INSTRUMENT FEEDER DEVICE ENGAGEMENT CONTROL

Abstract

Systems, devices, and methods for controlling an instrument feeder device to engage and / or control a medical instrument are described herein. For example, the instrument feeder device can be configured to couple to a drive output of a robotic arm and / or to engage an elongate shaft of a medical instrument. The drive output can be configured to control an engagement assembly to selectively engage and / or hold the elongate shaft. The state of the engagement assembly can be determined based on an amount of force applied by the drive output, a position of the drive output, and / or other information.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 150,527, filed February 17, 2021, and entitled "ENGAGEMENT CONTROL OF INSTRUMENT FEEDER DEVICES," and to U.S. Provisional Patent Application No. 63 / 150,533, filed February 17, 2021, and entitled "INSTRUMENT SHAFT TENSIONING SYSTEM AND METHOD," the disclosures of which are incorporated by reference in their entireties herein.

[0002] FIELD OF THEINVENTION The present disclosure relates to the field of medical procedures and devices. [Background technology]

[0003] Various medical procedures involve the use of one or more medical devices to access a target anatomical site within a patient. In some instances, improper use of a particular device when accessing a site in connection with a procedure can adversely affect the health of the patient, the integrity of the medical device(s), and / or the effectiveness of the procedure. Summary of the Invention [Means for solving the problem]

[0004] In some implementations, the present disclosure relates to a system comprising an instrument feeder device and a control circuit. The instrument feeder device includes an engagement assembly configured to couple to a drive output and to engage an elongate shaft of a medical instrument. The control circuit is configured to actuate the engagement assembly on the drive output and to determine a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output.

[0005] In some embodiments, the control circuitry is configured to determine a state of the engagement assembly based on at least one of a comparison of the amount of force applied by the drive output to one or more threshold values, or a comparison of the position of the drive output to one or more reference positions.

[0006] In some embodiments, the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft. In examples, the status of the engagement assembly indicates whether the actuator is engaged with the elongate shaft. In examples, the status of the engagement assembly indicates whether the elongate shaft is properly positioned within the channel.

[0007] In some embodiments, the control circuitry is configured to cause the drive output to actuate the engagement assembly from an engaged state, in which the actuator is engaged, to a disengaged state, in which the actuator is disengaged, and to determine a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state. The first change in force may be greater than a first threshold value.

[0008] In some embodiments, the control circuitry is configured to cause the drive output to actuate the engagement assembly from the disengaged state toward the engaged state and to determine a second position of the drive output associated with a second change in force applied by the drive output, The second change in force may be greater than the first threshold or the second threshold.

[0009] In some embodiments, the control circuitry is configured to identify a third position of the drive output associated with an intermediate state in which the actuator is disengaged from the elongate shaft and determine whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position and the third position. Further, the control circuitry can be configured to control the instrument feeder device based at least in part on determining whether the elongate shaft is properly received within the channel.

[0010] In some embodiments, the control circuitry is configured to detect at least one of: (i) an instrument feeder device is coupled to a robotic system associated with the drive output, (ii) a medical instrument is coupled to the robotic system, (iii) rotation of the elongate shaft is commanded, or (iv) manual movement of a robotic arm of the robotic system is enabled, and the control circuitry can be configured to actuate an engagement assembly on the drive output based at least in part on the detection.

[0011] In some implementations, the present disclosure relates to a system including a medical instrument including an elongated shaft, an instrument feeder including an engagement assembly configured to receive the elongated shaft and move the elongated shaft axially, and a control circuit. The instrument feeder is configured to couple to a robotic arm including a drive output. The control circuit is configured to actuate the drive output to move the engagement assembly and determine a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output.

[0012] In some embodiments, the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft. In examples, the instrument feeder device is configured to bias the actuator to an engaged or disengaged state. In examples, the status of the engagement assembly indicates whether the actuator is engaged with the elongate shaft. Further, in examples, the status of the engagement assembly indicates whether the elongate shaft is properly positioned within the channel.

[0013] In some embodiments, the control circuitry is configured to cause the drive output to actuate the engagement assembly from an engaged state, in which the actuator is engaged, to a disengaged state, in which the actuator is disengaged, and to determine a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state.

[0014] In some embodiments, the control circuitry is configured to cause the drive output to actuate the engagement assembly from a disengaged state toward an engaged state and to determine a second position of the drive output associated with a second change in force.

[0015] In some embodiments, the control circuitry is configured to determine whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position, and to control the instrument feeder device based at least in part on determining whether the elongate shaft is properly received within the channel.

[0016] In some embodiments, the control circuitry is configured to determine at least one of: that the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the second position relative to the first position; and cause the drive output to actuate the engagement assembly to a disengaged state based at least in part on the determination of at least one of: that the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly.

[0017] In some embodiments, the engagement assembly further includes a retention mechanism configured to selectively open and close the channel. The control circuitry can be configured to identify a third position of the drive output associated with an intermediate state in which the retention mechanism is closed and the actuator is disengaged from the elongate shaft, and determine at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the second position relative to the first and third positions. Further, the control circuitry can be configured to cause the drive output to actuate the engagement assembly to a disengaged state based at least in part on determining at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly.

[0018] In some implementations, the present disclosure relates to a method including controlling a drive output to cause actuation of an instrument feeder device configured to couple to a medical instrument; determining at least one of an amount of force applied by the drive output or a position of the drive output; and determining an engagement state of the instrument feeder device and the medical instrument based on at least one of the amount of force output by the drive output or the position of the drive output.

[0019] In some embodiments, the state of the instrument feeder device is determined based on at least one of a comparison of the amount of force applied by the drive output to one or more threshold values, or a comparison of the position of the drive output to one or more reference positions.

[0020] In some embodiments, the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft. In examples, the status of the instrument feeder device indicates at least one of whether the actuator is engaged with the elongate shaft or whether the elongate shaft is properly positioned within the channel.

[0021] In some embodiments, the method further includes controlling the drive output to actuate the engagement assembly to a disengaged state in which the actuator is disengaged, determining a first position of the drive output associated with a first change in force applied by the drive output during movement of the engagement assembly toward the disengaged state, and controlling the drive output to actuate the engagement assembly from the disengaged state toward an engaged state in which the actuator is engaged. Additionally, the method may further include determining a second position of the drive output associated with a second change in force, and determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position.

[0022] In some embodiments, the method further includes identifying a third position of the drive output associated with a state in which the actuator is disengaged from the elongate shaft and a retaining feature of the engagement assembly is closed. Determining whether the elongate shaft is received within the channel can be based at least in part on the second position relative to the first position and the third position.

[0023] In some implementations, the present disclosure relates to a robotic system comprising a robotic arm, an end effector associated with a distal end of the robotic arm, and a control circuit communicatively coupled to the robotic arm. The end effector includes a first drive output configured to actuate a first drive input of an instrument feeder to control engagement of the instrument feeder with an elongate shaft of an instrument. The control circuit is configured to determine a state of the instrument feeder device based on at least one of an amount of force applied by the first drive output or a position of the first drive output.

[0024] In some embodiments, the end effector further includes a second drive output configured to actuate a second drive input of the instrument feeder to cause axial movement of the elongate shaft.

[0025] In some embodiments, the instrument feeder includes an actuator configured to axially move the elongate shaft, a channel configured to receive the elongate shaft, and a retention mechanism configured to selectively open and close the channel.

[0026] In some embodiments, the state of the instrument feeder device indicates at least one of whether an actuator is engaged with the elongate shaft, whether a retention mechanism is closed, or whether the elongate shaft is properly positioned within the channel.

[0027] In some embodiments, the control circuitry is configured to transition the instrument feeder to a disengaged state in which the actuator is disengaged, move the instrument feeder toward the engaged state, and determine a first position of the drive output associated with a first change in force applied by the first drive output that occurred during moving the instrument feeder toward the engaged state. The control circuitry can further be configured to identify a second position of the drive output associated with at least one of: (i) a second change in force applied by the first drive output, or (ii) a state in which the actuator is disengaged from the elongate shaft and the retention mechanism is closed, and determine whether the elongate shaft is properly received within the channel based at least in part on the first position relative to the second position.

[0028] For purposes of summarizing this disclosure, certain aspects, advantages, and features are described. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, the disclosed embodiments may be practiced in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other advantages as may be taught or suggested herein. [Brief description of the drawings]

[0029] Various embodiments are illustrated in the accompanying drawings for purposes of illustration and should not be construed as limiting the scope of the present disclosure in any way. In addition, various features of different disclosed embodiments may be combined to form further embodiments that are part of the present disclosure. Throughout the drawings, reference numbers may be reused to indicate correspondence between referenced elements. [Figure 1] 1 illustrates an exemplary robotic medical system deployed for a diagnostic and / or therapeutic ureteroscopy procedure, according to one or more embodiments. [Diagram 2]2 illustrates the example robotic medical system of FIG. 1 deployed for a diagnostic and / or therapeutic bronchoscopy procedure, in accordance with one or more embodiment embodiments. [Diagram 3] 1 illustrates a table-based robotic system configured to perform a medical procedure, in accordance with one or more embodiments. [Figure 4] 1 illustrates medical system components that may be implemented in any of the medical systems described herein, according to one or more embodiments. [Diagram 5] 1 illustrates medical system components, including a scope assembly / system and an instrument feeder assembly, that may be implemented in any of the medical systems described herein, according to one or more embodiments. [Figure 6A] 1 illustrates a perspective view of an exemplary implement feeder device according to one or more embodiments. [Figure 6B] 1 illustrates an implement feeder device with a portion of the housing removed to show various features of the implement feeder device, according to one or more embodiments. [Figure 6C] 1 illustrates an implement feeder device with a portion of the housing and retention feature(s) removed, according to one or more embodiments. [Figure 6D] 1 illustrates a perspective view of an exemplary actuator / roller assembly that may be implemented in an implement feeder device according to one or more embodiments. [Figure 6E] 1 illustrates a perspective view of a roller assembly with a portion of the roller and carrier plate removed to illustrate an example gear assembly in accordance with one or more embodiments. [Figure 6F] FIG. 1 illustrates a top view of an example gear assembly according to one or more embodiments. [Figure 6G] 1 illustrates a bottom view of a roller assembly according to one or more embodiments. [Figure 7] 1 illustrates an exploded view of an example instrument device manipulator assembly associated with a robotic arm in accordance with one or more embodiments. [Figure 8-1] 1 illustrates an instrument feeder device with rollers engaged and cover closed in accordance with one or more embodiments. [Figure 8-2] 1 illustrates an instrument feeder device with rollers engaged and cover closed in accordance with one or more embodiments. [Figure 9-1] 14 illustrates the rollers of the instrument feeder device engaged with the instrument shaft and the cover closed, in accordance with one or more embodiments. [Figure 9-2] 14 illustrates the rollers of the instrument feeder device engaged with the instrument shaft and the cover closed, in accordance with one or more embodiments. [Figure 10-1] 14 illustrates the implement feeder device with the rollers disengaged and the cover closed in accordance with one or more embodiments. [Figure 10-2] 14 illustrates the implement feeder device with the rollers disengaged and the cover closed in accordance with one or more embodiments. [Figure 11-1] 14 illustrates the implement feeder device with the rollers disengaged and the cover open, in accordance with one or more embodiments. [Figure 11-2] 14 illustrates the implement feeder device with the rollers disengaged and the cover open, in accordance with one or more embodiments. [Figure 12] 14 illustrates an example state of the engagement assembly when an instrument shaft is not disposed / loaded within the engagement assembly, in accordance with one or more embodiments. [Figure 13] 1 illustrates an exemplary state of the engagement assembly when an instrument shaft is disposed / loaded within the engagement assembly, in accordance with one or more embodiments. [Figure 14] 14 illustrates an example process for determining a status of an engagement assembly of an implement feeder device, according to one or more embodiments. [Figure 15]1 illustrates an exemplary process for determining whether an elongate shaft of a medical instrument is loaded / properly loaded into an instrument feeder device, according to one or more embodiments. [Figure 16-1] 1 illustrates an exemplary process for determining and / or removing slack in an elongate shaft of a medical device, according to one or more embodiments. [Figure 16-2] 1 illustrates an exemplary process for determining and / or removing slack in an elongate shaft of a medical device, according to one or more embodiments. [Figure 16-3] 1 illustrates an exemplary process for determining and / or removing slack in an elongate shaft of a medical device, according to one or more embodiments. [Figure 17] 1 illustrates an exemplary process for determining and / or removing slack in an elongate shaft of a medical device in the context of inserting the elongate shaft, according to one or more embodiments. [Figure 18-1] Illustrates an example process for determining and / or removing slack in an elongate shaft of a medical instrument in connection with enabling an admittance control mode and / or rotating the elongate shaft, in accordance with one or more embodiments. [Figure 18-2] Illustrates an example process for determining and / or removing slack in an elongate shaft of a medical instrument in connection with enabling an admittance control mode and / or rotating the elongate shaft, in accordance with one or more embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] Although certain embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, and to modifications and equivalents thereof. Thus, the scope of the disclosure is not limited by any of the specific examples described below. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable order and are not necessarily limited to any particular disclosed order. Although various operations may be described in sequence as multiple separate operations in a manner that may be helpful in understanding a particular embodiment, the order of description should not be interpreted to imply that these operations are order-dependent. In addition, the structures, systems, and / or devices described herein may be embodied as integrated or separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily realized by any particular embodiment. Thus, for example, various embodiments may be implemented in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0031] While certain spatially relative terms, such as "outer", "inner", "upper", "lower", "below", "upper", "vertical", "horizontal", "top", "bottom" and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure, it is understood that these terms are used herein for ease of description to describe the positional relationship between the element(s) / structure(s) as illustrated in the drawings. It is understood that the spatially relative terms are intended to encompass different orientations of the element(s) / structure(s) during use or operation in addition to the orientation shown in the drawings. For example, when an element / structure is described as being "above" another element / structure, it may represent a position below or to the side of such other element / structure relative to the intended patient or alternative orientations of the element / structure, and vice versa. It is understood that the spatially relative terms, including those listed above, may be understood relative to the depicted orientation of each of the referenced figures.

[0032] For convenience of devices, components, systems, features, and / or modules having similar characteristics in one or more respects, certain reference numbers are reused across different figures of the set of figures of the present disclosure. However, with respect to any of the embodiments disclosed herein, the reuse of a common reference number in a figure does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, a person skilled in the art may be informed by the context as to the extent to which the use of a common reference number may imply similarity between the referenced subject matter. The use of a specific reference number in the context of the description of a particular figure may be understood to relate to the device, component, aspect, feature, module, or system identified in that particular figure, and not necessarily to any device, component, aspect, feature, module, or system identified by the same reference number in another figure. Furthermore, aspects of separate figures identified with a common reference number may be interpreted as sharing characteristics or as being entirely independent of each other.

[0033] Certain aspects of the present disclosure are described in detail herein in the context of renal, urological, and / or nephrological procedures, such as kidney stone removal / treatment procedures, with it being understood that such context is provided for convenience and that the concepts disclosed herein are applicable to any suitable medical procedure, such as bronchoscopy. However, a description of renal / urological anatomy and associated medical problems and procedures is provided below to aid in the explanation of the concepts disclosed herein.

[0034] Kidney stone disease, also known as urolithiasis, is a medical condition involving the formation of solid pieces of material in the urinary tract, referred to as "kidney stones", "urinary stones", "nephrolithiasis", or "nephrolithiasis". Urinary stones may form and / or be found in the kidneys, ureters, and bladder (referred to as "bladder stones"). Such urinary stones may form as a result of the concentration of minerals in the urine, and may cause significant abdominal pain if such stones reach a size sufficient to obstruct the flow of urine through the ureter or urethra. Urinary stones may be formed from calcium, magnesium, ammonia, uric acid, cystine, and / or other compounds, or combinations thereof.

[0035] Several methods can be used to treat patients with kidney stones, including observation, medical treatments (such as expulsion therapy), non-invasive treatments (such as extracorporeal shock wave lithotripsy (ESWL)), and minimally invasive or surgical treatments (such as ureteroscopy and percutaneous nephrolithotomy (PCNL)). In some approaches (e.g., ureteroscopy and PCNL), a physician accesses the stone, breaks it into smaller pieces or fragments, and uses a basket device and / or suction to remove the smaller stone fragments / particles from the kidney.

[0036] In a ureteroscopy procedure, a physician may insert a ureteroscope through the urethra into the urinary tract to remove urinary stones from the bladder and ureters. Typically, the ureteroscope includes an imaging device at its distal end configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotripsy device for capturing or breaking up urinary stones. During a ureteroscopy procedure, one physician / technologist may control the position of the ureteroscope while another physician / technologist may control the lithotripsy device(s).

[0037] In a PCNL procedure, which may be used to remove relatively large stones, a physician may insert a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site for breaking up and / or removing the stone(s). During a PCNL procedure, fluidics may be applied to clear stone dust, debris, and / or blood clots from the treatment site and / or field of view. In some instances, a relatively straight and / or rigid nephroscope is used, and the physician positions the tip of the nephroscope at the appropriate location within the kidney (e.g., calyx) by pushing / leveraging the device against the patient's body. This movement may be harmful to the patient (e.g., causing tissue damage).

[0038] In some procedures described herein, a robotic tool can be implemented to enable a physician to gain access to and / or treat a target anatomical site. For example, the medical system can be configured to engage a medical instrument including an elongated shaft, such as a scope or another medical instrument. The medical system can be configured to control the medical instrument to perform a procedure, such as removing kidney stones from a patient and / or otherwise treating a target site. The medical system can include one or more robotic arms configured to couple to an instrument base / handle of the medical instrument and / or to couple to the elongated shaft of the medical instrument.

[0039] In some examples, the medical system implements an instrument feeder device to assist in performing certain functions. The instrument feeder device can selectively engage with the elongated shaft of the medical instrument, control the movement of the elongated shaft, and / or otherwise support the elongated shaft. For example, the instrument feeder device can facilitate axial movement of the elongated shaft (e.g., inserting / retracting the shaft), hold the shaft during rotation of the shaft, hold the shaft during manual movement of the robotic arm, etc. Illustratively, the instrument feeder device can include one or more actuators configured to engage with the elongated shaft and move the elongated shaft axially during actuation of the medical instrument. Additionally, the instrument feeder device can include a retention mechanism that retains the elongated shaft while still providing some freedom of movement of the elongated shaft, such as rotating the elongated shaft within the instrument feeder device and sliding the elongated shaft through the instrument feeder device. In many cases, the instrument feeder device can efficiently / rapidly control the movement of the elongated shaft, such as inserting or retracting the elongated shaft and / or providing buckling-resistant support for the elongated shaft.

[0040] The instrument feeder device can generally be coupled to one robotic arm / component, and the instrument base of the medical instrument can generally be coupled to another robotic arm / component. In some examples, the instrument feeder device can be controlled in a manner that correlates with the movement of the instrument handle. For example, to insert a shaft, the instrument feeder device can cause axial movement of the shaft in an insertion direction, while the robotic arm coupled to the instrument handle moves closer to the robotic arm coupled to the instrument feeder device in a manner that correlates with the speed of the axial movement. Similarly, to retract a shaft, the instrument feeder device can cause axial movement of the elongated shaft in a retraction direction, while the robotic arm coupled to the instrument handle moves away from the robotic arm coupled to the instrument feeder device in a manner that correlates with the speed of the axial movement.

