a variety of ways. For example, in an embodiment where the medical device 106 is operatively coupled to a device actuator interface 122, the base portion 107 of the medical device 106 may include one or more drive actuators, wherein a drive system receives power transmission from one or more corresponding power actuation units via an interface with the device actuator interface 122. Each of the one or more drive actuators may include a cable reel or pulley and, when powered by a corresponding power actuation unit, tightens or loosens a cable or traction line inside or along the elongated body of the medical device 106. These cables or traction lines may be used for one or more actuation functions of the medical device 106, such as actuating an end effector 114 (e.g., a clamping or releasing gripping end effector), a rotation mechanism of the wrist assembly 116 of the end effector 114 (e.g., a gripping or releasing end effector), etc. Figure 6 As shown), the wrist mechanism that actuates the end effector 114 (such as...) Figure 7 (as shown), or manipulate drive joints 162a, 162b (as shown) Figure 9 (As shown). The drive joints in the above and following embodiments can be steerable. For example, the drive joint can have a universal joint mechanism, wherein a cable or traction line is anchored relative to the universal joint at the point of leverage. Tightening one or more of these cables anchored in this manner can create various joint connections. Steering joints can include planar joints, spatial joints, rolling joints, vertical joints, rotary rolling joints, planar sliding joints, vertical sliding joints, rotary sliding joints, vertical rolling sliding joints, planar rolling sliding joints, rotary rolling sliding joints, planar bending joints, vertical bending joints, and rotary bending joints. These steerable joints can be actuated by traction lines, cables, push rods, or concentric rotatable tubes.

[0093] Figure 10A , Figure 10B , Figure 11 and Figure 12 An embodiment of a fulcrum correction device is shown. The fulcrum correction device includes a stabilizing device 102, a linear guide 212, a medical device 206, and a control assembly 218. The stabilizing device 102 can function to... Figure 1AThe function of the stabilizing device 102 is illustrated in Figures 3 and 4. In embodiments with RCM functionality, the linear guide 212 can be considered part of the stabilizing device 102, causing joints 104a, 104b, and 205 to operate synchronously to maintain a remote center of motion, such as for… Figure 1A and Figures 3A to 4B The joints 104a, 104b, and 108 are described. Control assembly 218 may include a machine actuator interface 207, a handle bracket 204, and a handle 220. The handle 220 may serve as a main control input element and may include… Figure 1A Input mechanism 126 and Figure 6 Input mechanism 142. Input mechanisms 126 and 142 can be received by the controller and implemented onto the medical device 206 via the device actuator interface 207, such as for... Figure 6 and Figure 7 Described. This embodiment includes a linear guide 212 to which a device actuator interface 207 is operatively coupled, and a handle bracket 204 is operatively coupled to the linear guide. The linear guide 212 can be coupled to the device actuator interface 207 to limit the movement of the device actuator interface 207 to the length of the linear guide 212 (along path 209).

[0094] For example, and as Figure 10B As shown in the cross-section of the linear guide 212, the linear guide 212 may include an internal T-shaped track 290 along a portion of its length, which defines the shape of the top portion of the instrument actuator interface 207 (as shown in the image). Figure 10A (As shown). The handle bracket 204 can also be connected to the linear guide 212 in this way to limit the path 209 (as shown). Figure 10A The movement of (as shown). For example, the handle bracket 204 (as shown) Figure 10A The instrument actuator interface 207 (as shown) may include a top portion having a T-shape adapted to fit within an inner T-shaped track 290 within the linear guide 212. In the case where the handle bracket 204 includes a T-shaped top portion, the handle bracket 204 can be positioned within the inner T-shaped track 290 proximal to the top portion of the instrument actuator interface 207. Another example of the connection between the handle bracket 204 and the linear guide 212 can be an outer T-shaped track 294 defined by the linear guide 212 (e.g., ...). Figure 10B (As shown). The width 298 of the outer T-rail 294 may be greater than the width 296 of the inlet hole 292 defined by the inner T-rail 290. The handle bracket 204 may have a portion that slides into the outer T-rail 294, thereby restricting its movement along path 209 (as shown). Figure 10AThe movement of the device actuator interface 207 is shown. The device actuator interface 207 can interface with the internal T-rail 290 using wheels or rollers. The wheels or rollers of the device actuator interface 207 can provide a suitable interface for translating the device actuator interface 207 along path 209 and can be operatively coupled to one or more power actuation units within the device actuator interface 207. Additionally, the handle bracket 204 can interface with the linear guide rail 212 using wheels or rollers, whether via the internal T-rail 290 or the external T-rail 294. The wheels or rollers of the handle bracket 204 can assist in translating the handle bracket 204 along path 209. The handle bracket 204 can define a hole between the handle bracket 204 and the linear guide rail 212, which allows the end portion 208 of the medical device 206 and the device actuator interface 207 to pass through. By connecting the handle bracket 204 to... Figure 10B The external T-shaped track 294 and the hole allow the handle bracket 204 to pass over the medical device 206 and the device actuator interface 207. Furthermore, when installing the medical device 206, it can slide all the way to the device actuator interface 207 without interfering with the handle bracket 204.

[0095] Figure 10A , Figure 10B , Figure 11 and Figure 12 The embodiments include functionality for advancing and retracting the overall movement of the medical device 406. Furthermore, the overall movement of the medical device 406 can be accomplished when the handle 220 is coupled to the device actuator interface 207, which is further connected to the medical device 206. In some specific embodiments, when the handle 220 is coupled to the device actuator interface 207, the advancement or retraction of the medical device 206 can be performed during fulcrum effect mode by adjusting joints 104a, 104b, 205 of the stabilizing device 102. Alternatively, in some variations where the linear motion mode is independent of the FE mode and / or FEC mode, the linear motion mode can be entered by activating the input mechanism on the control assembly, wherein the handle 220 is coupled to the device actuator interface 207 and the stabilizing device 102 is locked simultaneously. The mechanism for sliding the handle 220 and the instrument actuator interface 207 up and down along the linear guide 212 can be provided by placing the drive mechanism at the interface between the instrument actuator interface 207 and the linear guide 212 in a neutral position (i.e., disengaged from the power actuation unit).

[0096] When the linear motion mode is independent of the fulcrum effect mode, the stabilizing device 102 can be locked. When the linear motion mode is used in combination with the fulcrum effect mode, the friction at the instrument actuator interface 207 and the linear guide 212 (e.g., when the drive mechanism is in neutral) can be less than the friction at the joints 104a, 104b of the stabilizing device 102 (considering leverage). This difference in friction allows the instrument actuator interface 207, handle 220, and medical device 206 to advance and retract relative to the stabilizing device 102. To further facilitate fulcrum effect mode movement of the stabilizing device joints 104a, 104b, the mechanism at the interface between the instrument actuator interface 207 and the linear guide 212 can have a locking mechanism controlled by an input mechanism on the handle 220. The locking mechanism at the interface between the instrument actuator interface 207 and the linear guide 212 can be normally engaged by default to facilitate independent fulcrum effect mode movement. When the dedicated input mechanism is engaged, the braking mechanism disengages, thereby allowing linear motion mode movement. The reverse method can also be used. For example, the braking mechanism can default to normal disengagement to facilitate linear motion mode movement, and the activation of the dedicated input mechanism engages the braking mechanism, thereby canceling the linear motion mode. The braking mechanism can be a literal braking mechanism (i.e., those known in the art), or it can be the engagement of the mechanism and the power actuation unit at the interface between the instrument actuator interface 207 and the linear guide 212.

[0097] Figure 10A An embodiment of a fulcrum correction device 200 in fulcrum effect mode is shown. As described elsewhere herein, control assembly 218 includes an instrument actuator interface 207 and a handle 220. A handle bracket 204 that ultimately secures the handle 220 is coupled to or connected to the instrument actuator interface 207. In fulcrum effect mode, the device can utilize a stabilizing device 102 (e.g., such as...) Figure 1A , Figures 3A to 4B Manipulation is performed using the degrees of freedom provided (as shown). A handle 220 connected to or attached to the actuator interface 207 enables operation in a fulcrum effect mode, allowing for overall movement at the handle 220.

[0098] Figure 11 This shows the switching to fulcrum effect correction mode. Figure 10A In this embodiment, the handle bracket 204 is detached from the instrument actuator interface 207 and is slidable on a portion of the instrument actuator interface 207 and the proximal end portion of the medical device 206 toward the proximal end 750 of the linear guide 212. (See embodiment 204.) Figure 11As shown, the device actuator interface 207 remains connected to the medical device 206. In this position, the linkage mechanism 308 is activated. The linkage mechanism 308 connects the handle 220 to the handle holder 204 and may include one or more sensorized joints. The linkage mechanism 308 can be unlocked when the handle 220 is in the appropriate position and the embodiment is in fulcrum effect correction mode.

[0099] Figure 12 A device 200 in fulcrum effect correction mode is shown, wherein a linkage 308 between a handle 220 and a handle holder 204 is unlocked. The linkage 308 is connected to the handle holder 204 via a first sensorized joint 309 (e.g., at or separate from the linkage 308) and to the handle 220 via a second sensorized joint 312. The position and / or orientation of the handle 220 can be measured by one or more position sensors of one or more sensorized joints 309, 312, and this measurement can be received by a controller. In response to the measured position of the sensorized joints 309, 312, the controller can send a control signal to actuate the device actuator interface 207 to move drive joints 162a, 162b, thereby positioning the distal portion 112 and / or end effector 114 of the medical device 106 to a position simulating the handle 220. Furthermore, in some embodiments, the linkage 308 may include two components that enable the handle 220 to extend or retract closer to or further away from the handle bracket 204. The telescopic joint may also include one or more position sensors, and the position of the telescopic joint measured by the one or more sensors may be received by a controller. The telescopic joint position measured by the one or more position sensors and received by the controller may be simulated by the position of the instrument actuator interface 207 relative to its position along the linear guide 212. The controller may receive the measured position of the telescopic joint and send control signals to the instrument actuator interface 207 to translate it distally and proximally along the length of path 209 (e.g., ...). Figure 10A(As shown). For example, pushing the handle 220 forward and shortening the measured length of the linkage 308 can cause the device actuator interface 207 to drive the medical device 206 away from the handle 220 and move it distally along path 209. Pulling the handle 220 away and extending the linkage 308 can cause the device actuator interface 207 to drive the medical device 206 toward the handle 220 and proximally along path 209. Alternatively, the position of the device actuator interface 207 relative to the linear guide 212 can be controlled by measuring the position of the handle bracket 204 relative to the linear guide 212. The interface between the handle bracket 204 and the linear guide 212 may include a position sensor (e.g., a roller with an encoder). The controller can receive the measured position of the handle bracket 204 and send control signals to the device actuator interface 207 to translate it distally and proximally along the length of path 209 (e.g., ...). Figure 10A (As shown). Furthermore, pushing the handle 220 forward causes the device actuator interface 207 to drive the medical device 206 away from the handle 220 and move it distally along path 209. Pulling the handle 220 away causes the device actuator interface 207 to drive the medical device 206 toward the handle 220 and proximally along path 209.

[0100] Alternatively, in FEC mode, the handle bracket 204 can be locked to the device actuator interface 207, thereby locking the proximal and distal movements of the handle 220 to the device actuator interface 207. In FEC mode, embodiments where the handle bracket 204 is locked to the device actuator interface 207 will allow the handle 220 to manipulate the medical device 206 for advance and retraction. In some specific implementations, locking the handle bracket 204 to the device actuator interface 207 creates or requires the fulfillment of preconditions, including one or more of the following: the scaling factor between the handle movement and the movement at the distal tip of the medical device is 1:1; the proximal joints of the handle and the distal joints of the medical device are similar in type and / or geometry; and / or the distal joints 162a, 162b can compensate for undesirable movements transmitted from the handle to the medical device.

[0101] The function of controlling the position of the device actuator interface 207 relative to the linear guide 212 allows the medical device 206 to be advanced and retracted during use in fulcrum effect correction mode. Additionally, some embodiments may include... Figure 19 The handle 220 is of the type described herein (i.e., handle 401). The position and orientation of the handle 220 can be measured, such as when targeting... Figure 19 Described.

[0102] Figure 13 , Figure 14 and Figure 15An embodiment of a fulcrum effect correction device 300 is depicted, which includes a control assembly 369, a first arcuate track 360, a second arcuate track 358, a control hub 366, an end effector interface 351, and a medical device 368. The control hub 366 may be supported by a mechanical or robotic support device that supports at least a portion of the weight of the device 300. The support device of the device 300 may also include a function to temporarily lock the control hub 366 of the device 300 in a certain position. Additionally, the support device may be similar to... Figure 1A and Figures 3A to 4B The stabilizing device 102 does not require the aforementioned RCM functionality. In other embodiments, the control hub 366 may be anchored to the bedside in other ways. The control hub 366 includes an instrument actuator interface 352, a sensorization mechanism 354, and a drive actuator 356. In some embodiments, the control hub 366, sensorization mechanism 354, and / or instrument actuator interface 352 may function as part of the stabilizing device. For example, the control hub 366 and / or sensorization mechanism 354 may include a rotary joint 104a (such as...). Figure 1A The function shown. For example, as illustrated. Figure 1A As shown in Figure 3, the control hub 366 and / or sensor mechanism 354 can allow yaw about an axis 130 relative to the instrument actuator interface 352 and perpendicular to the horizontal plane 94. Figure 3A and Figure 3B As shown, it performs a rotational motion 128 (e.g., about a yaw axis 130 perpendicular to the horizontal plane 94).

[0103] The drive actuator 356 and the sensorization mechanism 354 can be restricted to rotate independently about a concentric axis 355 relative to the instrument actuator interface 352. A first arcuate track 360 can be tracked within the sensorization mechanism 354. The interface between the first arcuate track 360 and the sensorization mechanism 354 can use one or more position sensors (e.g., rollers, potentiometers, etc., coupled to an optical encoder) to measure the position of the first arcuate track 360 relative to the sensorization mechanism 354. The interface between the sensorization mechanism 354 and the instrument actuator interface 352 can include one or more sensors (e.g., rollers and optical encoders, potentiometers, etc.) to measure the position of the sensorization mechanism 354 relative to the instrument actuator interface 352. A second arcuate track 358 is operatively coupled within the drive actuator 356. For example, the second arcuate track 358 can include a rack matching the arcuate shape of the second arcuate track 358, and the drive actuator 356 can include a pinion operatively coupled to the rack. Alternatively, the drive actuator 356 may include one or more friction wheels that contact the second arcuate track 358. Furthermore, the drive actuator 356 may be operatively coupled to the device actuator interface 352. For example, the drive actuator 356 may include a ring that engages with a pinion of the device actuator interface 352, or the device actuator interface 352 may include one or more friction wheels that contact the drive actuator 356. One or more power actuation units in the device actuator interface 352 may be operatively coupled to the pinion or one or more friction wheels at the interface of the drive actuator 356. Additionally, the drive actuator 356 may include one or more power actuation units coupled to the pinion or one or more wheels at the interface of the second arcuate track 358. Alternatively, the control hub 366 may include one or more mechanisms for manipulating each arcuate track and thereby manipulating the medical device, as described in WO2021046658, filed September 14, 2020, which is incorporated herein by reference in its entirety.

[0104] The control component 369 may include a handle 362, which is attached to a handle holder 364 via various sensorized joints 363, 365, and 367. The position of the handle 362 may be measured at one or more of the joints 363, 365, and 367. For example, sensorized joint 367 may measure the roll of the handle 362 about a roll axis 359; sensorized joint 363 may measure the pitch of the handle 362 about a pitch axis 361; and sensorized joint 365 may measure the yaw of the handle 362 about a yaw axis 357. The controller may receive the measured position of the handle 362 and may send corresponding control signals for control mode operation of the distal portion of the medical device.