[0041] The present disclosure relates, inter alia, to devices, systems, and methods for controlling an instrument feeder device to intelligently engage and / or control a medical instrument, which can assist a physician to use the instrument feeder device and / or the medical instrument in different ways / scenarios. For example, the medical system is configured to control the instrument feeder device to implement various configurations / states for using the medical instrument, such as loading the medical instrument into the instrument feeder device, controlling the movement of the elongated shaft of the medical instrument, allowing the physician to adjust devices / components of the medical system, etc. For example, the medical system can cause the instrument feeder device to be opened / disengaged at the appropriate time to allow the physician to load the elongated shaft into the instrument feeder device. Furthermore, the medical system can cause the instrument feeder device to be engaged with the elongated shaft at the appropriate time, such that the medical system can drive / navigate the medical instrument by inserting or retracting the elongated shaft, etc. Additionally, the medical system can disengage the instrument feeder device from the elongated shaft and retain the elongated shaft at appropriate times to facilitate certain operations, such as rotating the elongated shaft or allowing the robotic arm to move freely without resistance from engagement of the elongated shaft with the instrument feeder device.

[0042] The present disclosure further relates to devices, systems, and methods for determining the status of an instrument feeder device and / or a medical instrument relative to the instrument feeder device. For example, a robotic arm may include a drive output configured to couple to and provide an output to the instrument feeder device for controlling engagement of the medical instrument with the elongate shaft. The medical system may determine the engagement status of the instrument feeder device with the elongate shaft and / or the status of the medical instrument based on a force applied by the drive output, a position of the drive output, a sensor on the instrument feeder device, and / or otherwise. The instrument feeder device / medical instrument status may indicate whether a medical instrument is loaded / properly loaded into the instrument feeder device, whether the instrument feeder device is engaged with the medical instrument, whether the instrument feeder device is configured to hold the medical instrument and allow freedom of movement of the medical instrument, etc. This may enable the medical system to verify / determine that the instrument feeder device is operating in the proper configuration / state and / or that the medical instrument is loaded / properly loaded at the proper time. For example, if the medical instrument is determined to be properly loaded into the instrument feeder device, the medical system may proceed with driving / navigating the medical instrument. Additionally, if the medical instrument is determined to be unloaded or not properly loaded (e.g., not positioned within a proper position to facilitate driving of the shaft), the medical system may provide a notification / signal to notify a user / component of such condition and / or wait to drive the medical instrument until it is properly loaded.

[0043] Thus, in an embodiment, the medical system described herein may be configured to control the instrument feeder device to intelligently engage with and / or control the medical instruments. For example, the medical system may place the instrument feeder device in the right state at the right time and / or confirm the status of the instrument feeder device / medical instrument. This may assist the physician to use the instrument feeder device and / or medical instrument in different ways / scenarios by enabling smooth workflow transitions such as loading / removing the medical instrument, inserting / retracting the medical instrument, adjusting the position of the robotic arm or another component of the medical system, rotating the medical instrument, etc. In an embodiment, the instrument feeder device may be controlled without confirmation from the user regarding the status of the instrument feeder device / medical instrument. Additionally, by controlling and / or verifying the status of the instrument feeder device / medical instrument, the medical system can avoid / solve problems associated with improperly loading the medical instrument (e.g., avoiding the retention mechanism / cover pinching the elongated shaft (which could potentially damage the elongated shaft), avoiding driving the elongated shaft when it is improperly loaded (which could potentially damage the elongated shaft), etc.).

[0044] The present disclosure further relates to devices, systems, and methods for assessing and / or removing slack in an elongated shaft of a medical instrument. For example, as described above, an instrument feeder device can be implemented to control an elongated shaft of a medical instrument. The instrument feeder device can generally be coupled to one robotic arm / component, and an instrument base of the medical instrument is generally coupled to another robotic arm / component. In some cases, the elongated shaft may include slack between the instrument base and the instrument feeder device, which may occur due to backlash / play in one or more components such as loading of the medical instrument, the instrument feeder device / robot arm / handle, mismatch between actual backlash and software-configured backlash, slippage of the instrument feeder device on the elongated shaft, etc. Such slack may cause undesirable problems. For example, if there is slack in the elongated shaft when the shaft is inserted, the curvature of the slack may increase as the instrument handle moves closer to the instrument feeder device, which may potentially damage the elongated shaft and / or cause other problems. Furthermore, if there is slack in the elongate shaft when the instrument feeder device is disengaged from the elongate shaft (e.g., to initiate rotation of the elongate shaft, to allow manual movement of the robotic arm, and / or for other reasons), the elongate shaft may move in the insertion direction as energy in the shaft is released. This may cause harm to the patient (e.g., due to the tip of the elongate shaft contacting tissue with a relatively high force). To prevent such problems, the medical system may determine whether there is slack in the elongate shaft between the instrument handle and the instrument feeder device, and in some cases, remove / reduce slack in the elongate shaft, if any.

[0045] The medical system can determine the amount of slack in the elongate shaft in various ways. For example, the medical system can determine an amount of arm force applied by a robotic arm coupled to an instrument base of the medical instrument and / or determine an amount of drive output force applied by a drive output(s) of a robotic arm coupled to the instrument feeder device. The drive output(s) can be configured to control axial motion of the elongate shaft. The amount of arm force and / or drive output force can be used to determine whether there is slack or tension in the elongate shaft. Additionally or alternatively, the medical system can determine the amount of slack in the elongate shaft based on shape sensing data indicative of a shape of the elongate shaft, position sensor data indicative of a position of at least a portion of the elongate shaft, and / or other data.

[0046] In examples, the medical system can remove / reduce slack in the elongate shaft. For example, the medical system can move a robotic arm coupled to an instrument handle in a direction away from a robotic arm coupled to an instrument feeder device. This can be done without actively actuating the elongate shaft using an instrument feeder device. Alternatively or additionally, the medical system can cause the instrument feeder device to move the elongate shaft in an insertion direction away from the instrument handle. This can be done without actively actuating a robotic arm coupled to the instrument handle. In some examples, the medical system can identify slack in the elongate shaft and / or remove such slack before and / or as part of performing certain functions, such as before disengaging the instrument feeder device from the elongate shaft, before rotating the elongate shaft, as part of inserting the elongate shaft, and / or in other situations.

[0047] Thus, in an embodiment, the medical system described herein can be configured to intelligently assess slack in the medical instrument and / or remove such slack. This can prevent the elongate shaft from unintentionally moving in an insertion direction (e.g., when the instrument feeder device is disengaged from the shaft) that could harm the patient. Furthermore, assessing and / or removing slack in the elongate shaft can avoid damage to the medical instrument (e.g., by excessive bending of the elongate shaft when excessive slack is introduced between the instrument handle and the instrument feeder device). Furthermore, interruptions in performing a procedure can be avoided (e.g., avoiding a user having to check for slack in the medical instrument, reload the medical instrument, etc.). For example, the medical system can automatically assess and / or remove slack in the elongate shaft at certain points before, during, or after the procedure. In some cases, the technology can account for unknown causes of introducing slack into the elongate shaft.

[0048] Although various techniques are described in the context of implementing two robotic arms to couple to a medical instrument, these techniques can be implemented with multiple components included in a single robotic arm. For example, the robotic arm can include a first coupling element / robot component for coupling to an instrument feeder device and a second coupling element / robot component for coupling to an instrument handle, where the feeder device and handle can move relative to one another, such as along a rail or other feature.

[0049] Additionally, although some of the techniques are described in the context of robotic-assisted medical procedures, the techniques may be applicable to other types of medical procedures, such as procedures that do not implement robotic tools or that implement robotic tools for relatively few operations (e.g., less than a threshold number). For example, the techniques may be applicable to procedures that implement manually operated medical instruments, such as manual catheters and / or scopes that are fully controlled by a physician.

[0050] Certain aspects of the present disclosure are described herein in the context of renal, urological, and / or renal procedures, such as kidney stone removal / treatment procedures. However, such context is provided for convenience, and it should be understood that the concepts disclosed herein are applicable to any suitable medical procedure. For example, the following description is also applicable to other surgical / medical operations or medical procedures involving the removal of objects from a patient, including any object that can be removed from a treatment site or a patient's body cavity (e.g., esophagus, ureter, intestine, eyeball, etc.) via percutaneous and / or endoscopic access, such as gallbladder stone removal, pulmonary (pulmonary / transthoracic) tumor biopsy, cataract removal, etc. However, as previously mentioned, a description of the renal / urological anatomical structure and associated medical problems and procedures is provided below to aid in the explanation of the concepts disclosed herein.

[0051] FIG. 1 illustrates an exemplary robotic medical system 100 arranged for diagnostic and / or therapeutic ureteroscopy procedures, according to one or more embodiments. The medical system 100 includes a robotic system 110 configured to engage and / or control one or more medical instruments / devices to perform a procedure on a patient 120. In the example of FIG. 1, the robotic system 110 is coupled to a scope 130 and an electromagnetic (EM) field generator 140. However, the robotic system 110 may be coupled to any type of device / instrument. The medical system 100 also includes a control system 150 configured to interface with the robotic system 110 and / or a physician 160, provide information regarding the procedure, and / or perform various other operations. For example, the control system 150 may include a display(s) 152 configured to present certain information, and / or an input / output (I / O) device 154 (a controller in this example) configured to receive input from the physician 160, such as to control the robotic system 110. The medical system 100 may include a table 170 (e.g., a bed) for holding the patient 120. Various actions are described herein as being performed by the physician 160. These actions may be performed directly by the physician 160, by a user under the direction of the physician 160, by another user (e.g., a technician), a combination thereof, and / or any other user. The devices / components of the medical system 100 may be arranged in various ways depending on the type of procedure, the stage of the procedure, user preferences, etc.

[0052] The control system 150 can generally operate in cooperation with the robotic system 110 to perform a medical procedure. For example, the control system 150 can communicate with the robotic system 110 via a wireless or wired connection to control instruments / devices connected to the robotic system 110, receive image(s) acquired by the medical instrument, etc. For example, the control system 150 can receive image data from the scope 130 (e.g., an imaging device associated with the scope 130) and display the image data (and / or a representation generated therefrom) via the display(s) 152 to assist the physician 160 in navigating the scope 130 and / or another instrument within the patient 120. The physician 160 can provide input via the I / O device 154 or another I / O device, and the control system 150 can send control signals to the robotic system 110 to control the movement of the scope 130 connected to the robotic system 110. The scope 130 (and / or another medical instrument) can be configured to move in various ways, such as articulating, rotating, etc.

[0053] In some embodiments, control system 150 can provide power to robotic system 110 via one or more electrical connections, provide optics to robotic system 110 via one or more optical fibers or other components, etc. In examples, control system 150 can communicate with a medical instrument to receive sensor data (via robotic system 110 and / or directly from the medical instrument). The sensor data can indicate or be used to determine a position and / or orientation of the medical instrument. Additionally, in examples, control system 150 can communicate with table 170 to orient or otherwise control table 170. Additionally, in examples, control system 150 can communicate with EM field generator 140 to control generation of an EM field around patient 120.

[0054] The robotic system 110 can include one or more robotic arms 112 configured to engage and / or control a medical instrument(s) / medical device. Each robotic arm 112 can include multiple arm segments coupled to joints, thereby providing multiple degrees of movement. A distal end of the robotic arm 112 (e.g., an end effector) can be configured to couple to an instrument / device. In the example of FIG. 1, the robotic arm 112 (A) is coupled to an EM field generator 140. A second robotic arm 112 (B) is coupled to an instrument feeder device 180 that can facilitate robotic control / advancement of the scope 130. Additionally, a third robotic arm 112 (C) is coupled to a handle 132 of the scope 130, which can be configured to facilitate advancement and / or movement of the scope 130 and / or a medical instrument that can be deployed through the scope 130, such as an instrument deployed through a working channel of the scope 130. In this example, the second robotic arm 112(B) and / or the third robotic arm 112(C) can control the movement (e.g., articulation, rotation, etc.) of the scope 130. Although three robotic arms are shown in Figure 1 connected to specific instruments / devices, the robotic system 110 can include any number of robotic arms configured to connect to any type of medical instrument / device.

[0055] The robotic system 110 can be communicatively coupled to any component of the medical system 100. For example, the robotic system 110 can be communicatively coupled to the control system 150 to receive control signals from the control system 150 to perform actions such as controlling the robotic arm 112 in a particular manner, manipulating an instrument / device, etc. Additionally, the robotic system 110 can be configured to receive images (also referred to as image data) indicative of the internal anatomical structure of the patient 120 from the scope 130 and / or transmit the images to the control system 150, which can then display the images on the display(s) 152. Additionally, the robotic system 110 is coupled to components of the medical system 100, such as the control system 150, and / or to the fluid management system in a manner such that the robotic system 110 can receive fluids, optics, power, etc. from the components.

[0056] The medical instruments can include various types of instruments, such as scopes (sometimes referred to as "endoscopes"), catheters, needles, guidewires, lithotriptors, basket retrieval devices, forceps, vacuums, needles, scalpels, imaging probes, imaging devices, graspers, scissors, gripping instruments, needle holders, micro-dissection instruments, staple appliers, tackers, suction / irrigation tools, clip appliers, etc. The medical instruments can include direct entry instruments, percutaneous entry instruments, and / or other types of instruments. In some embodiments, the medical instruments are steerable devices, while in other embodiments, the medical instruments are non-steerable devices. In some embodiments, a surgical tool refers to a device configured to puncture or be inserted through the human anatomy, such as a needle, scalpel, guidewire, etc. However, a surgical tool can refer to other types of medical instruments.

[0057] The term "scope" or "endoscope" may refer to any type of elongated medical instrument having image generating, viewing, and / or capturing capabilities (or configured to provide such capabilities with an imaging device deployed through a working channel) and configured to be introduced into any type of organ, cavity, lumen, chamber, and / or body space of the body. For example, a scope or endoscope such as scope 130 may refer to a ureteroscope (e.g., for accessing the urinary tract), laparoscope, nephroscope (e.g., for accessing the kidneys), bronchoscope (e.g., for accessing airways such as the bronchi), colonoscope (e.g., for accessing the colon), arthroscope (e.g., for accessing joints), cystoscope (e.g., for accessing the bladder), borescope, etc. A scope / endoscope may, in some examples, include a rigid or flexible tube and / or may be sized to pass within an outer sheath, catheter, introducer, or other luminal device, or may be used without such a device. In some embodiments, the scope includes one or more working channels through which additional tools / medical instruments, such as lithotriptors, basket devices, forceps, laser devices, imaging devices, etc., can be introduced into the treatment site.

[0058] The terms "direct entry" or "direct access" can refer to any entry of an instrument through a natural or artificial orifice in a patient's body. For example, because the scope 130 enters the patient's urinary tract via the urethra, the scope 130 may be referred to as a direct access instrument.

[0059] The term "percutaneous entry" or "percutaneous access" may refer to entry, such as by puncture and / or small incision, of an instrument through a patient's skin and any other body layers necessary to reach a target anatomical location associated with a procedure (e.g., the calyx rete of a kidney). Thus, a percutaneous access instrument may refer to a medical instrument, device, or assembly configured to puncture or be inserted through the skin and / or other tissue / anatomical structure, such as a needle, scalpel, guidewire, sheath, shaft, scope, catheter, etc. However, it should be understood that a percutaneous access instrument may refer to other types of medical instruments in the context of this disclosure. In some embodiments, a percutaneous access instrument refers to an instrument / device inserted or implemented by a device that facilitates puncture and / or small incision through a patient's skin. For example, a catheter may be referred to as a percutaneous access instrument when inserted through a sheath / shaft inserted into the patient's skin.

[0060] In some embodiments, the medical instrument includes a sensor (also referred to as a position sensor) configured to generate sensor data. In examples, the sensor data can indicate a position and / or orientation of the medical instrument and / or can be used to determine the position and / or orientation of the medical instrument. For example, the sensor data can indicate a position and / or orientation of a scope, which can indicate a rotation of a distal end of the scope. The position and orientation of the medical instrument can be referred to as the pose of the medical instrument. The sensor can be located at the distal end of the medical instrument and / or at any other location. In some embodiments, the sensor can provide sensor data to the control system 150, the robotic system 110, and / or another system / device to implement one or more localization techniques to determine / track the position and / or orientation of the medical instrument.

[0061] In some implementations, the sensor can include an electromagnetic (EM) sensor with a coil of conductive material, where an EM field generator can provide an EM field that is detected by the EM sensor on the medical instrument. The magnetic field can induce small currents in the coil of the EM sensor, which can be analyzed to determine the distance and / or angle / orientation between the EM sensor and the EM field generator. Additionally, the sensor can include another type of sensor, such as a camera, a distance sensor (e.g., a depth sensor), a radar device, a shape-sensing fiber, an accelerometer, a gyroscope, an accelerometer, a satellite-based positioning sensor (e.g., a global positioning system, GPS), a radio frequency transceiver, etc.

[0062] In some embodiments, the medical system 100 may also include an imaging device (not shown in FIG. 1 ) that may be integrated into the C-arm and / or configured to image during a procedure, such as in the case of a fluoroscopy type procedure. The imaging device may be configured to obtain / generate one or more images of the patient 120 during the procedure, such as one or more X-ray or CT images. In an example, images from the imaging device may be provided in real time to view anatomical structures and / or medical instruments within the patient 120 to assist the physician 160 in performing the procedure. The imaging device may be used to perform fluoroscopy (e.g., with contrast agents within the patient 120) or another type of imaging technique.

[0063] Further, in some embodiments, the medical system 100 may also include a fluid management system (sometimes referred to as an "aspiration system" or "irrigation system") configured to control / provide aspiration and / or irrigation to a target site, such as via the catheter, the scope 130, an instrument / device associated with the catheter / scope (e.g., one or more access sheaths), and / or another instrument / device. The fluid management system may be configured to hold and / or control fluid flow to / from one or more fluid bags / containers. In an embodiment, the fluid management system includes certain electronic components, such as a display, a flow control mechanism, and / or control circuitry. The fluid management system may include a stand-alone tower / cart. The fluid management system may include a pump that may draw aspiration fluid into a collection container / cart via an aspiration channel / tube coupled to the catheter / scope.

[0064] The various components of the medical system 100 may be communicatively coupled to one another via a network, which may include a wireless network and / or a wired network. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), body area networks (BANs), cellular networks, the Internet, etc. Additionally, in some embodiments, the components of the medical system 100 are connected for data communication, fluid / gas exchange, power exchange, etc., via one or more supporting cables, tubes, etc.