[0105] for Figure 13 , Figure 14 and Figure 15 In an embodiment, the fulcrum effect correction device 300 can perform actions such as those targeting Figure 6 and Figure 7 The described end effector control mode operation is as follows, for example, in an embodiment including an end effector at the distal tip 370. The end effector control mode can be controlled based on a measured position of the handle 362 or one or more input mechanisms on the handle 362 or device 300. The end effector located at the distal tip 370 can be controlled using an end effector actuator interface 351. The end effector actuator interface 351 can be located on the medical device 368. The end effector actuator interface 351 can include one or more powered actuation units. The one or more powered actuation units can be combined as follows Figure 7 The actuated end effector. Additionally, the end effector actuator interface 351 can be coupled to the proximal portion 371 of the medical device 368, and the distal portion 373 of the medical device 368 can be operatively coupled to the end effector actuator interface 351. The operative coupling of the medical device 368 to the end effector actuator interface 351 allows the end effector actuator interface 351 to extend and retract the distal portion 373 of the medical device 368. The end effector actuator interface 351 may also include the function of rotating the distal portion 373 of the medical device 368 about a longitudinal axis 375. The extension and retraction of the distal portion 373 of the medical device 368 can be performed by one or more friction wheels in contact with the distal portion 373 of the medical device 368. One or more wheels for extending and retracting the distal portion 373 of the medical device 368 can be operatively coupled to an end effector actuator interface 351 and operatively coupled to one or more power actuation units within the end effector actuator interface 351. Additionally, rotation of the distal portion 373 of the medical device 368 about its longitudinal axis 375 can be achieved by one or more friction wheels in contact with the distal portion 373 of the medical device 368. One or more wheels for rotating the distal portion 373 of the medical device 368 can be operatively coupled to an end effector actuator interface 351 and operatively coupled to one or more power actuation units within the end effector actuator interface 351. The end effector actuator interface 351 can receive output signals from a controller that initiate end effector control mode processes.

[0106] Figure 13An embodiment of a fulcrum effect correction device in fulcrum effect mode is illustrated. A second arc track 358 can be coupled to a medical device 368. In fulcrum effect mode, arc tracks 358 and 360 are physically or virtually locked relative to each other. When the first arc track 360 slides in and out of the sensorization mechanism 354, the second arc track 358 slides in and out of the drive actuator 356. Simulated movement of the second arc track 358 relative to the first arc track 360 can be achieved by locking the first arc track 360 to the second arc track 358 and placing the drive mechanism at the interface between the drive actuator 356 and the second arc track 358 in neutral or an equivalent state. Alternatively, the first arc track 360 and the second arc track 358 can be virtually locked together. For example, the position of the first arc track 360 relative to the sensorization mechanism 354 can be measured by one or more sensors, and these measurements can be received by a controller. Upon receiving the position measurement value of the first arc track 360, the controller can send a control signal to the power actuator within the drive actuator, which moves the second arc track 358 to a corresponding position matching the position of the first arc track 360. Alternatively, the first arc track 360 and the second arc track 358 can be physically locked together, or virtually locked relative to their angular positions about the axis 355. As described above, locking the arc tracks 358 and 360 can be accomplished by physically locking the first arc track 360 to the second arc track 358 and placing the drive mechanism at the interface between the drive actuator 356 and the instrument actuator interface 352 in neutral or an equivalent state. Alternatively, the first arc track 360 and the second arc track 358 can be virtually locked together. For example, the angular position of the first arc track 360 relative to the instrument actuator interface 352 can be measured using one or more position sensors, and these measurements can be received by the controller. After receiving the angular position measurement value of the first arc track 360, the controller can send a control signal to the power actuator within the instrument actuator interface 352, which moves the second arc track 358 to a corresponding position matching the position of the first arc track 360. The movement of the second arc track 358 relative to the first arc track 360 can be proportional (i.e., 1:1) or scaled, such as 2:1, 1.5:1, 1.1:1, 1:1.1, 1:1.5, 1:2, etc. In the fulcrum effect mode, the distal tip 370 can include an end effector and can be like the previous embodiment (…). Figure 6 and Figure 7The end effector moves in the same fulcrum effect mode as the actuator. In other words, if handle 362 is pressed upward, the two arc-shaped tracks 360 and 358 move into the sensor mechanism 354 and the drive actuator 356, respectively, causing the distal tip 370 to move downward. If handle 362 is pressed to the left, the arc-shaped tracks 360 and 358 rotate about axis 355, causing the distal tip 370 to move to the right.

[0107] Figure 14 The device 300 in fulcrum effect correction mode is shown. When the input mechanism on the start handle 362 enters fulcrum effect correction mode, the arc tracks 360 and 358 are no longer locked together. As shown, when the handle 362 moves to the left, a position sensor at the interface between the instrument actuator interface 352 and the sensorization mechanism 354 measures the position change, and these measurements are received by the controller. Based on the position measurement, the controller outputs a control signal that activates the corresponding power actuation unit in the instrument actuator interface 352, which causes the drive actuator 356 to rotate about axis 355 to a position opposite in angle to the measured position of the handle 362. Additionally, when the handle 362 is pressed upwards, the first arc track 360 is pressed into the sensorization mechanism 354, and the sensorization mechanism 354 measures the position change via the position sensor. The position change measurement is received by the controller, and a corresponding output signal is sent to the instrument actuator interface 352 to drive the drive actuator 356 to move the second arc track 358 to the opposite position. Since the distal tip 370 is located opposite axis 355, moving the handle to the right will cause the distal tip 370 to move to the right, and moving the handle to the left will cause the distal tip 370 to move to the left. Based on the measured position of the first arc track 360, the reverse position change of the second arc track 358 can be proportional (i.e., 1:1) or scaled, such as 2:1, 1.5:1, 1.1:1, 1:1.1, 1:1.5, 1:2, etc. Therefore, this embodiment can perform fulcrum effect correction mode operation. Furthermore, for example, when an end effector is included on the distal tip 370, this embodiment can perform end effect control mode operation in fulcrum effect mode or fulcrum effect correction mode. The end effector is included on the distal tip 370 and... Figure 1A , Figure 6 and Figure 7 In the embodiment of the wrist mechanism connection, the end effector actuator interface 351 ( Figure 12 (As shown) can manipulate the end effector, such as for... Figure 7 As described. Additionally, the end effector actuator interface 351 can be used to actuate an end effector. For example, in an embodiment having a gripper-type end effector 114, as... Figure 1AAs shown, the end effector actuation interface 351 can induce the grasping action of the end effector 114. The actuation of the end effector can be performed after the end effector actuation interface 351 receives the corresponding output signal from the controller.

[0108] Figure 15 The illustration shows the rightward input movement of the handle 362 in this embodiment. Figure 14 As explained, the positional change of the handle 362 and the corresponding first arc track 360 will produce the opposite movement of the second arc track 358, causing the distal tip 370 to also move to the right.

[0109] Figures 16 to 25 An embodiment of a fulcrum effect correction device is shown, which includes a stabilizing device 102, a linear guide 412, a control assembly 415, and a medical device 406. The stabilizing device 102 may be... Figure 1A and Figures 3A to 4B The stabilizing device 102. For embodiments with RCM functionality, the linear guide 412 can be considered part of the stabilizing device 102, allowing joints 104a, 104b, and 205 to operate synchronously to maintain a remote center of motion, such as for... Figure 1A and Figures 3A to 4B Joints 104a, 104b, and 108 are described. Control assembly 415 includes a handle 401 coupled to a handle bracket 414 and a machine actuator interface 402. During fulcrum effect mode, the handle bracket 414 is coupled to multiple sensorized linkages housed within a linear guide rail 412. The handle 220 can serve as a main control input element and may include... Figure 1A Input mechanism 126 and Figure 6 Input mechanism 142. Input mechanisms 126 and 142 can be received by the controller and implemented onto the medical device 206 via the device actuator interface 207, such as for... Figure 6 and Figure 7 As described, the handle 401 and handle bracket 414 define an aperture through which the distal portion 404 of the medical device 406 can slide.