[0065] In some examples, the medical system 100 is implemented to perform medical procedures related to the kidney anatomy, such as treating kidney stones. For example, robotically assisted percutaneous procedures can be performed, and robotic tools (e.g., one or more components of the medical system 100) can enable a physician / urologist to perform endoscopic (e.g., ureteroscopy) targeting access as well as percutaneous access / treatment. However, the present disclosure is not limited to kidney stone removal and / or robotically assisted procedures. In some implementations, robotic medical solutions can provide relatively high precision, better control, and / or better eye-hand coordination for certain instruments compared to strictly manual procedures. For example, robotically assisted percutaneous access to the kidney through some procedures can enable a urologist to perform both direct entry endoscopic renal access and percutaneous renal access. Although some embodiments of the present disclosure are presented in the context of catheters, nephroscopes, ureteroscopes, and / or human kidney anatomy, it should be understood that the principles disclosed herein can be implemented in any type of endoscopic / percutaneous procedure or another type of procedure.

[0066] In one exemplary and non-limiting procedure, the medical system 100 can be used to inspect a kidney 190 and / or remove a kidney stone 191. During setup for a procedure, the physician 160 can position the robotic arms 112 of the robotic system 110 in a desired configuration and / or attach appropriate medical instruments. For example, the physician 160 can position the first robotic arm 112(A) near the treatment site and attach the EM field generator 140, which can assist in tracking the location of the scope 130 and / or other instruments / devices during the procedure. Additionally, the physician 160 can position the second robotic arm 112(B) between the legs of the patient 120 and attach an instrument feeder device 180, which can facilitate robotic control / advancement of the scope 130. In some examples, the physician 160 can insert a sheath / access instrument 134 into the urethra 192, through the bladder 193, and / or up the ureter 194 of the patient 120. The physician 160 can connect the sheath / access instrument 134 to the instrument feeder device 180. The sheath / access instrument 134 can include a luminal device configured to receive the scope 130, thereby aiding in inserting the scope 130 into the anatomy of the patient 120. However, in some embodiments, the sheath / access instrument 134 is not used (e.g., the scope 130 is inserted directly into the urethra 192). The physician 160 can then insert the scope 130 into the sheath / access instrument 134 manually, robotically, or a combination thereof. The physician 160 can attach the handle 132 of the scope 130 to a third robotic arm 112(C), which can be configured to facilitate movement of the handle 132, operation of a basket device / laser device / another medical instrument deployed through the scope 130, and / or facilitate other functions.

[0067] The physician 160 can interact with the control system 150 to cause the robotic system 110 to advance and / or navigate the scope 130 into the kidney 190. For example, the physician 160 can navigate the scope 130 using the controller 154 or another I / O device to identify the location of the kidney stone 191. The control system 150 can provide information about the scope 130 via the display(s) 152 to assist the physician 160 in navigating the scope 130, such as viewing an image representation (e.g., real-time image(s) acquired by the scope 130). In some embodiments, the control system 150 can use localization techniques to determine the position and / or orientation of the scope 130, which can be viewed by the physician 160 through the display(s) 152. Additionally, other types of information may be presented through display(s) 152 to assist physician 160 in controlling scope 130, such as x-ray or other images of the internal anatomy of patient 120.

[0068] When the scope 130 reaches the site of the kidney stone 191 (e.g., in the calyx of the kidney 190), the scope 130 can be used to designate / tag a target location for a catheter to percutaneously access the kidney 190. To minimize damage to the kidney 190 and / or surrounding anatomical structures, the physician 160 can designate the papilla as the target location for percutaneously entering the kidney 190. However, other target locations can be designated or determined. In some embodiments that designate the papilla, the physician 160 can navigate the scope 130 to contact the papilla, the control system 150 can use localization techniques to determine the location of the scope 130 (e.g., the location of the distal end of the scope 130), and the control system 150 can associate the location of the scope 130 with the target location. Additionally, in some embodiments, the physician 160 can navigate the scope 130 to be within a certain distance of the papilla (e.g., placed in front of the papilla) and provide an input indicating that the target location is within the field of view of the scope 130. The control system 150 can perform image analysis and / or other localization techniques to determine the location of the target location. Additionally, in some embodiments, the scope 130 can deliver a reference point to mark the nipple as the target location.

[0069] Once a target location has been designated, a catheter or other instrument may be inserted into the patient 120 through a percutaneous access pathway (e.g., in conjunction with the scope 130) to reach the target site. For example, the EM field generator 140 may be removed and a catheter (not shown) may be connected to the first robotic arm 112(A). The physician 160 may interact with the control system 150 to cause the robotic system 110 to advance and / or navigate the catheter. Alternatively or additionally, the catheter may be manually inserted and / or controlled, such as when the catheter is implemented as a manually controllable catheter. The control system 150 may provide information regarding the catheter via the display(s) 152 to assist the physician 160 in navigating the catheter. For example, the display(s) 152 may provide image data from the perspective of the scope 130, which may show the catheter (e.g., when within the field of view of an imaging device of the scope 130). In some embodiments, a needle or another medical instrument is inserted into the patient 120 to create a percutaneous access pathway for the catheter to enter. Additionally, in some embodiments, a percutaneous access device / assembly (e.g., one or more sheaths and / or shafts) is inserted into the pathway created by the needle or another instrument to provide an access pathway for the catheter to reach the target location. The catheter can then be inserted into the percutaneous access device. The percutaneous access device can provide irrigation to the target anatomical structure, while the catheter can provide suction (e.g., via a lumen within the catheter).

[0070] Once the scope 130 and / or catheter are positioned at the target location, the physician 160 can use the scope 130 to break up the kidney stone 191 and / or use the catheter to remove fragments of the kidney stone 191 from the patient 120. For example, the scope 130 can deploy a tool (e.g., laser, cutting instrument, etc.) through the working channel to fragment the kidney stone 191 into fragments, and the catheter can aspirate the fragments from the kidney 190 through the percutaneous access pathway. The catheter can provide suction to maintain / hold the kidney stone 191 at the distal end of the catheter and / or in a relatively fixed position while the scope 130 uses a tool (e.g., laser) to fragment the kidney stone 191, as shown in FIG. 1. The fluid management system can provide irrigation to the target site via a percutaneous access device / assembly associated with the catheter and / or provide suction to the target site via the catheter (e.g., a lumen within the catheter 140).

[0071] Although various examples have been described in the context of providing irrigation / aspiration via a catheter and / or percutaneous access device / assembly, irrigation fluid and / or suction may in some cases be provided to the treatment site (e.g., kidney) through another device, such as the scope 130. Additionally, irrigation and suction may or may not be provided through the same instrument(s). Where one or more of the instruments provide irrigation and / or aspiration functionality, one or more others of the instruments may be used for other functions, such as fracturing the object to be removed.

[0072] Additionally, although various exemplary procedures have been described in the context of implementing a robotically controlled catheter, the procedures may be performed using a manually controllable catheter. For example, the catheter may include a manually controllable handle configured to be held / manipulated by physician 160. Physician 160 may navigate the catheter by moving the handle and / or manipulating a manual actuator, which may effect articulation of a distal portion of the catheter.

[0073] The medical system 100 (and / or other medical systems described herein) may provide various benefits, such as providing guidance to assist physicians in performing procedures (e.g., instrument tracking, instrument navigation, instrument calibration, etc.), allowing physicians to perform procedures from ergonomic positions without requiring skilled arm movements and / or positions, allowing one physician to perform procedures with one or more medical instruments, avoiding radiation exposure (e.g., associated with fluoroscopy techniques), allowing procedures to be performed in a single surgical setting, providing continuous suction / irrigation to more efficiently remove objects (e.g., removing kidney stones), etc. For example, the medical system 100 may provide guidance information to assist physicians in using various medical instruments to access target anatomical structures while minimizing bleeding and / or damage to anatomical structures (e.g., critical organs, blood vessels, etc.). Additionally, the medical system 100 may provide non-radiation based navigation and / or localization techniques to reduce physician and patient radiation exposure and / or reduce the amount of equipment in the operating room. Additionally, the medical system 100 may provide distributed functionality between at least the control system 150 and the robotic system 110, which may be independently mobile. Such distribution of functionality and / or mobility may allow the control system 150 and / or the robotic system 110 to be placed in a location that is optimal for a particular medical procedure, thereby maximizing the working area around the patient and / or providing an optimized location for the physician to perform the procedure.

[0074] Although various techniques / systems are described as being implemented as a robotically assisted procedure (e.g., a procedure that at least partially uses the medical system 100), these techniques / systems may be implemented in other procedures, such as fully robotic medical procedures, human-only procedures (e.g., no robotic system), etc. For example, the medical system 100 may be used to perform a procedure without a physician holding / manipulating medical instruments and without a physician controlling the movements of a robotic system / arm (e.g., a fully robotic procedure that relies on relatively few inputs to direct the procedure). That is, each of the medical instruments used during the procedure may be held / controlled by a component of the medical system 100, such as the robotic arm 112 of the robotic system 110.

[0075] FIG. 2 illustrates an exemplary robotic medical system 100 arranged for diagnostic and / or therapeutic bronchoscopy procedures, according to one or more embodiments. During bronchoscopy, the arm(s) 112 of the robotic system 110 may be configured to deliver a medical instrument, such as a steerable endoscope 210 (also referred to as a "bronchoscope 210"), which may be a procedure-specific bronchoscope for bronchoscopy, to a natural orifice access point (i.e., the mouth of a patient 120 positioned on a table 170 in this example) for delivering diagnostic and / or therapeutic tools. As shown, the robotic system 110 may be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arm 112 may be actuated to position the bronchoscope 210 relative to the access point. The arrangement of FIG. 2 may also be utilized when performing gastro-intestinal (GI) procedures with a gastroscope, which is an endoscope specialized for GI procedures.

[0076] Once the robotic system 110 is properly positioned, the robotic arms 112 may insert the steerable endoscope 210 into the patient robotically, manually, or a combination thereof. The steerable endoscope 210 may include at least two nested parts, such as an inner leader section and an outer sheath section, each section coupled to a separate instrument drive from a set of instrument drives and / or each instrument drive coupled to the distal end of a respective robotic arm 112. This linear arrangement of the instrument drives creates a "virtual rail" 220 that can be repositioned in space by manipulating one or more of the robotic arms 112 to different angles and / or positions. The virtual rails / paths described herein are generally shown in the figures using dashed lines that do not depict any physical structure of the system. Translation of one or more of the instrument drives along the virtual rail 220 can advance or retract the endoscope 210 from the patient 120.

[0077] The endoscope 210 may be directed downstream of the patient's trachea and lungs after insertion using precise commands from the robotic system 110 until the target surgical site is reached. The use of separate instrument drives may allow for independent driving of separate parts of the endoscope / assembly 210. For example, the endoscope 210 may be directed to deliver a biopsy needle to a target, such as a lesion or nodule in the patient's lung. The needle may be deployed downstream of the working channel that runs the length of the endoscope 210 to obtain a tissue sample for a pathologist to analyze. Depending on the results of the pathology, additional tools may be deployed downstream of the working channel of the endoscope 210 for further biopsies. For example, upon identifying a nodule as malignant, the endoscope 210 may deliver a tool endoscopically to ablate the potentially cancerous tissue. In some instances, diagnostic and therapeutic treatments may be performed in separate procedures. In these situations, the endoscope 210 may also be used to deliver fiducials to "mark" the location of the target nodule. In other instances, diagnostic and therapeutic treatments may be performed during the same procedure.

[0078] In the arrangement of the system 100 of FIG. 2, the patient introducer 230 is attached to the patient 120 via a port (not shown, e.g., a surgical tube). The patient introducer 230 may be secured to the table 170 (e.g., via a patient introducer holder configured to support the introducer 230 and secure the position of the patient introducer 230 relative to the table 170 or other structure). In some embodiments, the patient introducer 230 may include a proximal end, a distal end, and an introducer tube therebetween. The proximal end of the patient introducer 230 may provide an opening / aperture that may be configured to receive the instrument 210 (e.g., a bronchoscope), and the distal end of the patient introducer 230 may provide a second opening that may be configured to guide the instrument 210 to the patient access port. A curved tube component of the introducer 230 connects its proximal and distal ends and may guide the instrument 210 through the introducer 230.

[0079] The curvature of the introducer 230 may allow the robotic system 110 to manipulate the instrument 210 from a position that is not directly axially aligned with the patient access port, thereby allowing for greater flexibility in placement of the robotic system 110 within a room. Additionally, the curvature of the introducer 230 may allow the robotic arm 112 of the robotic system 110 to be substantially horizontally aligned with the patient introducer 230, which may facilitate manual movement of the robotic arm(s) 112, if desired.

[0080] In some embodiments, one or more of the instrument feeder devices described herein can be implemented in a bronchoscopy procedure, such as that illustrated in Figure 2. For example, the instrument feeder device can be implemented in cooperation with an endoscope 210 to at least partially control the movement of the endoscope 210.

[0081] 3 illustrates a table-based robotic system 300 configured to perform a medical procedure, according to one or more embodiments, where one or more of the robotic components of the robotic medical system 100 can be incorporated into the table 302, which can reduce the amount of capital equipment in the operating room and / or allow greater access to the patient 120, as compared to a cart-based robotic system. For example, the system 300 can include one or more components of the control system 150 and / or the robotic system 110.

[0082] As shown, the table 302 can include / incorporate one or more robotic arms 304 configured to engage and / or control medical instrument(s) / devices. Each robotic arm 304 can include multiple arm segments coupled to joints, thereby providing multiple degrees of movement. The distal end of the robotic arm 304 (i.e., end effector) can be configured to couple to an instrument / device, which can include any of the medical instruments / devices described herein, such as a catheter, needle, scope, etc. For example, the robotic arm 304(B) can couple to an instrument feeder device 180, as shown in FIG. 3, and / or the robotic arm 304(C) can couple to the handle 132 of the scope 130. Each robotic arm 304 can be similar to or different from the robotic arm 112 of the system 100 of FIGS. 1 and 2. Additionally, each end effector can be similar to or different from the end effector of the robotic system 110.

[0083] As shown, the robot-enabled table system 300 can include a column 310 coupled to one or more carriages 312 (e.g., ring-like movable structures) from which one or more robotic arms 304 can emerge. The carriage(s) 312 can translate along a vertical column interface that runs at least a portion of the length of the column 310 to provide different viewing positions from which the robotic arms 304 can be positioned to reach the patient 120. The carriage(s) 312 can, in some embodiments, rotate about the column 310 using a mechanical motor positioned within the column 310 to allow the robotic arms 304 to access multiple sides of the table 302. By rotating and / or translating the carriage(s) 312, the system 300 can enable medical instruments, such as an endoscope and / or catheter, to be positioned to different access points on the patient 120. By providing vertical adjustment, the robotic arms 304 can be configured to be compactly housed under the platform of the table system 300 and then raised during a procedure. The robotic arm 304 may be mounted to the carriage(s) 312 through one or more arm mounts 314, which may include a series of joints that may individually rotate and / or telescopically expand to provide additional configurability to the robotic arm 304. The column 310 structurally provides support for the table platform and a path for vertical translation of the carriage(s) 312. The column 310 may also transmit power and control signals to the carriage(s) 312 and / or the robotic arm 304 mounted thereon.

[0084] In some embodiments, the table-based robotic system 300 can include or be associated with a control system similar to the control system 150 to interface with a physician and / or provide information regarding a medical procedure. For example, the control system can include input component(s) that enable a physician to control the one or more robotic arms 304 and / or a medical instrument attached to the one or more robotic arms 304. In some implementations, the input component(s) enable a physician to provide inputs to control the medical instrument in a manner similar to if the physician were physically holding / manipulating the medical instrument.

[0085] Figure 4 illustrates medical system components that may be implemented in any of the medical systems of Figures 1-3 in accordance with one or more embodiments of the present disclosure. Although certain components are illustrated in Figure 4, it should be understood that additional components not illustrated may be included in embodiments in accordance with the present disclosure. Additionally, any of the illustrated components may be omitted, replaced, and / or integrated into other devices / systems, such as table 170, medical instruments, etc.

[0086] The control system 150 may include one or more of the following components, devices, modules, and / or units (referred to herein as "components"): control circuitry 401, one or more communication interfaces 402, one or more power supply units 403, one or more I / O components 404, one or more mobilization components 405 (e.g., casters or other types of wheels), and / or memory / data storage 406, either separately / individually and / or in combination / collectively. In some embodiments, the control system 150 may include a housing / enclosure configured and / or dimensioned to house or contain at least a portion of one or more of the components of the control system 150. In this example, the control system 150 is illustrated as a cart-based system that is movable with one or more mobilization components 405. In some cases, after reaching the appropriate position, the one or more mobilization components 405 may be secured using wheel locks to hold the control system 150 in place. However, the control system 150 may be implemented as a fixed system, integrated into another system / device, etc.

[0087] The various components of control system 150 may be electrically and / or communicatively coupled using certain connection circuits / devices / features that may or may not be part of the control circuitry. For example, the connection mechanism(s) may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuits of control system 150. In some embodiments, two or more of the components of control system 150 may be electrically and / or communicatively coupled to one another.

[0088] The one or more communication interfaces 402 can be configured to communicate with one or more devices / sensors / systems. For example, the one or more communication interfaces 402 can transmit / receive data in a wireless and / or wired manner over a network. In some embodiments, the one or more communication interfaces 402 can implement wireless technologies such as Bluetooth, Wi-Fi, near field communication (NFC), etc.

[0089] The one or more power supply units 403 can be configured to manage and / or provide power to the control system 150 (and / or, in some cases, the robotic system 110). In some embodiments, the one or more power supply units 403 include one or more batteries, such as lithium-based batteries, lead-acid batteries, alkaline batteries, and / or another type of battery. That is, the one or more power supply units 403 can include one or more devices and / or circuits configured to provide a power source and / or provide power management functions. Additionally, in some embodiments, the one or more power supply units 403 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power source.

[0090] The one or more I / O components / devices 404 can include various components for receiving input and / or providing output, such as for interfacing with a user to assist in performing a medical procedure. The one or more I / O components 404 can be configured to receive touch, speech, gestures, or any other type of input. In an example, the one or more I / O components 404 can be used to provide input for device / system control, such as controlling the robotic system 110, navigating a scope / catheter or other medical instrument attached to the robotic system 110 and / or deployed through a scope, controlling the table 170, controlling a fluoroscopy device, etc. For example, a physician (not shown) can provide input via the I / O component(s) 404, and in response, the control system 150 can send control signals to the robotic system 110 to operate a medical instrument. In an example, a physician can use the same I / O device to control multiple medical instruments (e.g., switch control between instruments).

[0091] As shown, the one or more I / O components 404 can include one or more displays 152 (which may be referred to as “one or more display devices 152”) configured to display data. The one or more displays 152 can include one or more liquid-crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, e-paper displays, and / or any other type(s) of technology. In some embodiments, the one or more displays 152 include one or more touch screens configured to receive input and / or display data. Additionally, the one or more I / O components 404 can include one or more I / O device / controls 407, which can include controllers 154 (e.g., handheld controllers, video game type controllers, finger-based controls that enable finger-like movements, etc.), touch pads, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual or augmented reality devices (e.g., head-mounted displays), foot panels (e.g., buttons under the user's feet), etc. Additionally, the one or more I / O components 404 may include one or more speakers configured to output sound based on an audio signal and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, the one or more I / O components 404 include or are implemented as a console.