[0110] Figure 16 An embodiment of a fulcrum effect correction device in fulcrum effect mode is shown. The handle 401 is locked in the shown position by a release mechanism 410. The device 400 shown in fulcrum effect mode is capable of performing corrections for… Figure 1A and Figures 3A to 4B The described fulcrum effect pattern of motion.

[0111] Figure 17An embodiment of the fulcrum effect correction device switched to fulcrum effect correction mode is shown. The release mechanism 410 is released manually (as a latch) or electromechanically after a mode switching input mechanism is selected on the handle 401. Once the handle is released, multiple sensorized linkage mechanisms 416 (e.g., delta mechanisms) can slide out from within the linear guide 412 until the locking plate 420 engages. Once locked in this position, the device 100 is ready for fulcrum effect correction mode operation.

[0112] Figure 18 An embodiment of a fulcrum effect correction device in fulcrum effect correction mode is illustrated. Multiple sensorized linkages 416 (three are shown, but other numbers, such as two, four, etc., are contemplated herein) each include a first linkage 430 and a second linkage 432. The first linkage 430 is coupled to a locking plate 420 via a first sensorized joint 436. The first linkage 430 is coupled to the second linkage 432 via a second sensorized joint 438. The second linkage 432 is coupled to a handle bracket plate 434 via a third sensorized joint 440. Each of the multiple sensorized linkages 416 includes the sensorized joint function described elsewhere herein, and in doing so, the position of the handle 401 can be measured. These sensor measurements are received by a controller, which can output corresponding control signals to the device actuator interface 402 to actuate drive joints 162a, 162b using an end effector 114 to simulate the position of the handle 401. The sensors of multiple sensorized linkages 416 (e.g., delta mechanisms) are capable of measuring the handle 401 as a point in three-dimensional space. Therefore, the propulsion and retraction of the drive joints 162a, 162b of the medical device 406 and the device actuator interface 402, combined with the movement of the end effector 114, can simulate the position of the handle 401. The motion of the end effector 114 relative to the handle 401 can be proportional (i.e., 1:1) or scaled, such as 2:1, 1.5:1, 1.1:1, 1:1.1, 1:1.5, 1:2, etc.

[0113] Figure 19 The additional degrees of freedom that can be measured by the handle 401 are shown. The handle 401 can be a universal joint handle 401, which can be used to control the orientation mechanism of the end effector 114 during end effector control mode operation. As described above, the end effector 114 can rotate about the roll axis 150 (e.g., Figure 6 As shown), and the wrist mechanism of the end effector allows the end effector 114 to pitch about the pitch axis and yaw about the yaw axis (as shown). Figure 7(As shown). Handle 401 is rotatably coupled to sub-carrier 450 at a first joint 454, the sub-carrier being rotatably coupled to handle carrier 414 at a second joint 456, and handle carrier 414 being rotatably coupled to handle carrier plate 434 at a third joint 452. The first joint 454, second joint 456, and third joint 452 enable device 400 to generate motion that will be simulated by end effector 114. Furthermore, the first joint 454, second joint 456, and third joint 452 may include position sensors capable of measuring the position of each joint 454, 456, 452. For example, the first joint 454 may measure the roll of handle 401 about roll axis 490; the second joint 456 may measure the pitch of handle 401 about pitch axis 494; and the third joint 452 may measure the yaw of handle 401 about yaw axis 492. A controller receiving these position measurements can then generate control signals (such as for...). Figure 6 and Figure 7 (As described), to adjust the end effector 114 in such a way as to simulate the orientation of the handle 401.

[0114] Figures 16 to 25 Embodiments include functions for advancing and retracting the overall movement of the medical device 406. When the handle 401 is connected to the device actuator interface 402, the overall adjustment of the medical device 406 can be performed as directed... Figure 10A , Figure 10B , Figure 11 and Figure 12 The implementation.

[0115] Figure 20 An enlarged view of the release mechanism 410 of an embodiment of the fulcrum effect correction device 300 is shown. The sub-bracket 450 is removably coupled to the instrument actuator interface 402 via the release mechanism 410. When coupled to the instrument actuator interface, the second joint 456 and the third joint 452 ( Figure 19 (As shown) is fixed and locked to prevent rotation. Locking the handle 401 in this way may be advantageous when manipulating the device 300 in fulcrum effect mode. Figure 21A and Figure 21B This demonstrates that the handle 401 retains its roll input function even when locked in fulcrum effect mode. Because when the sub-bracket 450 ( Figure 19 and Figure 20 (As shown) Locked to release mechanism 410 ( Figure 16 When (as shown), the first joint 454 ( Figure 19 and Figure 20(As shown) remains unlocked, so handle 401 can still be used to induce roll, which is measured by first joint 454 and received by controller. Based on the roll measurement received by controller, controller can send control output to instrument actuator interface 402 to actuate end effector 114 to generate roll, simulating the roll position of handle 401.

[0116] Figure 22A and Figure 22B Another possible control input mechanism for actuating an end effector is shown. For example, a snap ring end effector 114 ( Figure 6 (As shown) can simulate the positions of propellers 470 and 472. Propellers 470 and 472, located near the handle, can be biased to the open position (as shown). Figure 22A (As shown). Bias on paddles 470 and 472 can be achieved by applying springs to paddle hinges 474 and 476. Furthermore, paddle hinges 474 and 476 may include position sensors (e.g., potentiometers). By receiving position measurements from the position sensors in paddle hinges 474 and 476, the controller can output corresponding control signals to the instrument actuator interface to manipulate the end effector, thus simulating the position of paddles 470 and 472. In other words, when the paddles are pressed together, the device response will, for example, cause the clamping of a snap-ring end effector. Conversely, when the paddles are released, the device response will, for example, cause the opening of a snap-ring end effector.

[0117] Figure 23A and Figure 23B The process of mounting a medical device 406 to an embodiment of a fulcrum effect correction device is illustrated. As shown, a sub-bracket 450 defines an aperture 451 that allows the distal end portion 407 of the medical device 406 to pass between the sub-bracket 450 and the linear guide 412. The medical device 406 has an elongated portion 409 that, when inserted into an aperture defined in the device actuator interface 402, allows the medical device 406 to slide in until the distal end portion 407 reaches contact with the device actuator interface 402. At the contact point, the medical device 406 is operatively coupled to the device actuator interface 402. Replacing the medical device 406 may require disengaging the medical device 406 from the device actuator interface 402. Disengagement can be manual or electromechanical, with the control input mechanism located on or near a handle 401. Once disengaged, medical device 406 can slide out of device actuator interface 402, and a new medical device can then be installed and operatively coupled to device actuator interface 402.

[0118] Figure 24A , Figure 24B and Figure 24C It shows Figures 16 to 20 The degrees of freedom of the handle in the embodiment. For example, Figure 24A The neutral position of handle 401 is shown. Figure 24B The rotation of handle 401 about yaw axis 492 is shown, and Figure 24C The rotation of handle 401 about pitch axis 496 is shown. Figure 19 The motion shown is described and the corresponding position measurements are shown.

[0119] Figure 25 An embodiment of a fulcrum effect correction device with a transparent linear guide 412 is shown. The illustration depicts a plurality of sensorized linkages 416 in a folded state, at least partially housed within a hollow aperture defined by the linear guide 412. Furthermore, a locking plate 420 and a handle bracket plate 434 may also be at least partially housed within the hollow aperture defined by the linear guide 412.

[0120] Figure 26 , Figure 27 and Figure 28 An embodiment of a fulcrum effect correction device 600 is shown, which includes a stabilizing device 102, a linear guide 614, an instrument actuator interface 602, a medical device 606, a sensor component 601, and a handle 401. This embodiment may include the stabilizing device 102, the performance of which is similar to... Figure 1A and Figures 3A to 4B The stabilizing device 102 may be the same as any other bedside configuration or device known in the art. For embodiments with RCM functionality, the linear guide 614 may be considered part of the stabilizing device 102, causing joints 104a, 104b, 205 to operate synchronously to maintain a remote center of motion, such as for… Figure 1A and Figures 3A to 4B The joints 104a, 104b, and 108 are described. The instrument actuator interface 602 can manipulate the drive joints 162a and 162b and the end effector 114, as described for... Figures 16 to 25 The description continues. Additionally, handle 401 and its orientation can be used in end effector control modes, such as those for... Figure 19 , Figure 21A , Figure 21B , Figure 22A and Figure 22B The description. Furthermore, medical device 606 can be used as targeted at... Figure 23A and Figure 23B The description describes the installation or replacement.

[0121] Figure 26 An embodiment of a fulcrum effect correction device 600 in fulcrum effect correction mode is shown. This embodiment utilizes a sensorized component 601, in conjunction with a plurality of sensorized linkage mechanisms described herein ( Figures 16 to 25Similarly, the sensorized component is housed within and extends from the linear guide 614. The sensorized component 601 may include a first linkage 608 and a second linkage 610. The first linkage 608 is coupled to the second linkage 610 via a first sensorized joint 603. The second linkage 610 is coupled to the handle bracket plate 616 via a second sensorized joint 604. When in fulcrum effect correction mode, as depicted, the position of the handle 401 can be measured by the first sensorized joint 603 and the second sensorized joint 604. These position measurements can be received by a controller, and in response, the controller can output control signals to the instrument actuator interface 602 to manipulate drive joints 162a, 162b to simulate the position of the handle 401. Furthermore, the device may include a slide plate 612 capable of sliding within and relative to the linear guide 614 to different positions. The slide plate 612 may include a position sensor that measures the position of the slide plate 612 relative to the linear guide 614. The instrument actuator interface 602, operably coupled to the linear guide 614, can translate back and forth along the length of the linear guide 614, thereby advancing or retracting the medical device 606. The controller can receive the position measured by a sensor on the slide plate 612 and output a control signal to change the position of the instrument actuator interface 602, thus simulating the position adjustment of the slide plate 612. With this function, when the handle 401 is manipulated towards the instrument actuator interface 602, the controller can output a control signal to the instrument actuator interface 602 to push the medical device 606 away from the handle 401. If the handle 401 is pulled away from the instrument actuator interface 602, the controller can output a control signal to the instrument actuator interface 602 to pull or manipulate the medical device 606 towards the handle 401. Figure 27 An embodiment is shown in which the sliding plate 612 is pressed closer to the instrument actuator interface 602. Accordingly, the instrument actuator interface 602 has moved distally along the linear guide 614 in direction 755, away from the handle 401. Figure 28 Further shown Figure 27The configuration includes a transparent linear guide 614 to display the position of the sliding plate 612 and the position of a portion of the first linkage 608 within the linear guide 614. Some embodiments may include a manually slidable instrument actuator interface 602 to advance and retract the medical device 606. In these embodiments, the sliding plate 612 may be coupled to the instrument actuator interface 602 when the handle is slid backward during FEC mode. For example, the sliding plate 612 may slide within a tube 757 coupled to the instrument actuator interface 602 and may be locked to the tube 757 at its proximal end. When the sliding plate 612 is locked to the tube 757 coupled to the instrument actuator interface 602, pressing the handle 401 proximally moves the medical device 606 proximally, and pulling the handle 401 moves the medical device 606 distally.

[0122] Figure 29 An embodiment of a fulcrum effect correction device 600 is shown, which includes a first handle 702 and a second handle 704. The first handle 702 is operable in fulcrum effect mode. The second handle 704 is also used in fulcrum effect correction mode. Therefore, the first handle 702 can be used when the device is set to operate in fulcrum effect mode via manual input or an input that generates an electromechanical mode switch. Furthermore, the first handle 702 may have the end effector control mode control function described herein to perform end effector control mode operation during fulcrum effect mode operation. The second handle 704 can be used when the device is set to operate in fulcrum effect correction mode via manual input or an input that generates an electromechanical mode switch. Furthermore, the second handle 704 may have the end effector control mode function described herein to perform end effector control mode operation during fulcrum effect correction mode operation. The fulcrum effect correction mode operation can be performed as described for… Figure 17 , Figure 18 and Figure 19 Described.

[0123] method like Figure 30 As shown, a method for performing minimally invasive surgery includes: in block S802, positioning an elongated body of a medical device using an attached handle for manual movement about a pivot point (i.e., a remote center of motion); and in block S804, controlling the position of a distal end of the medical device by reverse movement of the proximal end of the medical device (e.g., pivoting about the pivot point). This method is used to control the position of the distal end of the medical device (optionally including an end effector) during a minimally invasive procedure in a fulcrum effect mode. In some embodiments, the method is used to switch control modes (e.g., switch to a fulcrum effect correction mode, which will be relative to...) Figure 31(As described) Positioning the medical device in the appropriate location beforehand. This method is used in the surgical field but can be used alternatively or as a substitute for any suitable application, clinical or other field. The method can be configured and / or adapted for any suitable operation or procedure.

[0124] like Figure 30 As shown, one embodiment of a method for performing minimally invasive surgery includes block S802, which details the use of an attached handle to position the elongated body of a medical device for manual movement about a pivot point. Block S802 is used to introduce the distal end of the medical device into the surgical site or to control the distal end of the medical device near the surgical site. For example, regarding... Figure 1A and Figures 3A to 4B As described, the stabilizing device can be used to support at least a portion of the weight of the control components and the medical device. The stabilizing device provides the necessary degrees of freedom to manipulate the medical device to a position suitable for surgical use. The stabilizing device can be locked in any position suitable for operation. Positions suitable for surgical use can include overall movement in three-dimensional space and / or insertion of an elongated portion of the medical device into the access site or incision via a cannula or other means.

[0125] like Figure 30 As shown, one embodiment of a method for performing minimally invasive surgery includes block S804, which details controlling the position of the distal end of a medical device by a reverse input movement of a handle at the proximal end of the medical device. Block S804 is used to control the distal portion of the medical device in a fulcrum effect mode. The fulcrum effect mode defines the reverse pivoting control of the distal portion of the medical device relative to the handle. In other words, a leftward change in the handle position (also known as the input position) results in a rightward change in the distal end position (also known as the output position). Furthermore, an upward change in the handle position results in a downward change in the distal end position.

[0126] Figures 1A to 10A and Figures 11 to 29 Any device in the illustrated apparatus may be operable or configured to be relative to Figure 30 The description and operation are carried out under the fulcrum effect mode as described elsewhere in this document.

[0127] like Figure 31As shown, a method for performing minimally invasive surgery includes: in block S902, positioning an elongated body of a medical device using an attached handle such that the distal portion of the medical device is separated from the proximal portion by a pivot point; in block S904, activating a sensor assembly and a power actuation unit communicating with the medical device; in block S906, measuring the position of the handle and / or one or more joints using the sensor assembly; and in block S908, actuating the distal portion of the medical device to simulate the position of the handle about the pivot point. This method is used to control the position of the distal portion of the medical device during a minimally invasive procedure in a pivot effect correction mode. The pivot effect correction mode defines the corresponding control of the distal end of the medical device relative to the handle. In other words, a leftward change in the handle's position (also called the input position) results in a leftward change in the distal end of the medical device's position (also called the output position). Furthermore, an upward change in the distal end of the medical device's position results in an upward change in the distal end of the medical device's position. The simulated movement of the distal end of the medical device relative to the handle can be scaled. This method is intended for use in the surgical field, but may be used alternatively or as a substitute for any suitable application, clinical or other field. The method can be configured and / or adapted for any suitable operation or procedure.