[0092] In some embodiments, one or more I / O components 404 can output information related to a procedure. For example, the control system 150 can receive real-time images acquired by the scope and display the real-time images and / or a visual / pictorial representation of the real-time images via the display(s) 152. The display(s) 152 can present an interface(s) that can include image data from the scope and / or another medical instrument. Additionally or alternatively, the control system 150 can receive signals (e.g., analog signals, digital signals, electrical signals, acoustic / sonic signals, pneumatic signals, tactile signals, hydraulic signals, etc.) from medical monitors and / or sensors associated with the patient, and the display(s) 152 can present information related to the patient's health or environment. Such information may include, for example, information displayed via a medical monitor, such as heart rate (e.g., ECG, HRV, etc.), blood pressure / blood flow velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, brain waves (e.g., EEG), environmental temperature and / or local or core body temperature.

[0093] In some embodiments, the control system 150 can be coupled to the robotic system 110, the table 170 or another table, and / or medical instruments through one or more cables or connections (not shown). In some implementations, support functions from the control system 150 can be provided through a single cable, simplifying and cluttering the operating room. In other implementations, certain functions can be combined in separate cable runs and connections. For example, power can be provided through a single power cable, while support for control, optics, fluidics, and / or navigation can be provided through separate cables.

[0094] The robotic system 110 generally includes an elongated support structure 410 (also referred to as a "column"), a robotic system base 411, and a console 412 at the top of the column 410. The column 410 can include one or more carriages 413 (also referred to as "arm supports 413") for supporting the deployment of one or more robotic arms 112. The carriages 413 can include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arms 112 for positioning relative to the patient. The carriages 413 also include a carriage interface 414 that allows the carriage 413 to translate vertically along the column 410. The carriage interface 414 can connect to the column 410 through slots, such as slots 415 located on either side of the column 410 to guide the vertical translation of the carriage 413. The slot 415 can include a vertical translation interface for positioning and / or holding the carriage 413 at various vertical heights relative to the base 411. As the carriage 413 translates vertically, the robotic system 110 can adjust the reach of the robotic arm 112 to meet various table heights, patient sizes, physician preferences, and the like. Similarly, the robotic arm base 416 of the robotic arm 112 can be angled in various configurations by individually configurable arm mounts on the carriage 413. The column 410 can include devices therein, such as gears and / or motors, designed to use vertically aligned lead screws to translate the carriage 413 in a mechanized manner in response to control signals generated in response to user input, such as input from an I / O device(s).

[0095] The base 411 can balance the weight of the column 410, the carriage 413, and / or the robotic arm 112 on a surface such as a floor. Thus, the base 411 can house heavier components such as one or more electronics, motors, power supplies, and components that allow for movement and / or stabilize the robotic system 110. For example, the base 411 can include rotatable wheels 417 (also referred to as "casters 417" or "mobilization components 417") that allow the robotic system 110 to move around a room for a procedure. After reaching the appropriate position, the casters 417 can be locked using wheel locks to hold the robotic system 110 in place during a procedure. As shown, the robotic system 110 also includes a handle 418 to aid in steering and / or stabilizing the robotic system 110. In this example, the robotic system 110 is illustrated as a cart-based system that is mobile. However, the robotic system 110 can be implemented as a stationary system, integrated into a table, etc.

[0096] The robotic arm 112 can generally include a robotic arm base 416 and an end effector 419 separated by a series of linkages 420 (also referred to as "arm segments 420") connected by a series of joints 421. Each joint 421 can include an independent actuator, and each actuator can include an independently controllable motor. Each independently controllable joint 421 represents an independent degree of freedom available to the robotic arm 112. For example, each of the arms 112 can have seven joints, thus providing seven degrees of freedom. However, any number of joints can be implemented with any degrees of freedom. In an embodiment, multiple joints can provide multiple degrees of freedom, allowing for "redundant" degrees of freedom. Redundant degrees of freedom allow the robotic arm 112 to position each end effector 419 at a specific position, orientation, and / or trajectory in space using different linkage positions and / or joint angles. In some embodiments, the end effectors 419 can be configured to engage and / or control medical instruments, devices, objects, and the like. The freedom of movement of the arm 112 allows the robotic system 110 to position and / or orient a medical instrument from a desired point in space and / or allows a physician to move the arm 112 to a clinically advantageous position away from the patient to allow access while avoiding arm collisions.

[0097] The end effector 419 of each of the robotic arms 112 can include an instrument device manipulator (IDM). In some embodiments, the IDM can be removed and replaced with a different type of IDM. For example, a first type of IDM can manipulate an endoscope, a second type of IDM can manipulate a catheter, a third type of IDM can hold an EM field generator, etc. However, the same IDM can be used. In some examples, the IDM can include connectors for transmitting air pressure, power, electrical signals, and / or optical signals between the robotic arms 112. The IDM can be configured to manipulate the medical instrument using techniques including, for example, direct drive, harmonic drive, gear drive, belt / pulley, magnetic drive, etc. In some embodiments, an IDM can be attached to a respective one of the robotic arms 112, which is configured to insert or retract each coupled medical instrument into or from a treatment site.

[0098] In some embodiments, the robotic arm 112 can be configured to control the position, orientation, and / or articulation of a medical instrument attached thereto. For example, the robotic arm 112 can be configured / configurable to manipulate a scope / catheter using an elongated movement member. The elongated movement member can include one or more pull wires, cables, fibers, and / or flexible shafts. By way of example, the robotic arm 112 can be configured to actuate a number of pull wires of the scope / catheter to deflect the tip of the scope / catheter. The pull wires can include any suitable or desired material, such as metallic and / or non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, and the like. In some embodiments, the scope / catheter is configured to exhibit non-linear behavior in response to forces applied by the elongated movement member. The non-linear behavior can be based on the stiffness and / or compressibility of the scope / catheter and the variability in sag or stiffness between different elongated movement members.

[0099] As shown, the console 412 is positioned at the top of the column 410 of the robotic system 110. The console 412 may include a display(s) (e.g., a dual-purpose device such as a touch screen) to provide a user interface for receiving user input and / or providing output, such as to provide pre-operative data, intra-operative data, information for configuring the robotic system 110, etc. to the physician / user. Potential pre-operative data may include pre-operative planning, navigation and mapping data obtained from a pre-operative computerized tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data may include optical information provided by tools, sensors and / or coordinate information from sensors, and vital patient statistics such as respiration, heart rate, and / or pulse. The console 412 may be positioned and tilted to allow the physician to access the console 412 from the side of the column 410 opposite the arm base 416. From this position, the physician may view the console 412, the robotic arm 112, and the patient while operating the console 412 from behind the robotic system 110.

[0100] The robotic system 110 may also include control circuitry 422, one or more communication interfaces 423, one or more power units 424, one or more input / output components 425, one or more actuators / hardware 426, and / or memory / data storage 427. The one or more communication interfaces 423 may be configured to communicate with one or more devices / sensors / systems. For example, the one or more communication interfaces 423 may transmit / receive data in a wireless and / or wired manner over a network.

[0101] The one or more power supply units 424 can be configured to manage and / or provide power to the robotic system 110. In some embodiments, the one or more power supply units 424 include one or more batteries, such as lithium-based batteries, lead acid batteries, alkaline batteries, and / or another type of battery. That is, the one or more power supply units 424 can include one or more devices and / or circuits configured to provide a power source and / or provide power management functions. Further, in some embodiments, the one or more power supply units 424 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power source. Further, in some embodiments, the one or more power supply units 424 include a connector configured to couple to the control system 150 to receive power from the control system 150.

[0102] The one or more I / O components / devices 425 can be configured to receive input and / or provide output, such as for interfacing with a user. The one or more I / O components 425 can be configured to receive touch, speech, gestures, or any other type of input. In an example, the one or more I / O components 425 can be used to provide input for device / system control, such as for controlling / configuring the robotic system 110. The one or more I / O components 425 can include one or more displays configured to display data. The one or more displays can include one or more liquid crystal displays (LCDs), light emitting diode (LED) displays, organic LED displays, plasma displays, e-paper displays, and / or any other type(s) of technology. In some embodiments, the one or more displays include one or more touch screens configured to receive input and / or display data. Additionally, the one or more I / O components 425 can include a touch pad, a controller, a mouse, a keyboard, a wearable device (e.g., an optical head mounted display), a virtual reality device or an augmented reality device (e.g., a head mounted display), and / or the like. Additionally, the one or more I / O components 425 may include one or more speakers configured to output sound based on the audio signal and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, the one or more I / O components 425 include or are implemented as the console 412. Furthermore, the one or more I / O components 425 may include one or more buttons that can be physically pressed, such as a button on a distal end of the robotic arm 112 (which can enable / disable an admittance control mode of the robotic arm 112 for manual manipulation / movement of the robotic arm 112).

[0103] One or more actuators / hardware 426 can be configured to facilitate movement of the robotic arm 112. Each actuator 426 can include a motor, which can be implemented at a joint or elsewhere in the robotic arm 112 to facilitate movement of the joint and / or connected arm segment / linkage. In some embodiments, a user can manually manipulate the robotic arm 112 without the use of electronic user controls. For example, during setup in a surgical suite or at any point during a procedure, a user may select a button on the distal end of the robotic arm 112 to enable an admittance control mode and then manually move the robotic arm 112 to a particular orientation / position.

[0104] The various components of the robotic system 110 may be electrically and / or communicatively coupled using certain connection circuits / devices / features that may or may not be part of the control circuitry 422. For example, the connection mechanism(s) may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuits of the robotic system 110. In some embodiments, two or more of the components of the robotic system 110 may be electrically and / or communicatively coupled to one another.

[0105] As referenced above, systems 150 and 110 may include control circuitry 401 and 422, respectively, configured to perform certain functions described herein. The term "control circuitry" may refer to any collection of one or more processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connection circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, graphics processing units, field programmable gate arrays, application specific integrated circuits, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any devices that manipulate signals (analog and / or digital) based on hard-coding of circuitry and / or operational instructions. The control circuitry may further include one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuits of a device. Such data storage devices may include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information. It should be noted that in embodiments where the control circuitry includes a hardware state machine (and / or implements a software state machine) and includes analog, digital, and / or logic circuitry, the data storage device(s) / register(s) that store any associated operational instructions may be embedded within or external to the circuitry that includes the state machine, analog, digital, and / or logic circuitry.

[0106] Although the control circuitry is illustrated as a separate component from the other components of the control system 150 / robot system 110, any or all of the other components of the control system 150 / robot system 110 may be at least partially embodied in the control circuitry. For example, the control circuitry may include various devices (active and / or passive), semiconductor materials and / or areas, layers, regions, and / or portions thereof, conductors, leads, vias, connections, etc., and one or more of the other components of the control system 150 / robot system 110 and / or portions thereof may be at least partially formed and / or embodied in such circuit components / devices.

[0107] Further, the memory / data storage 406 / 427 can be configured to store data / instructions. For example, the data storage / memory 406 / 427 can store instructions executable by the control circuitry to perform a certain function / operation. The term "memory" can refer to any suitable or desired type of computer-readable medium. For example, the one or more computer-readable media can include one or more volatile, non-volatile, removable, and / or non-removable data storage devices implemented using any technology, layout, and / or data structure(s) / protocol that includes any suitable or desired computer-readable instructions, data structures, program modules, or other types of data. The one or more computer-readable media that may be implemented according to embodiments of the present disclosure include, but are not limited to, phase-change memory, static random-access memory (SRAM), dynamic random-access memory (DRAM), other types of random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technology, compact disk read-only memory (CD-ROM), digital versatile disk (DVD) or other optical storage device, magnetic cassette, magnetic tape, magnetic disk storage device or other magnetic storage device, or any other non-transitory medium that can be used to store information for access by a computing device. As used herein in certain contexts, the one or more computer-readable media may generally not include communication media such as modulated data signals and carrier waves.Accordingly, one or more computer-readable media should be understood to generally refer to non-transitory media.

[0108] In some examples, the control system 150 and / or the robotic system 110 are configured to perform one or more localization techniques to determine / track the orientation / position of an object / medical instrument. For example, the one or more localization techniques can process input data to generate position / orientation data of the medical instrument. The object / medical instrument position / orientation data can indicate the position / orientation of the object / medical instrument relative to a frame of reference. The frame of reference can be a frame of reference relative to a patient's anatomy, a known object (e.g., an EM field generator, system, etc.), a coordinate system / space, etc. In some implementations, the position / orientation data can indicate the position / orientation of the distal end (and / or, in some cases, the proximal end) of the medical instrument. For example, the position / orientation data of a scope can indicate the position and orientation of the distal end of the scope, including the amount of rotation of the distal end of the scope. The position and orientation of the object can be referred to as the pose of the object.

[0109] Exemplary input data that can be used to generate the object / medical instrument position / orientation data can include sensor data from sensors associated with the medical instrument (e.g., EM field sensor data, visual / image data acquired by an imaging / depth / radar device on the medical instrument, accelerometer data from an accelerometer on the medical instrument, gyroscope data from a gyroscope on the medical instrument, satellite-based positioning data from a satellite-based sensor (e.g., Global Positioning System (GPS)), etc.), feedback data (also referred to as "kinematic data") from the robotic arm / component (e.g., data indicating how the robotic arm / component moved / actuated), robot command data for the robotic arm / component (e.g., control signals sent to the robotic system 110 / robot arm 112 to control the movement of the robotic arm 112 / medical instrument), shape sensing data from shape sensing fibers (which can provide information regarding the position / shape of the medical instrument), model data regarding the patient's anatomy (e.g., models of internal / external parts of the patient's anatomy), patient position data (e.g., data indicating how the patient is positioned on a table), pre-operative data, etc.

[0110] 5 illustrates medical system components including a scope assembly / system 502 and an instrument feeder assembly 504 that may be implemented in any of the medical systems described herein, according to one or more embodiments. The scope system 502 and / or feed assembly 504 may include various hardware and control components. In an example, the scope system 502 may represent / include a scope 130 and / or other scopes described herein. Additionally, the instrument feeder assembly 504 may include the instrument feeder device 180 and / or any other instrument feeder device described herein.

[0111] 5, the scope system 502 includes a handle / instrument base 506 coupled to an elongated shaft 508. The handle 506 can be configured to couple to a robotic arm to be robotically operated and / or (in some examples) can be configured to be held and manually operated by a user. For example, the handle 506 can be configured to control the actuation of the elongated shaft 508. The elongated shaft 508 can comprise a rigid or flexible tube or another element. In some examples, the elongated shaft 508 and / or other components of the scope system 502 are sized to pass through an outer sheath, catheter, introducer, or other luminal device.

[0112] As shown, the scope system 502 can include one or more lights 510 disposed at least partially at the distal end of the elongated shaft 508 to provide light at the distal end. In an embodiment, the scope 502 can be configured to house an optical fiber to carry light from a proximally located light source, such as a light emitting diode, to the distal end of the elongated shaft 508. The distal end of the elongated shaft 508 can include a port for a light source to illuminate the anatomical space, which can be useful when using the imaging device(s) / camera(s) 512. The scope system 502 can be implemented with any number of light sources.

[0113] The scope system 502 may also include a camera / imaging device(s) 512 configured to acquire image data, such as image data representative of the patient's internal anatomical structures. In examples, the imaging device 512 may include optical fibers, fiber arrays, and / or lenses. One or more optical components of the imaging device 512 may move with the tip of the scope system 502, such that movement of the tip results in changes in images acquired by the imaging device 512. Thus, the imaging device 512 may acquire data from a distal end of the elongated shaft 508. In some embodiments, the scope system 502 may contain wires and / or optical fibers for transmitting signals between the optical assembly and the distal end of the scope system 502.

[0114] The scope system 502 may also include working channel(s) 514 for deploying the instrument(s) / tool(s) 516 and / or for other functions. Exemplary instruments 516 include a laser device configured to provide a laser, a basket device configured to capture / retrieve an object (e.g., fragments of a kidney stone), forceps configured to grasp / hold an object, a scalpel configured to cut an object, a lithotriptor, an irrigation / aspiration device configured to provide irrigation / aspiration to a target site, and the like. In the example of FIG. 5, a basket device is deployed through the working channel 514. The working channel(s) 514 may extend longitudinally through the scope system 502 from a proximal end to a distal end. In an embodiment, the working channel(s) 514 is offset to one side of the elongated shaft 508 (e.g., offset from a longitudinal axis), as illustrated in FIG. 5. In other examples, the working channel(s) 514 is positioned at the center of the scope system 502 or at another location. Although imaging device(s) 512 are shown as attached to the distal end of scope system 502 (e.g., integrated with scope system 502), in some cases imaging device(s) 512 are separate devices deployed through working channel(s) 514. Additionally, although a single working channel 514 is shown, any number of working channels may be implemented.

[0115] In some examples, the scope system 502 may be powered through a power interface 518 and / or controlled through a control interface 520, each or both of which may be interfaced with a robotic arm / component of the robotic system 110.

[0116] In some embodiments, the scope system 502 includes sensor(s) 522 (sometimes referred to as "position sensor") configured to generate and / or transmit sensor data to another device. The sensor data may indicate a position and / or orientation of the scope system 502 (e.g., its distal end) and / or may be used to determine / estimate the position / or orientation of the scope system 502. For example, the sensor 522 may provide sensor data to a control system, which is then used to determine the position and / or orientation of the scope system 502. The sensor 522 may be located at the distal end of the scope system 502 and / or at another location. In some embodiments, the sensor 522 may include an electromagnetic (EM) sensor having a coil of conductive material, or another form / embodiment of an antenna. However, the scope system 502 may include other types of sensors, such as shape-sensing fiber, accelerometer(s), gyroscope(s), satellite-based positioning sensor(s) (e.g., Global Positioning System (GPS) sensor), radio frequency transceiver(s), etc.

[0117] The scope system 502 may be articulatable, such as with respect to at least a distal portion of the scope, such that the scope system 502 can be steered within the human anatomy. In some embodiments, the scope system 502 is configured to be articulated with five degrees of freedom (DOF), including, for example, XYZ coordinate translation, as well as pitch and yaw. Additionally, in some embodiments, the scope system 502 is articulatable with six DOF, including XYZ coordinate translation, as well as pitch, yaw, and rotation. In other embodiments, the scope system 502 is articulatable with other DOF. In embodiments in which the scope system 502 is equipped with a position sensor, the position sensor can provide position information, such as five DOF position information (e.g., x, y, and z coordinates, as well as pitch and yaw angles), six DOF position information (e.g., x, y, and z coordinates, as well as pitch, yaw, and rotation angles), etc. In some embodiments, the scope system 502 can include telescoping components, such as an inner leader portion and an outer sheath portion, that can be manipulated to telescopically extend the scope system 502.

[0118] The scope system 502 may include one or more elongated movement members (not shown) configured to control the movement of the elongated shaft 508, such as at the distal end of the scope system 502. The elongated movement members may include one or more wires (e.g., pull wires or push wires), cables, fibers, and / or flexible shafts. The pull wires may include any suitable or desired material, such as metallic and non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, and the like. In some embodiments, the scope system 502 is configured to exhibit non-linear behavior in response to a force applied by the elongated movement members. The non-linear behavior may be based on the stiffness and / or compressibility of the scope system 502, as well as the variability in sag or stiffness between different elongated movement members. In a robotic implementation, the robotic arm may be configured to actuate one or more pull wires coupled to the scope system 502 to deflect the tip of the elongated shaft 508. Alternatively, in a user handheld implementation, a user can provide manual input via an actuator to actuate one or more pull wires in the scope system 502 to deflect the tip of the elongate shaft 508.

[0119] FIG. 5 further illustrates an instrument feeder assembly 504 that includes an instrument feeder device 530 (sometimes referred to as “instrument feeder 530 ”) and an access sheath assembly 560 that may be physically coupled to the instrument feeder device 530 .

[0120] The instrument feeder device 530 may include an engagement assembly 532 configured to engage and / or control at least a portion of a shaft-type instrument, such as the scope 130. The engagement assembly 532 may include a channel 534 sized and / or configured to position at least a portion of a shaft-type instrument therein. For example, the instrument may be at least partially nested within the channel 534 when positioning a scope or the like to allow the instrument feeder device 530 to axially drive such instrument. The engagement assembly 532 may also include retention mechanism(s) 536 for maintaining the instrument within the channel 534. For example, the retention mechanism(s) 536 may include a robotically actuated cover that allows the channel 534 to be selectively opened and closed. Additionally, the engagement assembly 532 may include actuator means / mechanism(s) 538 for axially moving the shaft / instrument, such as when loaded into the channel 534. Although various components are illustrated as being included within the engagement assembly 532, the engagement assembly 532 may include fewer or more components. In some examples, the implement feeder device 530 does not include a sensor(s), such as a sensor for detecting a state of the implement feeder device 530, while in other examples, the implement feeder device 530 includes such a sensor(s).

[0121] The actuator 538 may be configured to move a shaft-type instrument placed in engagement therewith relative to the instrument axis. In an embodiment, the actuator(s) 538 include one or more shaft-engaging wheels / rollers, conveyor belts, gears, tracks, finger / needle mechanisms, or other actuator(s). The actuator(s) 538 may be controlled through engagement with one or more drive inputs 540, which may actuate the actuator means / mechanism 538 and / or allow for physical engagement with mechanical components of the instrument feeder device 530 that may directly actuate the actuator means / mechanism 538. In one example, the actuator(s) 538 include one or more feed rollers. As used herein, the term "feed roller" may include any number of roller(s) / wheel(s) configured to effect axial movement of a shaft engaged therewith. The "feed roller" may further include an input drive or an output drive associated with the instrument feeder device 530 that directly or indirectly causes movement of the roller(s) / wheel(s). In some embodiments, the rollers 538 may comprise or include a deformable material that provides grip, friction, traction, or pressure between the rollers 538 and the elongate shaft 508. The deformable material may include silicone rubber or another material.

[0122] The instrument feeder device 530 further includes a sheath coupling member / clip 542 that may be configured to secure or hold in place at least a portion of the access sheath assembly 560. For example, the sheath clip 542 may be configured to clamp onto or over at least a portion of the funnel port structure 562 of the access sheath assembly 560, as shown. The clip 542 may be supported by one or more clip support arms 544. The sheath clip 542 may be positioned at a distal end of the instrument feeder device 530.

[0123] In some embodiments, the instrument feeder assembly 504 includes or is associated with a specimen collector structure 546, which may be at least partially affixed to one or more components of the instrument feeder assembly 504. The specimen collector 546 may comprise a cup-like or other structure configured to allow placement or dropping of a kidney stone or other specimen or debris retracted through the access sheath assembly 560, such as by using a basket tool deployed through the instrument shaft. In some embodiments, the specimen collector 546 is disposed between the distal opening of the channel 534 and the funnel port structure 562, and the instrument (e.g., a basket device) may be retracted into position over the specimen collector 546 such that the stone / specimen may be dropped or placed into the specimen collector 546.

[0124] As shown, the access sheath assembly 560 can include an access sheath tube or conduit 564, which can be physically coupled at its proximal end to a funnel port structure 562. The funnel port structure 562 can provide an at least partially conical introducer opening into the access sheath 564, with the proximal opening of the port 562 having an area or diameter greater than the cross-sectional area or diameter of the access sheath 564. In some embodiments, the access sheath 564 is not docked to the instrument feeder device 530, but rather is coupled to a robotic arm, stand, or other structure. The access sheath 564 can include a tube or other structure through which the elongated shaft 508 can be inserted. In some embodiments, the access sheath 564 can include an elongated flexible access sheath configured to be inserted into an anatomical lumen. In some embodiments, an access sheath is not used, and the elongated shaft 508 of the scope assembly 502 can be inserted directly into the patient (e.g., through a natural orifice in the patient or other surgical access port or incision). Although certain examples described herein refer to an access sheath assembly including a port / introducer structure and a sheath component, it should be understood that embodiments of the present disclosure may implement an access sheath having integrated port and sheath components. Thus, references herein to an "access sheath" or simply a "sheath" may refer to the sheath portion, the port portion, or both of the access sheath / assembly. Additionally, the access sheath assemblies described herein may be a single device, configuration, or structure rather than an assembly of separate components.

[0125] Figures 6A-6G illustrate example details of an implement feeder device 530, according to one or more embodiments. Specifically, Figure 6A illustrates a perspective view of the implement feeder device 530, Figure 6B illustrates the implement feeder device 530 with a portion of the housing removed to show various features of the implement feeder device 530, Figure 6C illustrates the implement feeder device 530 with a portion of the housing and retention mechanism(s) 536 removed, and Figures 6D-6G illustrate example mechanisms / gears that may be implemented to facilitate movement of the rollers 538.

[0126] As shown in FIG. 6A, the instrument feeder device 530 can include a housing 602 configured to surround / enclose (partially or completely) various internal components of the instrument feeder device 530. The housing 602 can include an upper portion 604 and a lower portion 606, where the lower portion 606 can be configured to attach to a robotic arm, a sterilization adapter, and / or other mechanisms / components. The upper portion 604 can include a channel 534 formed therein and configured to receive an instrument shaft. Such a configuration can allow the instrument shaft to be loaded into the instrument feeder device 530 from the top and / or laterally. The channel 534 can be sized to receive the instrument shaft such that the channel 534 generally has a width greater than the outer diameter of the instrument shaft. The C-clip support arm 544 can be part of the housing 602 or can be a separate component.

[0127] In some embodiments, the instrument feeder device 504 can include one or more clip / retention mechanisms 608 configured to secure the instrument shaft within the channel 534. For example, a first clip (A) 608 can be positioned at a proximal end of the channel 534 and a second clip 608 (B) can be positioned at a distal end of the channel 534. The clips can be configured to secure the instrument shaft without substantially restricting axial movement of the shaft through the channel 534. The inner diameter of the retention portion of the clip 608 can generally be larger than the outer diameter of the instrument shaft. In some examples, the clip 608 can be configured to provide tactile feedback to indicate to a user that the instrument shaft is properly loaded within the channel 534, such as by snapping through an entry portion of the clip 608. In some examples, the instrument shaft can exhibit some amount of pivoting / tilting movement about the point where the instrument shaft contacts the actuator, as the contact point can be relatively small. Thus, the channel 534, clip 608, and / or other features of the instrument feeder device 504 may assist in maintaining the instrument shaft in the proper orientation within the instrument feeder device 530. In some cases, the channel 534 may have a sufficient length to limit / prevent misalignment of the instrument shaft.

[0128] In the illustrated example, the channel 534 includes a flared or tapered portion 610 that may be positioned at the proximal end of the channel 534. In some examples, the instrument shaft (which may be relatively flexible) may form a service loop or other excess slack between the instrument feeder device 530 and an additional robotic arm coupled to and positioned at an instrument base / handle associated with the instrument shaft. The tapered portion 610 may facilitate feeding the instrument shaft into the instrument feeder device 530 in the presence of angled conditions and / or service loops while avoiding sharp bends in the instrument shaft. For example, the tapered portion 610 may provide space for feeding an elongated shaft into the proximal end of the channel 534 at various angles, while the sidewalls of the tapered portion 610 may provide an enlarged bend radius or smooth entry portion for the instrument shaft in the region where the instrument shaft enters the instrument feeder device 530. The tapered portion 610 may also accommodate some degree of misalignment between the instrument feeder device 530 and an instrument base / handle associated with the instrument shaft. Additionally, the tapered portion 610 can facilitate feeding the elongate shaft through the instrument feeder device 530 as the shaft is driven axially.

[0129] As shown in Figures 6B and 6C, the instrument feeder device 530 can include an actuator 538 configured to drive the axial movement of the instrument shaft. In this example, the actuator 538 is implemented as a feed roller, although other types of actuators can be implemented. The rollers 538 can be positioned on either side of the channel 534 such that the rollers 538 are positioned on either side of the instrument shaft when the instrument shaft is loaded into the instrument feeder device 530. Thus, the rollers 538 can be referred to as opposing rollers. The rollers can be configured to move between a first position generally associated with an engaged state, a second position generally associated with a disengaged state, and / or other positions. For example, in the first position, the rollers 538 can press or otherwise engage with the opposite / both sides of the instrument shaft and / or with each other. In an embodiment, when the rollers 538 are positioned in the first position, the rollers 538 can be rotated to drive the insertion / retraction of the instrument shaft. Further, in embodiments, when rollers 538 are positioned in the second position, rollers 538 can be spaced apart from the instrument shaft and / or channel 534. The second position can be associated with loading the instrument shaft, rotating the shaft, etc. Exemplary states / positions of rollers 538 and / or other features of engagement assembly 532 are described in further detail below.

[0130] As shown in FIG. 6B, the instrument feeder device 530 can include a retention mechanism(s) 536. In this example, the retention mechanism 536 is implemented as a cover, although other retention mechanisms may be implemented. Here, the cover 536 is coupled / mechanically linked to one or more other mechanisms of the instrument feeder device, such as rollers 538(A). In an example, the cover 536 can automatically open and close as the rollers 538(A) move between various positions / states (e.g., engaged or disengaged). As shown, the cover 536 can include a plate positioned over the rollers 538(A). The cover 536 can include a slot 616 or other opening for receiving / engaging with a cam / shaft 618 that can extend from the rollers 538(A). In this example, as the rollers 538(A) move, the cam 618 engages the slot 616 to cause a corresponding movement of the cover 536, such as opening and closing the cover 536 along with the movement of the rollers 538(A). Although various examples have been described in the context of the retention mechanism 536 being implemented as a cover, other mechanisms may be implemented. For example, the clip 608 may be configured to be selectively opened and closed to facilitate opening and closing of the channel 534 in some examples. While the illustrated embodiment utilizes a cam mechanism to open / close a sliding or translating cover, other mechanisms may be used to form an operable coupling between the drive input and the cover 536. Additionally or alternatively, the cover 536 may be a pivoting cover or may be actuated to open and close by other motions.

[0131] In some embodiments where the position of cover 536 is mechanically coupled to the position of roller 538 (as in the illustrated example), cover 536 can be long enough to continue to close channel 534 even when roller 538 is initially disengaged from the instrument shaft. Cover 536 can then continue to move and uncover channel 534 as roller 538 continues to move away from the shaft. In other embodiments, the position of cover 536 can be controlled differently. For example, cover 536 need not be mechanically coupled to roller 538(A). In some examples, cover 536 is independently controlled and / or is not mechanically coupled to roller 538(A), in which case the fully open, closed, or any other intermediate position of cover 536 can be controlled by a separate drive input and / or in another manner. That is, in some examples, cover 536 is coupled to its own drive input.

[0132] The instrument feeder device 530 may further include one or more springs 612 that may be configured to apply a force to the rollers 538. In some examples, the springs 612 may bias the rollers 538 toward a particular position, such as a first position where the rollers 538 are engaged (e.g., closed / engaged state). Here, the drive output may provide / apply a force that overcomes the force of the springs 612 to move the rollers 538 to a second position where the rollers 538 are disengaged. In examples, in addition to biasing the rollers 538 toward the engaged position, the springs 612 may also be configured to provide a pressure or friction force to engage the rollers 538 with the instrument shaft. Thus, the spring force may be selected such that the rollers 538 begin to slip on the instrument shaft at a predefined load. By adjusting this drive / spring force, the system may maintain a level of applied force that is determined or defined as acceptable or safe for the patient. Although various examples have been described in the context of spring 612 biasing roller 538 toward a first position in which the roller is engaged, spring 612 can be configured to bias roller 538 toward a second position in which the roller is disengaged and / or to bias roller 538 to another position. In some examples, one or more springs 612 are part of engagement assembly 532.

[0133] In an example, the one or more springs 612 include a mechanical spring, such as a torsion spring. However, other types of springs can be implemented, such as a coil spring or other type of spring. In the case of a mechanical spring, the force of the spring 612 can be adjusted (to provide the safety mechanism described above) by adjusting the size of the spring 612 and / or the material from which the spring 612 is made. In addition, various other parameters of the instrument feeder device 530 can be considered. For example, the material of the contact area of ​​the rollers 538 can be adjusted to provide a different coefficient of friction between the instrument shaft and the rollers 538. Similarly, the coefficient of friction of the instrument shaft can be adjusted. One or more of these parameters can be configured to reduce or prevent the rollers 538 from slipping against the instrument shaft and causing the shaft to apply excessive force to the patient's anatomy. In some embodiments, the springs 612 can be omitted and the instrument feeder device 530 can include a virtual spring that exerts a force against the instrument shaft controlled via the operation of the drive shaft or drive output. For example, instead of or in addition to including spring 612, drive input 540 can operate to provide a function similar to that of a mechanical spring, thus providing a virtual spring that can grip the instrument shaft.

[0134] In an embodiment, the rollers 538 are coupled to a drive shaft 614 to facilitate rotation of the rollers 538. For example, the drive shaft 614 may be coupled to a drive input 540 of the implement feeder device 530 to receive input from a drive output of a robotic arm to control rotation of the rollers 538. The drive shaft 614 may be rotated to provide corresponding rotation in the rollers 538. In one example, the drive shaft 614(A) may be coupled to the drive input 540(A) and / or the drive shaft 614(B) may be coupled to the drive input 540(B) (as illustrated in FIG. 7). In an embodiment, each of the rollers 538 may be independently driven. The rollers 538 may be connected to the drive input 540 and / or the drive shaft 614 through a direct connection and / or through a gear assembly, a belt drive system, and / or other means / mechanisms. Although two rollers 538 and two drive shafts 614 are illustrated in this example, any number of rollers and / or drive shafts may be implemented. For example, a single drive shaft can be implemented to drive one or more rollers.

[0135] In an embodiment, the rollers 538 operate in a cooperative relationship such that the rollers 538 move toward or away from each other in a correlated manner. For example, each of the rollers 538 can be coupled to a carrier / support plate, and the two carrier plates are meshed or otherwise coupled together such that rotation of one carrier plate causes an opposite and corresponding rotation of the other carrier plate, as described in the embodiment of Figures 6D-6G below. In this manner, the rotation of both carrier plates can be driven by a single open / close drive input, such as drive input 540(C) (as illustrated in Figure 7 and elsewhere). Thus, in some examples, a single drive input can control the engagement assembly 532 of the implement feeder device 530.

[0136] 6D illustrates a perspective view of an example actuator / roller assembly 620 that may be implemented within the instrument feeder device 530 to facilitate movement of the rollers 538. This shows one of many example implementations. In the illustrated example, the roller assembly 620 includes a right assembly and a left assembly. Each of the right assembly and the left assembly may include a carrier plate 622. The term plate may generally refer to a support structure, and the carrier plate 622 need not necessarily be considered flat or planar. Rather, the carrier plate 622 may include various shapes and / or geometries configured to support various components of the roller assembly 620. The carrier plate 622 may also be referred to as a linkage or other support structure.

[0137] Generally, carrier plate 622 supports or connects to various other features or structures of roller assembly 620. For example, each carrier plate 622 can support or connect to one of rollers 538 and one of roller drive shafts 614. As shown in FIG. 6D, each roller 538 is configured to rotate about a roller axis 626. Each roller drive shaft 614 can be configured to rotate about a drive input axis 628. As shown, roller axis 626 and drive input axis 628 need not be coaxial. In some examples, roller axis 626 and drive input axis 628 are parallel (e.g., as shown). The carrier plate 622 can also support or be connected to a gear assembly 630, as described below with reference to Figures 6E and 6F, which connects the roller drive shaft 614 to the rollers 538 such that rotation of the roller drive inputs 540(A), 540(B) can cause rotation of the rollers 538.

[0138] In the illustrated example, the carrier plate 622 can be configured to rotate about a drive input axis 628. Rotation of the carrier plate 622 about the drive input axis 628 can move the rollers 538 between various positions. As shown in FIG. 6G, the instrument feeder device 530 can include a drive input 540(C) (also referred to as an “open / close drive input 540(C)”) configured to move the rollers 538 between various positions. The open / close drive input 540(C) can be connected to an open / close drive shaft 632 shown in FIG. 6D. Rotation of the open / close drive input 540(C) can cause rotation of the open / close drive shaft 632. The open / close drive input 540(C) and the open / close drive shaft 632 can rotate about an open / close drive axis 634. The open / close drive shaft 632 can further be connected to an off-axis protrusion 636. Thus, as the open / close drive shaft 632 rotates, the off-axis protrusion 636 also rotates about the open / close drive axis 634. However, the off-axis protrusion 636 does not have to be symmetrical about the open / close axis 634. Thus, the off-axis protrusion 636 can provide an eccentric member that can move in an arc about the open / close axis 634.

[0139] As shown in FIG. 6D, the carrier plates 622 can each include a pocket / cavity 638. In the illustrated embodiment, the off-axis protrusion 636 is at least partially positioned within the pocket 638 of one of the carrier plates 622. As the off-axis protrusion 636 rotates about the open / close axis 634, the off-axis protrusion 636 can contact the walls of the pocket 638, which can cause the carrier plate 622 to rotate about the drive input axis 628. The off-axis protrusion 636 can also be rotated to a position where it does not contact the walls of the pocket 638. In this position, where the off-axis protrusion 636 is not contacting the pocket 638, the force applied by the roller 538 to the shaft of the medical instrument can be determined entirely by the spring 612, which can be adjusted to provide the desired force. In this position, the carrier plate 622 can be biased by the spring 612 to rotate to a position where the roller 538 is in a particular position (e.g., a closed position). When the off-axis protrusion 636 is rotated to contact and press against a side wall of the pocket 638, the carrier plate 622 can rotate against the spring force of the spring 612. In some examples, the off-axis protrusion 636 includes a roller configured to rotate about an axis that is not coaxial with the open / close drive axis 634. Such a roller may reduce friction between the off-axis protrusion 636 and the pocket 638.

[0140] In the example of FIG. 6D, the roller assembly 620 includes one open / close drive shaft 632 and one off-axis projection 636. In some examples, such as this example (and as seen in FIGS. 6E-6G), the two carrier plates 622 can be meshed together such that rotation of one carrier plate 622 causes an opposite and corresponding rotation of the other carrier plate 622. In this manner, rotation of both carrier plates 622 can be driven by a single open / close drive input 540(C). This can also allow the rollers 538 to be symmetrically positioned relative to the channel 534 of the instrument feeder device 530. Although the illustrated example includes one off-axis projection 636, both carrier plates 622 can include pockets 638, one of which can be empty. The inclusion of an empty pocket can facilitate manufacturing since the same or similar molds can be used for each carrier plate 622. Additionally or alternatively, a second off-axis projection or other drive member can be used to rotate the other carrier plate independently, in which case the two carrier plates do not need to be meshed together. Further, one of the carrier plates 622 need not include a pocket.