[0128] like Figure 31 As shown, one embodiment of a method for performing minimally invasive surgery includes block S902, which uses an attached handle to position an elongated body of a medical device such that the distal portion of the medical device is separated from the proximal portion by a pivot point. Block S902 is used to introduce the distal end of the medical device (with an optional end effector) into or near the surgical site, reaching a position suitable for surgical use. A suitable position for surgical use may be achieved by inserting the elongated portion of the medical device into an access site or incision via a cannula or other means, such that a first portion of the medical device is within the incision (e.g., distal), and a second portion is outside the incision (e.g., proximal). This forms a pivot point (e.g., a remote center of motion). When the medical device is in this position, embodiments employing a stabilizing device can then lock at least a portion of the stabilizing device, as for... Figure 8 and Figure 9 The described stabilizing device locks the device into fulcrum effect correction mode operation. In some implementations, the user can perform all adjustments and locks of the stabilizing device without removing the control hand from the handle.

[0129] like Figure 31As shown, one embodiment of a method for performing minimally invasive surgery includes block S904, which details the activation of sensor components and a power actuation unit communicating with a medical device. Block S904 is used to switch to a fulcrum effect correction mode. The mode switching can be performed without the user removing their hand from the handle. In some embodiments, switching to the fulcrum effect correction mode is accomplished by activating a control input on the handle; when the controller receives this control input, it sends a control signal to activate the sensor components and the power actuation unit communicating with the medical device. In some embodiments, switching to the fulcrum effect correction mode is accomplished by unlocking the handle and sliding it proximally to a position suitable for the fulcrum effect correction mode. Furthermore, sliding the handle distally can unlock it, thereby activating the sensor components.

[0130] like Figure 31 As shown, one embodiment of a method for performing minimally invasive surgery includes block S906, which details the use of a sensor assembly to measure or monitor the position of a handle and / or one or more joints. Block S906 is used to map the position of the handle and / or one or more joints. The mapping of the position of the handle and / or one or more joints is performed by one or more sensors of the sensor assembly (e.g., Figure 9 The sensor-based joints 160a and 160b are used for measurement, and the controller receives the measured values.

[0131] like Figure 31 As shown, one embodiment of a method for performing minimally invasive surgery includes block S908, which details the distal portion of an actuating medical device to simulate the position of a handle and / or one or more joints about a pivot point. Block S908 is used to simulate the position of the handle and / or one or more joints by moving the distal portion of the medical device to a position and / or orientation equal to or proportionally matched to the position and / or orientation of the handle and / or one or more joints (e.g., Figure 9 (As shown). Additionally, it can be found... Figure 1A An example is shown where a simulated plane 95 is formed at pivot point 124, around which simulated motion is performed. In some implementations, the pivot effect correction mode operation may not require the user to remove their hand from the handle.

[0132] Figures 1A to 10A and Figures 11 to 29 Any device in the illustrated apparatus may be operable or configured to be relative to Figure 31 The description and operation are performed in the fulcrum effect correction mode as described elsewhere in this document.

[0133] The preferred embodiments and variations of the systems and methods may be at least partially embodied and / or implemented as a machine configured to receive a computer-readable medium storing computer-readable instructions. The instructions are preferably executed by a computer-executable component, which is preferably integrated with one or more portions of a processor in a system and controller and / or computing device. The computer-readable medium may be stored on any suitable computer-readable medium, such as RAM, ROM, flash memory, EEPROM, optical devices (e.g., CDs or DVDs), hard disk drives, floppy disk drives, or any suitable device. The computer-executable component is preferably a general-purpose or special-purpose processor, but any suitable special-purpose hardware or hardware / firmware combination may alternatively or additionally execute the instructions.

[0134] The references to "an embodiment," "an embodiment," "an exemplary embodiment," "some embodiments," etc., in this specification indicate that the described embodiments may include specific features, structures, or characteristics, but each embodiment may or may not include specific features, structures, or characteristics. Furthermore, such phrases do not necessarily refer to the same embodiment. Additionally, when a specific feature, structure, or characteristic is described in connection with an embodiment, it should be understood that those skilled in the art know that combining it with other embodiments can affect such features, structures, or characteristics, whether explicitly described or not.

[0135] Unless explicitly stated in the context, as used in the specification and claims, the singular forms “a,” “an,” and “the” include both singular and plural references. For example, the term “powered actuation unit” may include and contemplate including multiple powered actuation units. Sometimes, the claims and disclosure may include terms such as “a plurality,” “one or more,” or “at least one”; however, the absence of these terms is not intended to mean, nor should be construed as, that a plurality is not contemplated.

[0136] The terms “about” or “approximately”, when used before a numerical name or range (e.g., specifying length or pressure), indicate an approximate value that may vary by (+) or (-) 5%, 1%, or 0.1%. All numerical ranges provided herein include the beginning and end figures of the statement. The term “substantially” means substantially (i.e., greater than 50%) or substantially all of a device, substance, or composition.

[0137] As used herein, the terms "comprising" or "comprises" are intended to mean that an apparatus, system, or method includes the listed elements and may additionally include any other elements. "Substantially constitutes" means that the apparatus, system, or method includes the listed elements and excludes other elements essential to the combination for this purpose. Therefore, a system or method substantially constitutes the elements defined herein does not exclude other materials, features, or steps that do not materially affect the essential and novel features of the claimed disclosure. "Constitutes" means that the apparatus, system, or method includes the listed elements and excludes any elements or steps that are more than trivial or unimportant. Embodiments defined by each of these transitional terms are within the scope of this disclosure.

[0138] The examples and illustrations contained herein are shown by way of example and do not limit the specific embodiments in which the subject matter can be practiced. Other embodiments may be utilized and derived therefrom, allowing for structural and logical substitutions and changes without departing from the scope of this disclosure. These embodiments of the subject matter of the invention may be referred to individually or collectively herein as the term "invention," which is merely for convenience, and if more than one invention or inventive concept is actually disclosed, this is not intended to voluntarily limit the scope of this application to any single invention or inventive concept. Thus, although specific embodiments have been shown and described herein, any arrangement intended to achieve the same purpose may replace the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of the various embodiments. Combinations of the above embodiments and other embodiments not specifically described herein will be apparent to those skilled in the art upon reading the above description.

[0139] Example Example 1. A system for performing minimally invasive surgery, comprising: a stabilizing device configurable between an unlocked state and a locked state; a control assembly including: a handle pivotally coupled to the stabilizing device and including one or more sensorized joints; and an instrument actuator interface configured to be reversibly coupled to the handle; a medical device coupled to and operable by the handle, the medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints; and an end effector coupled to the distal portion; wherein, in a first mode, the stabilizing device is configured to be in an unlocked state, such that the medical device can be operable by the handle about a pivot point or in a first three-dimensional space; wherein, in a second mode, the handle is configured to operable the end effector of the medical device; and wherein, in a third mode, the stabilizing device is configured to be in a locked state, and such that the handle can cause movement of one or more sensorized joints, such that movement of one or more sensorized joints causes corresponding distal movement of one or more distal joints of the medical device about a pivot point.

[0140] Example 2. The system according to any of the foregoing examples (especially Example 1), wherein, in a first mode, the handle is connected to the instrument actuator interface.

[0141] Example 3. A system according to any of the foregoing examples (particularly Example 2), wherein a first input of the handle is configured to manipulate an end effector of a medical device.

[0142] Example 4. A system according to any of the foregoing examples (particularly Example 3), wherein a first or second input of the handle is configured to cause the elongated body to roll about the longitudinal axis of the medical device.

[0143] Example 5. The system according to any of the foregoing examples (especially Example 1), wherein the stabilizing device includes one or more joints, and wherein the manipulation of the elongated body of the medical device in a first three-dimensional space includes movement of the medical device about the yaw axis of one or more joints of the stabilizing device.

[0144] Example 6. A system according to any of the foregoing examples (particularly Example 1), wherein manipulation of the elongated body of the medical device in a first three-dimensional space includes insertion or retraction of the medical device relative to a stabilizing device.

[0145] Example 7. The system according to any of the foregoing examples (especially Example 1), wherein the handle includes an input element configured to switch between a first mode, a second mode, and a third mode.