[0141] 6E and 6F illustrate isometric and top views of roller assembly 620 with portions of rollers 538 and carrier plate 622 removed to illustrate example gear assemblies 630. Gear assemblies 630 can transmit rotational motion between drive inputs 540(A), 540(B) and rollers 538. As shown, gear assemblies 630 can include (for each carrier plate 622) a first gear 640 (e.g., a sun gear) and a second gear 642 (e.g., an orbital gear). In the illustrated example, each first gear 640 can be connected to a roller drive shaft 614 / roller drive input 540(A), 540(B) such that rotation of the roller drive shaft 614 / roller drive input 540(A), 540(B) causes rotation of the first gear 640. The first gears 640 can be mounted to the carrier plate 622 such that the first gears 640 can rotate relative to the carrier plate 622. Each first gear 640 can rotate about a respective drive input axis 628 (shown in FIG. 6D).

[0142] Each first gear 640 can be engaged with an associated second gear 642 such that rotation of the first gear 640 causes rotation of the second gear 642. The second gears 642 can be mounted to the carrier plate 622 such that the second gears 642 can rotate relative to the carrier plate 622. The second gears 642 can rotate about their respective roller axes 626 (shown in FIG. 6D ). The second gears 642 can also be attached to (or otherwise engaged with) the rollers 538 such that rotation of the second gears 642 causes rotation of the rollers 538. Thus, rotation of the roller drive inputs 540(A), 540(B) can rotate the rollers 538 through transmission by the first gears 640 and the second gears 642.

[0143] As described above, the carrier plate 622 can rotate about the drive input axis 628 to move the rollers 538 between various positions (e.g., closed and open positions). In the illustrated example, the second gear 642 is mounted to the carrier plate 622 at a position spaced from the drive input axis 628 and therefore rotates (with the carrier plate 622) about the drive input axis 628. As the second / orbital gear 642 rotates with the carrier plate 622 about the drive input axis 628, it also rotates about the first / sun gear 640.

[0144] This arrangement of the second / orbital gear 642 rotating around the first / sun gear 640 can be seen in the top view of FIG. 6F. As shown, the off-axis projection 636 can be rotated into contact with the pocket 638 of the carrier plate 622 to drive the rotation of the carrier plate 622 in the direction indicated by the arrow in FIG. 6F. In particular, with respect to the orientation shown in the figure, the bottom of the carrier plate 622 can be rotated inward, toward the center of the page, and the top of the carrier plate 622 can be rotated outward, toward the outer edge of the page. Gearing 644 between the plates 622 can cause a corresponding opposite rotation of one carrier plate 622 as the other plate 622 moves / rotates. Each of the carrier plates 622 can rotate about a corresponding drive input axis 628. As the carrier plate 622 rotates, the second / orbital gear 642 is driven outward to rotate about the sun gear 640. This arrangement can allow rollers 538 (not shown in FIG. 6F but coupled to second / orbital gear 642) to be driven regardless of the rotational position of carrier plate 622. This arrangement can accommodate, for example, instrument shafts having different diameters.

[0145] FIG. 6G is a bottom view of roller assembly 620 illustrating the relationship of roller drive inputs 540(A), 540(B) and open / close drive input 540(C) of roller assembly 620, according to an embodiment.

[0146] 6D-6G illustrate one exemplary actuator / roller assembly 620 that may be implemented within the instrument feeder device 530. Although various mechanisms are shown in a particular arrangement, these mechanisms may be implemented in other manners and / or other mechanisms may be implemented to facilitate movement of the rollers 538.

[0147] Exemplary mechanisms for the instrument feeder assembly are described in Application No. 16 / 994,504, filed August 14, 2020, and entitled "Axial Motion Drive Devices, Systems, and Methods for a Robotic Medical System," the entire contents of which are incorporated herein by reference.

[0148] 7 illustrates an exploded view of an exemplary instrument device manipulator assembly 702 associated with a robotic arm 112, in accordance with one or more embodiments. The instrument device manipulator assembly 702 includes an end effector 704 associated with a distal end of the robotic arm 112. The instrument manipulator assembly 702 further includes an instrument feeder 530 / instrument feeder assembly 504. The instrument feeder 530 / instrument feeder assembly 504 can incorporate electromechanical means for actuating an instrument 706, such as a scope 502 or other shaft-type instrument. In an example, the instrument manipulator assembly 702 can also include an adapter 708 configured to provide a drive interface between the end effector 704 and the instrument feeder 530 / instrument feeder assembly 504. Descriptions of upward and downward facing surfaces, plates, faces, components, and / or other features or structures herein may be understood with reference to the particular orientation of the instrument device manipulator assembly 702 shown in FIG. That is, the end effector 704 may generally be configurable to face and / or be oriented in a range of directions and orientations, but for convenience, the description of such components herein may be in the context of a generally vertically facing orientation of the end effector 704.

[0149] As shown, the end effector 704 of the robotic arm 112 can include various components / elements configured to connect to and / or align with components of the adapter 708, the instrument feeder assembly 504, the access sheath assembly 560, and / or the instrument 706. For example, the end effector 704 can include a drive output 710 (e.g., a drive spline, gear, or rotatable disk with engagement mechanism) for controlling / actuating the medical instrument, a reader 712 for reading data from the medical instrument (e.g., a radio-frequency identification (RFID) reader for reading a serial number from the medical instrument), one or more fasteners 714 for attaching to the instrument feeder 530 / instrument feeder assembly 504 and / or the adapter 708, a marker 716 for aligning with an instrument (e.g., the access sheath 564) that is manually attached to the patient and / or for defining a front face of the device manipulator assembly 702. In some embodiments, the end effector 704 and / or the robotic arm 112 include a button 718 for activating an admittance control mode in which the robotic arm 112 can be moved manually.

[0150] In this example, the instrument device manipulator assembly 702 includes an adapter component 708 configured to provide a drive interface between the end effector 704 and the instrument feeder 530 / instrument feeder assembly 504. The adapter 708 and / or the instrument feeder 530 may be removable or detachable from the robotic arm 112 and, in some embodiments, may lack any electromechanical components, such as motors. This dichotomy may be caused by the need to sterilize medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to the complex mechanical assembly and sensitive electronics of medical instruments. Thus, the instrument feeder 530 / instrument feeder assembly 504 and / or the adapter 708 may be designed to be detached, removed, and replaced from the end effector 704 (and thus the system) for individual sterilization or disposal. For example, the instrument feeder assembly 504 can be removed and replaced with a different type of instrument. Alternatively, the end effector 704 may not need to be replaced or sterilized in some cases and may be covered (e.g., using a drape 711) for protection. The adapter 708 may include connectors for transmitting pneumatic, power, electrical, and / or optical signals from the robotic arm 112 and / or end effector 704 to the instrument feeder 530 / instrument feeder assembly 504. In embodiments, the adapter 708 includes coupler(s) / drive mechanism(s) 720 configured to couple a drive output 710 of the end effector 704 to a drive input 540 of the instrument feeder assembly 504. Additionally, in some examples, the adapter 708 may include fastener(s) 722 configured to couple the adapter 708 to the end effector 704.

[0151] In some configurations, a sterile drape 711, such as a plastic sheet, may be disposed between the end effector 704 and the adapter 708 to provide a sterile barrier between the robotic arm 112 and the instrument feeder assembly 504. For example, the drape 711 may be coupled to the adapter 708 to allow for the transfer of mechanical torque from the end effector 704 to the adapter 708. The adapter 708 may be generally configured to maintain a seal around its working components such that the adapter 708 itself provides a sterile barrier. The use of the drape 711 coupled to the adapter 708 and / or more other component(s) of the device manipulator assembly 702 may provide a sterile barrier between the robotic arm 112 and a surgical field, thereby enabling the use of a robotic cart associated with the arm 112 in a sterile surgical field. The end effector 704 may be configured to be coupled to various types of sterile adapters that may be loaded onto and / or removed from the end effector 704 of the robotic arm 112. With the arm 112 covered in plastic, the physician and / or other technician(s) may interact with the arm 112 and / or other components of the robotic cart (e.g., a screen) during the procedure. The draping may provide additional protection from biohazard contamination of equipment and / or minimize post-procedure cleaning.

[0152] In this example, the instrument feeder 530 includes multiple drive inputs 540. In the illustrated embodiment, the instrument feeder 530 includes three drive inputs 540, but can include other numbers of drive inputs. The drive inputs 540 may be at fixed, spaced locations along the lower mating surface 724 of the instrument feeder 530, which facilitates coupling the drive inputs 540 to corresponding drive outputs (e.g., on the sterilization adapter 708 and / or the end effector 704). The drive inputs 540 may be at fixed, spaced locations along the corresponding mating surface designed for modular use and attachment to a variety of other instruments. Although various examples have described the drive inputs 540 mounted at fixed locations, in some cases the drive inputs 540 can move within the lower surface 724. For example, the drive inputs 540(A) and 540(B) can be repositioned within the lower surface 724 to engage and / or disengage the opposing rollers 538 from each other and / or the instrument shaft.

[0153] The mechanical assembly within the instrument feeder 530 can enable the drive input 540 to be used to drive the rotation of actuator(s) 538 (e.g., drive the rotation of opposing rollers) for axial movement of the instrument shaft and / or to facilitate changing the engagement state of the engagement assembly 532 with the instrument shaft. For example, the drive inputs 540(A) and 540(B) can receive inputs to control the actuator(s) 538 to axially drive a shaft disposed within the channel 534. The drive inputs 540(A) and / or 540(B) can receive torque / force applied by a drive output that causes a feed roller or other actuator to axially drive a shaft-like instrument. Additionally, drive input 540(C) (also referred to as “open / close drive input”) can receive input from the drive output to control engagement assembly 532 to engage / disengage with the instrument shaft, open / close channel 534 (e.g., using retention mechanism(s) 536), or implement another state, as described in more detail below. The various states of engagement assembly 532 can facilitate loading or unloading an instrument shaft, engaging with an instrument shaft, driving an instrument shaft, or other functions. In the illustrated example, three drive inputs 540 are shown, although any number of drive inputs can be implemented. Each of the drive inputs 540 can be configured to engage with a corresponding drive output on the robot arm 112 and / or the sterile adapter 708. For example, each drive input 540 can include a receptacle configured to mate with a drive output configured as a spline. The drive input and drive output can be configured to engage to transfer motion therebetween. Thus, rotation of the drive output can cause corresponding rotation of the drive input 540 to control various functions of the implement feeder 530.

[0154] References herein to an "instrument device manipulator assembly," "instrument manipulator assembly," "manipulator," "manipulator assembly," and other variations thereof, may refer to any subset of the components of assembly 702 shown in FIG. 702, including the robot arm, the end effector of the robot arm, an adapter configured to be coupled to the robot end effector, an instrument feeder configured to be coupled to the end effector and / or adapter, an actuator of the instrument feeder (e.g., feed roller(s), shaft channel, retention mechanism, and / or other component(s)), and / or a means / mechanism associated with the instrument feeder. Furthermore, it should be understood that references herein to an "actuator" may refer to any component of assembly 702 that directly or indirectly affects or causes movement of an instrument engaged with, coupled to, or otherwise actuable by the instrument feeder. For example, according to embodiments disclosed herein, an "actuator" may include any set or subset of the following devices or components: feed roller(s), shaft actuation wheel(s) / roller(s), feed roller channel(s), instrument feed drive input(s), adapter drive output(s), adapter drive input(s), and / or end effector drive output(s).

[0155] 8-11 illustrate example states / positions of an engagement assembly 532 of an instrument feeder device 530, according to one or more embodiments. In general, a drive output may engage one or more drive inputs 540 (not shown) of the instrument feeder device 530 to actuate one or more components of the engagement assembly 532 and cause the engagement assembly 532 / instrument feeder device 530 to enter a certain state / position. In this example, the engagement assembly 532 is implemented with opposing feed rollers 538, a channel 534, and / or a cover 536. However, the feed rollers 538 may be implemented as other types of actuators and / or the cover 536 may be implemented as another type of retention mechanism. Additionally, one or more of the illustrated components of the engagement assembly 532 may be removed and / or implemented in other ways. For example, the cover 536 may not be implemented in some cases.

[0156] 8-1 and 8-2 illustrate the rollers 538 engaged and the cover 536 closed. In an embodiment, the rollers 538 may exert some amount of force on each other and / or on a hard stop mechanism (not shown) when engaged, which may be due to the biasing force of one or more springs 612 (not shown), a force exerted by a drive output, and / or another force applied to actuate the rollers 538 toward each other. In an embodiment, the rollers 538 may be in contact with each other. However, the rollers 538 may not be in contact with each other but may be within a threshold distance of each other (which may be facilitated by the hard stop mechanism).

[0157] In this example, the cover 536 is closed to prevent objects from entering or exiting the channel 534. As mentioned above, in some examples, the cover 536 can be coupled to one or more of the rollers 538 such that movement of the rollers 538 causes the cover 536 to open and close. However, the cover 536 can be independently actuated. The cover 536 can have a variety of shapes and / or sizes. In this example, the cover 536 includes dimensions that substantially close / cover the channel 534 when positioned over the channel 534.

[0158] In some examples, outer edge portion 538(A)(1) / 538(B)(1) of roller 538(A) / 538(B) can be formed of a different material than inner portion 538(A)(2) / 538(B)(2) of roller 538. For example, outer / circumferential portion 538(A)(1) / 538(B)(1) can include a deformable material configured to axially drive the elongate shaft and / or grip / contact the instrument shaft to avoid damage to the elongate shaft. However, outer edge portion 538(A)(1) / 538(B)(1) and inner portion 538(A)(2) / 538(B)(2) can be formed of the same material.

[0159] 9-1 and 9-2 illustrate the rollers 538 engaged with the instrument shaft 902 and the cover 536 closed. As shown, the rollers 538 may engage or otherwise contact the opposite or opposing side of the elongated shaft 902, which is positioned between the rollers 538 in the channel 534. As illustrated, the elongated shaft 902 is loaded into the channel 534 and inserted into the access sheath assembly 560. The rollers 538 may be press-fit onto or otherwise engaged with the elongated shaft 902. In embodiments, the rollers 538 may apply some amount of force to engage the elongated shaft 902, which may result from the biasing force of one or more springs 612 (not shown), a force applied by a drive output, and / or another force applied to actuate the rollers 538 toward one another.

[0160] In this position / state, rollers 538 can rotate to drive axial motion of instrument shaft 902 (eg, inserting / retracting shaft 902). For example, rotating the rollers 538 in a first direction can cause insertion of the shaft 902 (e.g., in a distal direction toward the patient) and rotating the rollers 538 in an opposite second direction can cause retraction of the shaft 902 (e.g., in a proximal direction away from the patient). Here, the direction of the rollers 538 can refer to the direction of movement of a portion of the rollers 538. For example, rotation in a first direction for insertion of the shaft 902 can refer to rotation of an engaged portion of the rollers 538 in a distal direction and rotation for retraction can refer to rotation of an engaged portion of the rollers 538 in a proximal direction. With respect to the illustration of the rollers 538 in FIG. 9-2, the left roller 538 (B) can rotate counterclockwise and the right roller 538 (A) can rotate clockwise to rotate the roller 538 in a distal direction (e.g., to insert the shaft 902) and vice versa to rotate the roller 538 in a proximal direction (e.g., to retract the shaft 902).

[0161] In this example, cover 536 is at least partially closed to help retain instrument shaft 902 within channel 534, such as by preventing rollers 538 from ejecting shaft 902 upwardly and / or laterally from channel 534. In other words, cover 536 surrounds at least a portion of channel 534 in which instrument shaft 902 is located to prevent shaft 902 from leaving channel 534. However, as discussed above, cover 536 may be removed in some cases.

[0162] 10-1 and 10-2 illustrate a state in which rollers 538 are disengaged and cover 536 is closed. Such a state / position may be an intermediate state between the closed / engaged state and the open / loaded state. As shown, rollers 538 may disengage from or otherwise move out of contact with elongated shaft 902. Additionally, cover 536 may close over at least a portion of channel 534 such that instrument shaft 902 is still retained within channel 534. In this state / position, rollers 538 may disengage from instrument shaft 902, allowing shaft 902 to slide or rotate freely within channel 534.

[0163] In an embodiment, this position / state is used for various cases during a procedure when retention of the instrument shaft is desired, but freer movement of the shaft relative to the instrument feeder device 530 is desired. For example, this state / position can be used to allow the instrument shaft 902 to rotate about its longitudinal axis, allow the robotic arm coupled to the instrument feeder device 530 to be repositioned (while avoiding insertion / retraction of the shaft 902), allow the robotic arm coupled to the handle / instrument base of the shaft 902 to be repositioned (and allow the shaft 902 to slide freely within the channel 534), and / or allow other functions without engaging the shaft 902. In some cases, the robotic arm can move while operating in admittance / manual mode. However, the robotic arm can be controlled to move based on control signals or other inputs.

[0164] In one example, the robotic arm coupled to the instrument feeder device 530 can be moved during a procedure (or at other times) to adjust the position / location of an access sheath coupled to the robotic arm. The access sheath is disposed at least partially within a patient and can be used to insert a medical instrument into the patient. To maintain within the instrument feeder device 530, the instrument feeder device 530 implements this intermediate state to allow the elongated shaft 610 to move freely within the instrument feeder device 530 while the robotic arm coupled to the instrument feeder device is repositioned. In an example, the robotic arm moves using an admittance control mode, although the robotic arm can be moved in other manners.

[0165] 11-1 and 11-2 illustrate a state in which the rollers 538 are disengaged and the cover 536 is open. Such a state / position may be referred to as a fully open / disengaged state or a loaded state. As shown, the rollers 538 may disengage or otherwise move away from contact with the elongated shaft 902, and the cover 536 may be fully open to allow access to the channel 534. Although the rollers 538 are shown positioned farther apart from each other than the intermediate state in FIGS. 10-1 and 10-2, the rollers 538 may be positioned in the same position and / or in a different disengaged position as in FIGS. 10-1 and 10-2. The cover 536 may be opened or otherwise repositioned to provide access (e.g., from above) to the channel 534. In the illustrated example, the cover 536 is positioned completely below the upper housing 604. However, the cover 536 may be at least partially within the channel 534 but may otherwise be positioned elsewhere which may allow the instrument shaft 902 to be loaded or removed from the channel 534.

[0166] In embodiments, the open / fully disengaged state can facilitate loading or unloading of the instrument shaft 902 into the instrument feeder device 530, which can simplify use of the device and / or reduce operation time. For example, the open channel can facilitate loading and / or unloading of the instrument shaft 902 before, during, or after a medical procedure. In one example, the fully open / disengaged state can allow a user to manually adjust the shaft 902 and / or an associated medical instrument without having to fully retract the shaft 902 from within the patient.

[0167] 12 and 13 illustrate various details regarding example states of the engagement assembly 532 and example drive output 1202 of the engagement assembly 532, according to one or more embodiments. In particular, FIG. 12 illustrates a state 1204 of the engagement assembly 532 (in block 1206) in which an instrument shaft is not disposed / loaded therein, and FIG. 13 illustrates a state 1204 of the engagement assembly 532 in which an instrument shaft is disposed / loaded therein. These figures illustrate some of the many example states of the engagement assembly 532 described herein. Although various states are illustrated, any number of states may be implemented, such as to transition between the illustrated states and / or to implement other states not expressly shown.

[0168] In Fig. 12 and Fig. 13, the images in block 1208 illustrate example positions (e.g., rotational angles) of the drive output 1202 associated with an end effector 1210 of a robotic arm. Here, the end effector 1210 is coupled to an instrument feeder device 530, which is shown separated from the end effector 1210 for purposes of illustration. In these examples, the drive output 1202 rotates to implement various states 1204 of the engagement assembly 532. For ease of illustration, the drive output 1202 is shown as a gear (including markings to indicate the rotational position of the gear), but the drive output 1202 can be implemented in other ways. The illustrated positions of the drive outputs 1202 indicate relative positions with respect to one another and may not indicate the amount of actual rotation of the drive output 1202 to facilitate a particular state of the engagement assembly 532. For example, the drive output 1202 can rotate any number of times to facilitate a particular position.

[0169] In some examples, the drive output 1202 is configured to apply different amounts of force to the drive input 540 of the engagement assembly 532 to facilitate different states 1204. Graphs 1212 and 1312 in FIGS. 12 and 13 respectively illustrate example forces that may be applied / received by the drive output 1202 relative to the position of the drive output 1202. The applied forces may be linear (e.g., solid lines) or non-linear (e.g., dotted lines). The lines in these graphs are provided for illustrative purposes and may not reflect the actual amount of force applied by the drive output 1202. While in this example, different forces are applied to control the state of the engagement assembly 532, in other examples, the engagement assembly 532 may be controlled in other ways.

[0170] In these examples, the engagement assembly 532 may be generally configured to bias toward the engaged / closed state. Such biasing may be facilitated through one or more springs 612 (not shown) and / or other means / mechanisms, as described herein. A representation 1214 of the one or more springs 612 is provided in block 1206 to illustrate the amount of compression and / or force exerted by the one or more springs 612 and / or other components of the instrument feeder device 530. It should be understood that this representation 1214 is provided for illustrative purposes only and should not be used to limit the mechanism of the instrument feeder device 530 (including the one or more springs 612). In examples, the engagement assembly 532 may be positioned in the engaged state when the instrument feeder device 530 is not attached to the robot arm, when less than a threshold amount of force is applied to the drive input 540, etc. Thus, the drive output 1202 may generally be configured to apply a force (eg, torque) to the drive input 540 to actuate the engagement assembly 532 toward an open / disengaged state.

[0171] Although some examples have described the instrument feeder device 530 configured to bias toward the engaged state, the instrument feeder device 530 may be implemented in other ways. For example, the engagement assembly 532 may be configured to bias toward the disengaged / open state by using differently configured springs and / or implementing other mechanisms. Furthermore, in some examples, the engagement assembly 532 may not be configured to bias toward any state. Here, the engagement assembly 532 may be configured to remain in any state even when the instrument feeder device 530 is decoupled from the robot arm.

[0172] FIG. 12 illustrates exemplary states 1204 of the engagement assembly 532 when an instrument shaft is not disposed / loaded within the engagement assembly 532. As shown at 1218, states 1204(1) through 1204(3) are generally associated with disengaged states where the rollers 538 are disengaged, while states 1204(3) through 1204(5) are generally associated with engaged states where the rollers 538 are engaged. An engaged state may refer to the rollers 538 contacting one another, being disposed in a hard stop position (which may be facilitated by a hard stop mechanism on the instrument feeder device 530 that keeps the rollers 538 from contacting one another), being disposed within a predetermined distance from one another, being disposed within a predetermined distance relative to an axis / region, etc. In contrast, a disengaged state may refer to the rollers 538 not contacting one another, not contacting the instrument shaft, not disposed in a hard stop position, being positioned beyond a predetermined distance from one another, being positioned beyond a predetermined distance relative to an axis / region, etc. Further, cover 538 can be implemented to facilitate an open or closed state. For example, cover 538 can be in an open / partially open state from 1204(1) to 1204(2) and in a closed state from 1204(2) to 1204(5). Block 1218 is provided for illustrative purposes, and the states of these elements may differ from those shown. For example, transitions between different states (e.g., from an engaged state to a disengaged state and / or from a cover open state to a cover closed state) may occur at different points other than those shown.

[0173] In FIG. 12, states 1204(1)-1204(5) are associated with rotational positions 1202(A)-1202(E) and applied forces 1216(A)-1216(E), respectively. For example, state 1204(2) may be implemented when drive output 1202 is positioned at rotational position 1202(B) and / or applies an amount of force 1216(B). In some examples, positions 1202(A) and / or 1202(E) are associated with hard stop positions facilitated by a hard stop mechanism on the instrument feeder device 530. The hard stop positions may be detected based on a change in the force applied by drive output 1202 (e.g., a spike in the applied force). In some cases, positions 1202(A) and / or 1202(E) are used as reference positions.

[0174] The exemplary state 1204 is shown with a floating zone where the engagement assembly 532 remains in an engaged state for various rotational positions (e.g., positions 1202(C)-1202(E)) of the drive output 1202. This may be implemented to provide some amount of play / backlash between components of the instrument feeder device 530, which may be facilitated by hard stop and / or other mechanisms within the instrument feeder device 530. However, in other examples, a floating zone is not implemented and / or fewer engaged states are implemented.

[0175] In the example of FIG. 12, to transition the engagement assembly 532 from an engaged state to a disengaged state, the drive output 1202 can rotate and / or apply a certain amount of force. For example, as the drive output 1202 rotates clockwise from position 1202(D) to reach rotational position 1202(C), one or more springs 612 of the instrument feeder device 530 can begin to return force to the drive output 1202 such that a force 1220 exceeding a threshold amount is required (as shown in graph 1212) to transition the engagement assembly 532 to a disengaged state. This change in force at position 1202(C) can be detected (e.g., as a force spike). In some cases, position 1202(C) is used as a reference position. In this example where the instrument shaft is not loaded, state 1204(3) is generally associated with transitioning from an engaged state to a disengaged state.

[0176] As shown in FIG. 12, the drive output 1202 can continue to rotate clockwise and / or apply additional force to cause the engagement assembly 532 to reach state 1204(2). For example, as the drive output 1202 rotates clockwise, the distance between the rollers 538 increases and / or the cover 536 begins to move / open. The one or more springs 610 can compress to require the drive output 1202 to increase the amount of force (e.g., torque) applied to reach state 1204(2). In state 1204(2), the rollers 538 are disengaged (e.g., separated from each other by a certain distance) and the cover 536 remains closed over the channel 534 even as the cover 536 begins to open. State 1204(2) can be referred to as an intermediate state between the closed / engaged state and the fully open / loaded state. Further, drive output 1202 can continue to rotate clockwise to reach state 1204(1), where rollers 538 are disengaged (eg, further separated from one another) and cover 536 is fully open.

[0177] In this example, an increasing amount of force (e.g., torque) is required to transition engagement assembly 532 from state 1204(3) to state 1204(1) (as shown in graph 1212), although such transition may be implemented in other manners, such as by applying a decreasing amount of force, a constant amount of force, simply changing the rotational position of drive output 1202, etc. Additionally, while this example describes a clockwise rotation to transition from an engaged state to a disengaged state, drive output 1202 may rotate counterclockwise or in other manners.

[0178] 13 illustrates example states 1204 of the engagement assembly 532 when an instrument shaft is disposed / loaded within the engagement assembly 532. Here, the engagement assembly 532 can transition between at least some of the states 1204 at different rotational positions of the drive output 1202. Specifically, as the instrument shaft is loaded into the engagement assembly 532, the point at which the one or more springs 612 begin to exert a force on the drive output 1202 moves (e.g., to the left in this illustration). As shown, the engagement assembly 532 now transitions from an engaged state to a disengaged state when the drive output 1202 is rotated to position 1202(C)(1). The engagement assembly 532 can begin to transition from an engaged state 1204(3)(A) when the drive output 1202 exerts a force 1318 that exceeds a threshold amount, as shown in graph 1312. Further, in this example, the floating zone has shifted such that an end of the zone is associated with rotational position 1202(E)(1) and engaged state 1204(5)(A) of the drive output 1202. This may occur in some cases due to a rotational displacement or shift of a component of the engagement assembly 532 that facilitates a hard stop position. For example, rotational position 1202(E)(1) may be associated with a hard stop feature of the instrument feeder device 530. However, in other examples, the floating zone may be further expanded to allow the drive output 1202 to reach a previous rotational position 1202(E). Additionally, the floating zone may be expanded and / or otherwise implemented to include other rotational positions of the drive output 1202.

[0179] Although various examples have been described in the context of determining the state of the instrument feeder device based on the force applied by the drive output and / or the position of the drive output, the state of the instrument feeder device can additionally or alternatively be determined based on other information. For example, the instrument feeder device can include one or more sensors for / on the rollers, cover, channel, and / or other components configured to detect proximity, pressure, and / or another characteristic. In one example, a sensor can be implemented on the rollers and / or another component around the rollers to determine the proximity of the rollers to each other and / or the proximity of the instrument shaft. Additionally, the drive input of the instrument feeder device can include a sensor / mechanism for detecting the rotational position of the drive input, which can be used to determine the state of the instrument feeder device. Additionally, a sensor can be implemented on the cover to detect when the cover is open, partially open, or closed. Additionally or alternatively, the elongated shaft of the medical instrument can include a sensor configured to detect pressure / proximity, such as pressure applied by the rollers of the engagement assembly. In some cases, the instrument feeder device may not implement a spring(s) to bias the rollers to a particular state (e.g., clamped onto the instrument shaft), where the state of the instrument feeder device may be based on the position of the drive output and / or the force applied by the drive output (this may include detecting a fully engaged state based on a force spike due to contact with the instrument shaft). In some cases where a spring(s) is not implemented, the drive output may apply some amount of force to fully engage / clamp the instrument shaft.

[0180] In some examples, the instrument feeder device can be implemented with a first drive input configured to control engagement of the rollers (e.g., the distance between the rollers) and a second drive input configured to control actuation of the cover (e.g., opening and closing the cover). Thus, separate drive outputs can be implemented to control different states of the engagement assembly, and the state of the rollers can be controlled independently from the state of the cover. Further, in some examples, the state of the first component (e.g., rollers or cover) can be manually controlled and detected by a sensor(s), and such detected state can control the second component (e.g., cover or rollers) to facilitate a particular state for the engagement assembly.

[0181] 14-18 illustrate example flow diagrams of processes 1400, 1500, 1600, 1700, and 1800, respectively, for implementing various techniques described herein. The various operations / acts associated with processes 1400, 1500, 1600, 1700, and 1800 may be implemented by control circuitry implemented in any of the devices / systems described herein, such as control system 150, robotic system 110, table 170, medical instruments, instrument feeder devices, and / or another device, or combinations thereof. Although various blocks are illustrated as being part of processes 1400, 1500, 1600, 1700, and / or 1800, any such blocks may be omitted. Additionally, additional blocks may be implemented as part of processes 1400, 1500, 1600, 1700, and / or 1800. The illustrated order of the blocks is for illustrative purposes only, and the blocks may be implemented in any order. In some embodiments, one or more of the blocks of processes 1400, 1500, 1600, 1700, and / or 1800 are implemented as executable instructions that, when executed by control circuitry, cause the control circuitry to perform the described functions / operations. However, one or more of the blocks of processes 1400, 1500, 1600, 1700, and / or 1800 may be implemented in other manners, such as by other devices / systems, by user(s), etc.

[0182] FIG. 14 illustrates an example process 1400 for determining a status of an engagement assembly of an instrument feeder device, according to one or more embodiments.

[0183] At block 1402, the process 1400 may include detecting one or more events. For example, the control circuitry may detect one or more events associated with the instrument feeder device, the medical instrument, the robotic system, and / or another device / component of the medical system configured to perform a medical procedure. By way of example, the control circuitry may detect coupling of the instrument feeder device to a robotic arm of a robotic system (e.g., based on sensor data from the robotic arm / instrument feeder device), coupling / uncoupling of an instrument base of a medical instrument to a robotic arm (e.g., based on sensor data from the robotic arm / medical instrument base), passage of a predetermined period of time, coupling of an instrument base to a robotic arm, a request / command to rotate an elongated shaft (e.g., based on user input, system decision, etc.), a request / command to enable / disable manual movement of the robotic arm (e.g., admittance control mode is enabled), etc.

[0184] As described herein, the medical system can include a robotic system having one or more robotic arms configured to couple to a medical instrument, an instrument feeder device, and / or another device / component. For example, the robotic system can include a first robotic arm having an end effector configured to couple to an instrument feeder device (capable of engaging an elongate shaft of a medical instrument) and a second robotic arm configured to couple to an instrument base of a medical instrument. The first robotic arm can include one or more drive outputs configured to couple to and / or actuate one or more drive inputs of the instrument feeder device. For example, the first drive output can be configured to actuate a first drive input of the instrument feeder device to control engagement of the instrument feeder with the elongate shaft of the medical instrument, and the second drive output can be configured to actuate a second drive input of the instrument feeder device to axially move the elongate shaft.

[0185] Additionally, the instrument feeder device may include an engagement assembly configured to receive and / or engage an elongate shaft of a medical instrument. The engagement assembly may include an actuator configured to axially move the elongate shaft, a channel configured to receive the elongate shaft, and / or a retention mechanism configured to selectively open and close the channel. In some examples, the instrument feeder device is configured to bias the actuator into an engaged or disengaged state.

[0186] At block 1404, the process 1400 may include causing a first drive output to actuate an engagement assembly of the implement feeder device. For example, the control circuitry may actuate a first drive output of the robotic arm, thereby causing actuation of a first drive input associated with the engagement assembly of the implement feeder device. The first drive input may be configured to control an engagement state of the engagement assembly.

[0187] In some examples, the control circuitry actuates the first drive output based on detecting one or more events in block 1402. This can intelligently / automatically control the engagement assembly, such as without user interaction with the engagement assembly. In some examples, the control circuitry can control the engagement assembly to actuate from an engaged state to a fully open / disengaged state upon detecting that an associated instrument feeder device is loaded / coupled to the robotic arm, such as during setup for a procedure. This can allow a user to load a shaft of a medical instrument into the engagement assembly.

[0188] Further, in some examples, the control circuitry can control the engagement assembly to actuate from a disengaged state (e.g., a fully open state) toward / to an engaged state upon detecting that an instrument base of a medical instrument is coupled to a robotic arm and / or after a predetermined period of time has elapsed since detecting coupling of the instrument base to the robotic arm. For example, a user may first load an instrument shaft into an instrument feeder device coupled to a first robotic arm and then couple the instrument base to a second robotic arm. However, a user may couple / load components of a medical instrument in any order. Here, by transitioning the instrument feeder device to an engaged state after detecting coupling of the instrument base to the second robotic arm, the control circuitry can engage with and start driving the medical instrument.

[0189] Further, in some examples, the control circuitry can control the engagement assembly to actuate from an engaged state to a disengaged / intermediate state upon determining to rotate the elongated shaft of the medical instrument and / or upon determining to enable an admittance control mode of the robotic arm. For example, a user can provide an input to rotate the shaft or enable an admittance control mode of the robotic arm coupled to the instrument feeder device and / or the robotic arm coupled to the instrument base. The admittance control mode can be used to adjust the position of the robotic arm for various purposes. In response to the rotation / admittance control detection, the control circuitry can transition the engagement assembly from the engaged state to an intermediate state in which the cover is substantially closed and the roller is disengaged from the shaft. This can allow the engagement assembly to hold the shaft without restricting the movement of the shaft. When the rotation is completed and / or the admittance control mode is disabled, the control circuitry can transition the engagement assembly back to the engaged state.

[0190] Further, in some examples, the control circuitry can control the engagement assembly to actuate from an engaged state to a disengaged state upon determining to disengage the instrument base from the robotic arm. For example, a user may disengage the instrument base from the robotic arm upon completion of a procedure and / or to facilitate manual actuation of the medical instrument. Here, the control circuitry can detect that the instrument base has been removed from the robotic arm and control the engagement assembly to actuate to a fully open state, and the shaft can be removed from the engagement assembly.

[0191] Although various descriptions are provided, the control circuitry can operate the first drive output in other scenarios, such as to transition the engagement assembly between any states, to transition the engagement assembly toward a state without changing states, to transition the engagement assembly to a hard stop position (e.g., when coupling an implement feeder device to a robotic arm), etc. Thus, the control circuitry can operate the first drive output for a variety of purposes.

[0192] In an embodiment, the control circuitry can detect when an instrument / device is coupled / detached from the robotic arm based on data from a sensor(s) on the end effector, the instrument feeder device, the medical instrument base, the instrument shaft, etc. Such sensor(s) can include proximity sensor(s), magnetic sensor(s), etc. For example, the instrument feeder device / instrument base can include a magnet, a radio frequency identification (RFID) tag, a quick response / barcode, and / or another element, and the end effector of the robotic arm can include a sensor / device configured to detect such an element, such as when the instrument feeder device / instrument base is positioned proximate to the end effector.

[0193] At block 1406, the process 1400 may include determining an amount of force applied by the first drive output and / or a position of the first drive output. For example, the control circuitry may determine the amount of force applied by the first drive output and / or the position of the first drive output based on readings / data from one or more sensors (e.g., force / torque sensors of the first drive output), one or more signals generated / transmitted to control the first drive output, etc. In some examples, the amount of force applied by the first drive output represents a net resultant force taking into account the amount of force (e.g., torque) applied by a motor / mechanism driving the first drive output and / or the amount of feedback force applied by a drive input of the implement feeder device (e.g., which may be due to one or more springs biasing the engagement assembly). Additionally, in some examples, the position of the first drive output may include a rotational position of the first drive output, which may include / indicate any number of rotations / turns of the first drive output.

[0194] At block 1408, process 1400 may include determining a status of the engagement assembly based on the amount of force applied by the first drive output and / or the position of the first drive output. For example, the control circuitry may determine whether the amount of force applied by the first drive output is above / below one or more thresholds, within a predetermined range of forces, etc. Thus, in some examples, the control circuitry may compare the amount of force applied by the first drive output to one or more thresholds. Additionally, the control circuitry may compare the position of the first drive output to one or more predetermined / reference positions, ranges of positions, etc. The status of the engagement assembly may indicate whether the engagement assembly is engaged / disengaged, whether a retention feature of the engagement assembly is open / closed (or partially open / closed), whether an elongate shaft of a medical instrument is received / properly received within the engagement assembly, etc.