[0146] Example 8. The system according to any of the foregoing examples (especially Example 1), wherein the handle includes a first input element configured to manipulate the end effector of a medical device in a second mode.

[0147] Example 9. A system according to any of the foregoing examples (particularly Example 8), wherein a first input element is operable about a pitch axis, roll axis or yaw axis associated with the first input element to operate an end effector of a medical device in a second mode.

[0148] Example 10. A system according to any of the preceding examples (especially Example 9), wherein manipulating the first input element about the pitch axis of the first input element causes a corresponding movement of the end effector about the pitch axis of the end effector.

[0149] Example 11. A system according to any of the foregoing examples (particularly Example 9), wherein manipulating the first input element about the yaw axis of the first input element causes a corresponding movement of the end effector about the end effector yaw axis.

[0150] Example 12. A system according to any of the foregoing examples (particularly Example 9), wherein manipulating the first input element about the roll axis of the first input element causes a corresponding movement of the end effector about the roll axis of the end effector.

[0151] Example 13. A system according to any of the foregoing examples (particularly Example 1), wherein the pivot point includes a remote pivot point configured to be located near or within the cannula through which the medical device is inserted during the procedure.

[0152] Example 14. A system according to any of the foregoing examples (particularly Example 1), wherein one or more sensorized joints include sensor assemblies, and the instrument actuator interface includes a power actuation unit and a controller communicatively connected to the sensor assemblies and the power actuation unit.

[0153] Example 15. The system according to any of the foregoing examples (particularly Example 14), wherein the sensor assembly is configured to monitor at least a first position of one or more sensorized joints and generate a corresponding sensor signal; the controller is configured to receive the corresponding sensor signal and generate a corresponding control signal; and the power actuation unit is configured to receive the corresponding control signal and actuate one or more distal joints based on the first position to cause translation of one or more distal joints.

[0154] Example 16. The system according to any of the foregoing examples (especially Example 1), wherein the handle includes a sleeve comprising one or more sensorized joints, and wherein the handle is configured to manipulate the sleeve to cause movement of one or more sensorized joints.

[0155] Example 17. The system according to any of the foregoing examples (especially Example 1), wherein the handle is coupled to the proximal portion of the medical device.

[0156] Example 18. The system according to any of the foregoing examples (especially Example 1), wherein, in the third mode, the handle is configured to be detached from the instrument actuator interface.

[0157] Example 19. A system for performing minimally invasive surgery, comprising: an elongated body including a distal end having an end effector and one or more distal joints, and a proximal end opposite the distal end; a handle configured to receive the proximal end of the elongated body, wherein the handle includes a cannula including one or more sensorized joints; a sensor assembly configured to monitor the position of each of the one or more sensorized joints; and an instrument actuator interface coupled to the cannula of the handle, and including: a power actuation unit; and a controller communicatively connected to the sensor assembly and the power actuation unit, wherein: the sensor assembly is configured to monitor at least a first position of one or more sensorized joints and generate a corresponding sensor signal, wherein the first position is based on proximal movement of the handle; the controller is configured to receive the corresponding sensor signal and generate a corresponding control signal; and the power actuation unit is configured to receive the corresponding control signal and actuate one or more distal joints based on the first position of one or more sensorized joints to cause translation of one or more distal joints.

[0158] Example 20. The system according to any of the foregoing examples (especially Example 19) further includes a stabilizing device capable of switching between an unlocked state and a locked state.

[0159] Example 21. The system according to any of the foregoing examples (especially Example 20), wherein the stabilizing device is configured to be locked when the power actuation unit actuates one or more distal joints to cause translation.

[0160] Example 22. A system according to any of the foregoing examples (particularly Example 21), wherein one or more distal joints are configured to be manipulated about a remote pivot point.

[0161] Example 23. A system according to any of the foregoing examples (particularly Example 22), wherein a remote pivot point is configured to align with a cannula needle through which an elongated body is inserted during the procedure.

[0162] Example 24. A system for minimally invasive surgery, comprising: a medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints, and an end effector; and a control assembly including: a handle configured to be coupled to the proximal portion of the medical device and to manipulate the medical device, wherein the handle includes one or more sensorized joints, and a device actuator interface configured to be reversibly coupled to the handle, wherein the system is configured to selectively operate in a first control mode or a second control mode, and wherein selecting between the first control mode and the second control mode includes modifying the range of motion associated with the one or more sensorized joints.

[0163] Example 25. A system according to any of the preceding examples (particularly Example 24), wherein: the first control mode is a fulcrum effect mode, wherein a first input of the handle is configured to manipulate the end effector of a medical device; and the second control mode is a fulcrum correction mode, wherein one or more sensorized joints of the handle are movable, such that manipulation of the handle causes movement of one or more sensorized joints, which causes one or more distal joints to move at least about a predefined pivot point or a corresponding distal movement in a predefined three-dimensional space.

[0164] Example 26. The system according to any of the foregoing examples (particularly Example 25), wherein, in a first control mode, a first input or a second input is configured to cause the elongated body to roll about the longitudinal axis of the medical device.

[0165] Example 27. A system for performing minimally invasive surgery, comprising: a control assembly including: a handle pivotally coupled to a bedside device, wherein the handle includes one or more sensorized joints, and an instrument actuator interface; and a medical device coupled to and operable by the handle, the medical device including: an elongated body having a proximal portion and a distal portion including one or more distal joints, wherein, in a fulcrum effect mode, mechanical movement of the handle coupled to the proximal portion of the medical device causes movement of the medical device about a pivot point, and wherein, in a fulcrum correction mode: the pivot point is between one or more sensorized joints of the handle and one or more distal joints of the medical device, and actuation of the handle causes movement of one or more sensorized joints, thereby causing the instrument actuator interface to map the movement to a corresponding distal movement of one or more distal joints at least about the pivot point.

[0166] Example 28. A method for performing minimally invasive surgery, comprising: in a fulcrum effect mode: receiving a first input at a handle coupled to a medical device, wherein the first input causes manual movement of the medical device about a pivot point, wherein the pivot point is between a distal portion and a proximal portion of the medical device; and in a fulcrum correction mode: activating a control device at the handle, the control device being configured to engage a sensor assembly and a power actuation unit in communication with the medical device for electronically assisted movement; using the sensor assembly communicatively coupled to the controller to monitor the position of one or more sensorized joints of the handle; and in response to a change in position detected by the sensor assembly, using the power actuation unit to cause translation of the distal portion of the medical device, wherein the translation of the distal portion of the medical device is based on the position of one or more sensorized joints.

[0167] Example 29. The method according to any of the preceding examples (especially Example 28), wherein one or more sensorized joints are proximal to the pivot point.

[0168] Example 30. A handle configured for mounting at the bedside of a patient support device and for performing minimally invasive surgery, the handle comprising: a first input mechanism configured to select a fulcrum effect mode, wherein the handle is configured to be attached to a medical device mechanically movable about a pivot point; and a second input mechanism configured to select a fulcrum correction mode, wherein selection of the second input mechanism is configured to activate a sensor assembly, a power actuation unit, and a controller communicatively coupled to the power actuation unit and the sensor assembly.

[0169] Example 31. A handle according to any of the foregoing examples (particularly Example 30), wherein the first input mechanism includes a first grip portion of the handle; and the second input mechanism includes a second grip portion of the handle.

[0170] Example 32. A handle according to any of the foregoing examples (particularly Example 30), wherein the first input mechanism includes a button, a joystick, or a grip portion of the handle; and the second input mechanism includes a second button.

Claims

1. A system for performing minimally invasive surgery, the system comprising: A stabilizing device that can switch between an unlocked state and a locked state; Control component, the control component includes: A handle, pivotally coupled to the stabilizing device and including one or more sensorized joints, and A device actuator interface configured to be reversibly coupled to the handle. A medical device, the medical device being coupled to and operable by the handle, the medical device comprising: An elongated body having a proximal portion and a distal portion including one or more distal joints, and An end effector, the end effector being coupled to the distal portion; and In the first mode, the stabilizing device is configured to be in the unlocked state, so that the medical device can be manipulated by the handle around the pivot point or in a first three-dimensional space. In the second mode, the handle is configured to manipulate the end effector of the medical device, and In the third mode, the stabilizing device is configured to be in the locked state, and the handle is configured to cause movement of the one or more sensorized joints, such that the movement of the one or more sensorized joints causes corresponding distal movement of the one or more distal joints of the medical device about the pivot point.

2. The system according to claim 1, wherein, In the first mode, the handle is connected to the instrument actuator interface.

3. The system of claim 2, wherein the first input of the handle is configured to manipulate the end effector of the medical device.

4. The system of claim 3, wherein the first or second input of the handle is configured to cause the elongated body to roll about the longitudinal axis of the medical device.

5. The system of claim 1, wherein the stabilizing device comprises one or more joints, and wherein the manipulation of the elongated body of the medical device in the first three-dimensional space comprises movement of the medical device about a yaw axis of the one or more joints of the stabilizing device.

6. The system of claim 1, wherein the manipulation of the elongated body of the medical device in the first three-dimensional space comprises the insertion or retraction of the medical device relative to the stabilizing device.

7. The system of claim 1, wherein the handle includes an input element configured to switch between the first mode, the second mode and the third mode.

8. The system of claim 1, wherein the handle includes a first input element configured to manipulate the end effector of the medical device in the second mode.

9. The system of claim 8, wherein the first input element is operable about a pitch axis, roll axis, or yaw axis associated with the first input element to operate the end effector of the medical device in the second mode.

10. The system of claim 9, wherein manipulating the first input element about the pitch axis of the first input element causes a corresponding movement of the end effector about the pitch axis of the end effector.

11. The system of claim 9, wherein manipulating the first input element about the yaw axis of the first input element causes a corresponding movement of the end effector about the end effector yaw axis.

12. The system of claim 9, wherein manipulating the first input element about the roll axis of the first input element causes a corresponding movement of the end effector about the end effector roll axis.

13. The system of claim 1, wherein the pivot point includes a remote pivot point configured to be located near or within the cannula, through which the medical device is inserted during the procedure.

14. The system of claim 1, wherein the one or more sensorized joints include a sensor assembly, and the instrument actuator interface includes a power actuation unit and a controller, the controller being communicatively connected to the sensor assembly and the power actuation unit.

15. The system of claim 14, wherein the sensor assembly is configured to at least monitor a first position of the one or more sensorized joints and generate a corresponding sensor signal; the controller is configured to receive the corresponding sensor signal and generate a corresponding control signal; and the power actuation unit is configured to receive the corresponding control signal and actuate the one or more distal joints based on the first position to cause translation of the one or more distal joints.

16. The system of claim 1, wherein the handle includes a sleeve comprising the one or more sensorized joints, and wherein the handle is configured to manipulate the sleeve to cause movement of the one or more sensorized joints.

17. The system of claim 1, wherein the handle is coupled to the proximal portion of the medical device.

18. The system according to claim 1, wherein, In the third mode, the handle is configured to detach from the instrument actuator interface.

19. A system for performing minimally invasive surgery, the system comprising: An elongated body comprising a distal end having an end effector and one or more distal joints, and a proximal end opposite the distal end; A handle configured to receive the proximal end of the elongated body, wherein the handle includes a sleeve comprising one or more sensorized joints; A sensor assembly configured to monitor the position of each of the one or more sensorized joints; as well as A device actuator interface, the device actuator interface being coupled to the sleeve of the handle and comprising: Power actuation unit, and The controller is communicatively connected to the sensor assembly and the power actuation unit. in: The sensor assembly is configured to monitor at least a first position of the one or more sensorized joints and generate a corresponding sensor signal, wherein the first position is based on proximal movement of the handle; The controller is configured to receive the corresponding sensor signals and generate corresponding control signals; and The power actuation unit is configured to receive the corresponding control signal and actuate the one or more distal joints based on the first position of the one or more sensorized joints to cause translation of the one or more distal joints.

20. The system of claim 19, further comprising a stabilizing device capable of switching between an unlocked state and a locked state.

21. The system of claim 20, wherein the stabilizing device is configured to be in the locked state when the power actuation unit actuates the one or more distal joints to cause the translation.

22. The system of claim 21, wherein the one or more distal joints are configured to manipulate about a remote pivot point.

23. The system of claim 22, wherein the remote pivot point is configured to align with the cannula needle, and the elongated body is inserted through the cannula needle during the procedure.

24. A system for minimally invasive surgery, the system comprising: Medical devices, the medical devices comprising: An elongated body having a proximal portion and a distal portion including one or more distal joints, and End effector; and Control component, the control component includes: A handle configured to engage with and manipulate the proximal portion of the medical device, wherein the handle includes one or more sensorized joints, and A device actuator interface configured to be reversibly coupled to the handle. The system is configured to operate selectively in a first control mode or a second control mode, and the selection between the first control mode and the second control mode includes modifying the range of motion associated with the one or more sensorized joints.

25. The system according to claim 24, wherein: The first control mode is a fulcrum effect mode, wherein the first input of the handle is configured to manipulate the end effector of the medical device; and The second control mode is a pivot correction mode, in which the one or more sensorized joints of the handle are movable, such that the manipulation of the handle causes the movement of the one or more sensorized joints, which results in the one or more distal joints moving at least about a predefined pivot point or at a corresponding distal end in a predefined three-dimensional space.

26. The system according to claim 25, wherein, In the first control mode, the first input or the second input is configured to cause the elongated body to roll about the longitudinal axis of the medical device.

27. A system for performing minimally invasive surgery, the system comprising: Control component, the control component includes: A handle pivotally connected to a bedside device, wherein the handle includes one or more sensorized joints, and Machine actuator interface; and A medical device, which is connectable to and operable by the handle, comprising: An elongated body having a proximal portion and a distal portion including one or more distal joints, and In the fulcrum effect mode, the mechanical movement of the handle connected to the proximal portion of the medical device causes the medical device to move about a pivot point, and In the fulcrum correction mode: The pivot point is between the one or more sensorized joints of the handle and the one or more distal joints of the medical device, and Actuation of the handle causes movement of the one or more sensorized joints, thereby causing the instrument actuator interface to map the movement to corresponding distal movements of the one or more distal joints at least around the pivot point.

28. A method for performing minimally invasive surgery, the method comprising: In the fulcrum effect model: A first input is received at the handle of the medical device, wherein the first input causes manual movement of the medical device about a pivot point, wherein the pivot point is between the distal and proximal portions of the medical device; and In fulcrum correction mode: The control device at the handle is activated, and the control device is configured to engage a sensor assembly and a power actuation unit that communicate with the medical device to perform electronically assisted movement; The sensor assembly, communicatively connected to the controller, is used to monitor the position of one or more sensorized joints of the handle; as well as In response to a change in position detected by the sensor assembly, the power actuation unit causes translation of the distal portion of the medical device, wherein the translation of the distal portion of the medical device is based on the position of the one or more sensorized joints.

29. The method of claim 28, wherein the one or more sensorized joints are proximal to the pivot point.

30. A handle configured for mounting at the bedside of a patient support device and for performing minimally invasive surgery, the handle comprising: The first input mechanism is configured to select the fulcrum effect mode. The handle is configured to be attached to a medical device that can move mechanically about a pivot point. as well as The second input mechanism is configured to select a fulcrum correction mode. The selection of the second input mechanism is configured to activate the sensor assembly, the power actuation unit, and the controller communicatively connected to the power actuation unit and the sensor assembly.

31. The handle of claim 30, wherein the first input mechanism includes a first grip portion of the handle; and the second input mechanism includes a second grip portion of the handle.

32. The handle of claim 30, wherein the first input mechanism comprises a button, a joystick, or a grip portion of the handle; and the second input mechanism comprises a second button.

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