[0195] In one example, the control circuitry can determine that the engagement assembly is associated with an engaged state (e.g., a fully engaged state) when the amount of force applied by the first drive output is less than a first threshold. Exemplary engaged states are illustrated in FIGS. 8-1-8-2 and 9-1-9-2. Additionally, the control circuitry can determine that the engagement assembly is associated with a first disengaged state (e.g., an intermediate state) when the amount of force applied by the first drive output exceeds a first threshold and is less than a second threshold. The first disengaged state can be a state in which an actuator of the engagement assembly is disengaged from the elongated shaft and a retention mechanism of the engagement assembly is substantially closed to retain the elongated shaft, such as the engaged state illustrated in FIGS. 10-1 and 10-2. Additionally, the control circuitry can determine that the engagement assembly is associated with a second disengaged state (e.g., a fully open state) when the amount of force applied by the first drive output exceeds a second threshold. An example of such a disengaged state is illustrated in Figures 11-1 and 11-2.

[0196] In another example, the control circuitry can determine a reference position(s) associated with a force change (e.g., a spike in force applied by the first drive output) that exceeds a threshold amount. For example, the control circuitry can actuate the first drive output to a hard stop position and / or in a direction toward a hard stop position when the implement feeder device is initially coupled to the robotic arm. The control circuitry can detect the force spike(s) applied by the first drive output during such actuation and designate the position of the first drive output at the force spike as a reference position (e.g., a transition position between an engaged and disengaged state, a hard stop position of the engagement assembly, or another position / state). The control circuitry can then determine a state of the engagement assembly based on the proximity of the current position of the first drive output to the reference position (e.g., the proximity of the current rotational position to the reference rotational position).

[0197] In yet other examples, the control circuitry may determine the state of the engagement assembly in other manners based on the force applied by and / or the position of the first drive output.

[0198] At block 1410, process 1400 may include actuating a second drive output to axially move the elongated shaft. For example, when the engagement assembly is positioned in an engaged state (e.g., ready to drive), the control circuitry may control a second drive output of the robot arm to cause actuation of a second drive input of the engagement assembly, and the second drive input may be configured to control the axial movement of the elongated shaft. Thus, the second drive output may axially move (e.g., insert or retract) the elongated shaft. In an embodiment, the second drive output may be controlled based on a signal from an I / O device to insert / retract the elongated shaft, a system decision to insert / retract the elongated shaft (e.g., without receiving user input), etc.

[0199] FIG. 15 illustrates an exemplary process 1500 for determining whether an elongate shaft of a medical instrument is loaded / properly loaded into an instrument feeder device, according to one or more embodiments.

[0200] At block 1502, the process 1500 may include causing the drive output to actuate the engagement assembly from an engaged state, where the actuator is engaged, to a disengaged state, where the actuator is disengaged. For example, the control circuitry may actuate (e.g., rotate) a drive output of a robotic arm to actuate (e.g., rotate) an associated drive input of an engagement assembly of an instrument feeder device coupled to the robotic arm. Actuation of the drive input may change the engagement assembly from an engaged state (which may be a default state of the instrument feeder device) to a disengaged state. In some examples, the engagement assembly may transition to a fully disengaged / open state, such as that illustrated in FIGS. 11-1 and 11-2. The fully disengaged / open state may allow an instrument shaft to be loaded into the engagement assembly.

[0201] At block 1504, process 1500 may include determining a first position of the drive output associated with a first change in force (e.g., torque) applied by the drive output that occurs while moving the engagement assembly from an engaged state to a disengaged state. For example, while moving the engagement assembly from an engaged state to a disengaged state, the control circuitry may monitor the amount of force applied by the drive output. When the drive output undergoes / applies a change in force that exceeds a threshold change amount to move the drive output a particular amount (e.g., a threshold increase / decrease in force for a given amount of rotation), the control circuitry may identify the position of the drive output at that time (also referred to as an "initial position of force change" or "reference position"). In one example, in the context of FIG. 12, the control circuitry may move the engagement assembly 532 from an engaged state 1204(4) to a disengaged state 1204(1) and detect a change in force applied by the drive output 1202 at position 1202(C), where such change is greater than a threshold.

[0202] At block 1506, process 1500 may include causing the drive output to actuate the engagement assembly from a disengaged state toward an engaged state. For example, the control circuitry may cause the drive output to actuate the engagement assembly from a fully disengaged / open state toward an engaged state. In some examples, this may occur after a predetermined period of time has elapsed since performing operations 1502 / 1504, upon detecting that an instrument base of the medical instrument has been coupled to a robotic arm (e.g., a second robotic arm), after a predetermined period of time has elapsed since coupling the instrument base to the robotic arm (which may be based on starting a timer when coupling occurs), and / or when another event is detected. In one example, operation 1506 may be performed in an attempt to engage the engagement assembly with the elongate shaft of the medical instrument, such as upon determining / presuming that the elongate shaft has been loaded into the engagement assembly.

[0203] At block 1508, process 1500 may include determining a second position of the drive output associated with a second change in force. In one example, the engagement assembly may transition from a fully disengaged / open state to an engaged state (e.g., block 1506). Once engagement is complete, the engagement assembly may move back toward the disengaged state, and the control circuitry may monitor the amount of force applied by the drive output. This may include moving a relatively small amount (e.g., less than a certain amount) in the disengagement direction. When the drive output undergoes / applies more than a threshold change in force to move the drive output a certain amount (e.g., a threshold increase / decrease in force for a given amount of rotation), the control circuitry may identify the position of the drive output at that time (also referred to as a "secondary position of the force change"). The threshold amount of the force change may be greater than the threshold and / or another threshold as described above for block 1504. Thus, the secondary position of the force change may be identified by detecting a change in force (contact force) in the disengagement direction. However, in other examples, the secondary position of the force change can be detected in other ways, such as by detecting a change in force (contact force) in the engagement direction (e.g., a loss of contact while transitioning to the engaged state). In some examples, once the secondary position of the force change is identified, the engagement assembly can enter the float zone.

[0204] At block 1510, process 1500 may include identifying a third position of the drive output associated with a state where the retention mechanism begins to open. For example, the control circuitry may identify a position of the drive output associated with an intermediate state where the cover of the engagement assembly is closed (but beginning to open) and the roller is disengaged from the elongated shaft. In some examples, such a position may be a predetermined position defined / referenced relative to another position of the drive output, such as a position associated with a fully disengaged / open state, a position associated with an engaged state, a reference position, and / or another position. In one example, in the context of FIG. 12, the control circuitry may identify position 1202(B) (where cover 536 transitions between a closed state and an open state) based on knowing that position 1202(B) is at a predetermined rotational angle from positions 1202(A) / 1202(C) and / or another position (e.g., any reference position that can be detected based on a change in force).

[0205] At block 1512, process 1500 can determine whether the elongate shaft of the medical instrument is received and / or properly received within the engagement assembly. For example, the control circuitry can determine whether the elongate shaft is loaded into a channel of the engagement assembly and / or whether the elongate shaft is properly loaded into the channel. Such a determination can be based on the location of the second position (i.e., a secondary position of force change) relative to the first position and the third position (e.g., a secondary position of force change between the first position and the third position).

[0206] In one example, in the context of FIG. 12 , assume that the instrument shaft is not loaded into the engagement assembly 532. For example, the engagement assembly 532 may transition (at block 1502) to a fully open / disengaged state to facilitate loading of the instrument shaft into the engagement assembly 532, but without the instrument shaft being loaded. The control circuitry may detect (at block 1504) position 1202(C) as a first position of a force change. The control circuitry may now transition (at block 1506) the engagement assembly 532 from the fully open / disengaged state 1204(1) toward the engaged state 1204(3) and detect (at block 1508) a change in the force applied by the drive output 1202 at position 1202(C) (i.e., a secondary position of the force change). At block 1512, the control circuitry can determine that the instrument shaft is not loaded in the engagement assembly 532 based on the secondary position of the force change (1202(C)) being the same as the initial position of the force change (1202(C)). Here, the control circuitry has determined the same position for both cases of the force change. Similarly, the control circuitry can determine that the instrument shaft is not loaded when the secondary position of the force change is closer to position 1202(E) (e.g., the secondary position of the force change is between positions 1202(C) and 1202(E)).

[0207] In another example, in the context of FIG. 13 , assume that an instrument shaft has been properly loaded into engagement assembly 532. For example, engagement assembly 532 may be transitioned (at block 1502) to a fully open / disengaged state and the instrument shaft is loaded by a user. The control circuitry may determine (at block 1504) position 1202(C) as the first position of force change when transitioning to the fully open / disengaged state. Additionally, the control circuitry may transition (at block 1506) engagement assembly 532 from fully open / disengaged state 1204(1) toward engaged state 1204(3) and detect (at block 1508) a change in force applied by drive output 1202 at position 1202(C)(1) (i.e., a secondary position of force change). The control circuitry may identify (at block 1510) position 1202(B) as a third position (i.e., an intermediate position). In block 1512, the control circuit can determine that the instrument shaft is properly loaded into the engagement assembly 532 based on the secondary position of the force change (1202(C)(1)) being between (with respect to rotation) the initial position of the force change (1202(C)) and the intermediate position (1202(B)).

[0208] In a further example, assume that the instrument shaft is improperly loaded in engagement assembly 532, such as by being partially positioned in channel 534 so as to prevent cover 536 from fully closing. For example, engagement assembly 532 may be transitioned (at block 1502) to a fully open / disengaged state with the instrument shaft positioned in an upper portion of channel 534. The control circuitry may determine (at block 1504) position 1202(C) as a first position of a force change. Further, the control circuitry may transition (at block 1506) engagement assembly 532 from fully open / disengaged state 1204(1) toward engaged state 1204(3) and detect (at block 1508) a change in force applied by drive output 1202 at a position prior to position 1202(B) (i.e., a secondary position of the force change), which may result from improper loading of the instrument shaft. The control circuit may identify (at block 1510) position 1202(B) as the third position (i.e., the intermediate position). At block 1512, the control circuit may determine that the instrument shaft is improperly loaded in the engagement assembly 532 based on the secondary position of the force change being before the intermediate position (1202(B)).

[0209] In yet a further example, the instrument shaft can be determined to be improperly loaded when the second position of the force change is after / past the first position of the force change.

[0210] In any event, if at 1512 it is determined that the elongate shaft is / is not properly received within the engagement assembly, process 1500 may proceed to block 1514 (i.e., the YES branch). Alternatively, if it is determined that the elongate shaft is not / is not properly received within the engagement assembly, process 1500 may proceed to block 1516 (i.e., the NO branch).

[0211] At block 1514, process 1500 may include having the drive output actuate the engagement assembly towards / into an engaged state and / or drive the elongate shaft. For example, the control circuitry may actuate the drive output to the engagement assembly to an engaged state, and the control circuitry may drive the elongate shaft / medical instrument with the elongate shaft properly loaded into the engagement assembly. In one example, in the context of FIG. 13 , the control circuitry may transition the engagement assembly 532 to state 1204(4) and then drive / control the medical instrument (e.g., receive input from a user to insert / retract and control the elongate shaft to insert / retract).

[0212] At block 1516, process 1500 may include actuating the engagement assembly to a disengaged state at the drive output. For example, the control circuitry may actuate the engagement assembly to a fully open / disengaged state at the drive output to facilitate loading / reloading of the elongate shaft of the medical instrument. In one example, in the context of FIG. 12, the control circuitry may transition the engagement assembly 532 to state 1204(1).

[0213] At block 1518, process 1500 may include generating a signal indicating that the elongate shaft is not / properly received within the channel. For example, the control circuitry may generate a signal (e.g., a fault / error signal) indicating that the elongate shaft is not / properly loaded into the engagement assembly and / or send a signal to another component / device to facilitate additional processing. In some examples, the signal may cause a notification to be provided via a user interface, and such a notification may inform a user to load / reload the elongate shaft of the medical instrument.

[0214] At block 1520, process 1500 may include determining whether a signal is addressed. For example, the control circuitry may determine (i) whether a user input has been received indicating that the elongated shaft is currently loaded / properly loaded, (ii) whether a period of time has passed since providing a fault / error notification, (iii) whether data from a sensor (e.g., a light barrier sensor, a force sensor, etc.) on the instrument feeder device / engagement assembly indicates that the elongated shaft is loaded / properly loaded, (iv) whether the elongated shaft is properly positioned relative to the instrument feeder device / engagement assembly (e.g., based on data from a shape sensor in the elongated shaft), and / or another determination.

[0215] If it is determined that the signal is addressed, process 1500 may return to block 1506 (i.e., the YES branch). Alternatively, if it is determined that the signal is not addressed, process 1500 may return to block 1520 (i.e., the NO branch) and perform operation 1520 again (e.g., after a period of time has elapsed).

[0216] 16-1 and 16-2 illustrate an exemplary process 1600 for determining and / or removing slack in an elongate shaft of a medical device, according to one or more embodiments.

[0217] In FIG. 16-1, at block 1602, process 1600 may include determining to check for slack in an elongated shaft of a medical instrument. For example, the medical instrument may include an elongated shaft and an instrument handle, where the elongated shaft may be coupled / engaged with an instrument feeder device coupled to a first robotic arm / component, and the instrument handle may be coupled to a second robotic arm / component. In some examples, the control circuitry may determine to evaluate an amount of slack in the elongated shaft between the instrument handle and the instrument feeder device. Such evaluation may be initiated when a determination is made that the elongated shaft is inserted (or possibly retracted), the instrument shaft is rotated, an admittance control mode of the robotic arm is enabled, a procedure is completed, a period of time has passed since the last check for slack in the elongated shaft, a medical instrument has recently been coupled to the robotic arm(s) (e.g., an instrument handle / elongated shaft is loaded to begin driving the medical instrument), a procedure is about to begin, etc. In some cases, the determination is made based on receiving user input, system processing (e.g., the system determining that an event has occurred), etc.

[0218] In one example, a check for slack in the elongated shaft can be initiated when a user input to insert the elongated shaft is received or when it is otherwise determined to insert the elongated shaft. To insert the elongated shaft of the medical instrument, the robotic arms can work in concert. For example, a first robotic arm can be coupled to an instrument feeder device and a second robotic arm can be coupled to an instrument handle. The instrument feeder device can cause axial movement of the elongated shaft in an insertion direction, while the second robotic arm moves closer to the first robotic arm in a manner that correlates to the speed of the axial movement of the shaft. If there is slack in the elongated shaft (e.g., a service loop) when the shaft is inserted, the curvature of the slack can increase, which can potentially damage the elongated shaft (e.g., by bending the shaft beyond a threshold amount) and / or cause a delay in the procedure to reload / replace the medical instrument. Therefore, a check for slack in the elongated shaft can be initiated to prevent such undesirable problems.

[0219] In another example, the elongate shaft slack check can be initiated when an instrument shaft rotation is commanded, when an admittance control mode is enabled / requested for the robotic arm, and / or when another event occurs associated with implementing an intermediate / disengaged state for the instrument feeder device. For example, during a procedure / setup for a procedure, a physician can provide a user input to enable an admittance control mode to manually move a robotic arm coupled to the instrument feeder device and / or provide a user input to rotate the instrument shaft. In response to such user input, the control circuit can generate / receive a signal to insert the shaft / enable the admittance control mode. As described above, the admittance control mode can allow a physician to manually adjust the robotic arm and / or an access sheath coupled to the robotic arm. To facilitate the movement of the robot arm / access sheath and / or the rotation of the elongated shaft, the instrument feeder device may be transitioned to an intermediate state, such as the state illustrated in Fig. 10-1 and Fig. 10-2, in which the instrument feeder device is disengaged from the elongated shaft and the elongated shaft is held within the instrument feeder device to allow the movement of the instrument shaft. If there is slack in the elongated shaft (e.g., the service loop) when the instrument feeder device is disengaged from the elongated shaft (e.g., the roller separates from the shaft), the elongated shaft may move in the insertion direction when the energy / service loop is released, which may cause undesired insertion of the elongated shaft. This may cause harm to the patient (e.g., due to the tip of the elongated shaft contacting the patient's tissue with a relatively strong force). Therefore, a check for slack in the elongated shaft may be initiated to prevent such undesired problems.

[0220] In yet another example, a slack check can be initiated when a determination is made that a procedure is complete. For example, upon completing a procedure, a physician may wish to decouple the medical instrument from one or more robotic arms (e.g., remove the elongate shaft from the instrument feeder device). This may include transitioning the instrument feeder device to a fully open / disengaged state. As also described above, if there is slack in the elongate shaft when the instrument feeder device is disengaged from the elongate shaft, the elongate shaft may move in the insertion direction. Thus, a slack check can be initiated to prevent such problems.

[0221] In further examples, slack checks can be initiated periodically when the robotic arm is idle (e.g., has not been moved for a period of time), when a medical instrument is coupled to the robotic arm, and / or upon the occurrence of various other types of events / decisions.

[0222] In the example shown in block 1603 of Figure 16-1, the medical instrument can include an elongate shaft 508 coupled / engaged with an instrument feeder device 530 (coupled to a first robotic arm 112(B)) and an instrument handle 506 coupled to a second robotic arm 112(C). The elongate shaft 508 is shown with some amount of slack for illustrative purposes.

[0223] At block 1604, process 1600 may include applying a force to the elongate shaft of the medical instrument to prevent axial movement of the elongate shaft. For example, the control circuitry may control one or more drive outputs of a first robotic arm (coupled to the instrument feeder device) to cause the instrument feeder device to apply a force to the elongate shaft to prevent axial movement of a portion of the elongate shaft positioned within the instrument feeder device (e.g., pinching the elongate shaft). This force may be applied to prevent backout (or possibly insertion) of the elongate shaft 508 from the patient while other aspects of process 1600 or other processes are being performed, as described below.

[0224] In the example shown in blocks 1605(A)-1605(C) of FIG. 16-1, the rollers 538 can be controlled to apply a force to the elongated shaft 508, such as to pinch the elongated shaft 508 between the rollers 538 with a particular amount of force (e.g., greater than the spring force biasing the rollers 538 toward one another). For example, as described above, the instrument feeder device 530 can include a carrier plate 622 that is rotated based on the position of the off-axis protrusions 636 within the pockets 638. The rotation / movement of the carrier plate 622 can move the rollers 538 closer or farther away from one another, thereby positioning the rollers 538 and / or adjusting the amount of force applied to the elongated shaft 508.

[0225] Illustratively, the open / close drive shaft 632 may rotate (by a drive input, not shown) clockwise relative to the image of FIG. 16-1 to cause the off-axis protrusion 636 (coupled to the open / close drive shaft 632) to contact a first surface / edge within the pocket 638, illustrated in darker lines in block 1605(B). The off-axis protrusion 636 may exert a force on the first surface to rotate the carrier plate 622 about the axis 628, thereby moving the rollers 538 away from each other (e.g., to a disengaged / open state). In contrast, the open / close shaft 632 may rotate counterclockwise to cause the off-axis protrusion 636 to move toward and contact a second surface, illustrated in darker lines in block 1605(C). The off-axis protrusions 636 can apply a force to the second surface to rotate the carrier plate 622 in the opposite direction, and the rollers 538 can apply an additional force to the elongated shaft 508. In some examples, as shown, the off-axis protrusions 636 can move freely between the first and second surfaces of the pocket 638 (e.g., applying no force to either surface), where a spring force can cause the rollers 538 to apply a force to the elongated shaft 508.

[0226] In the example of FIG. 16-1 , the elongated shaft 508 may be positioned between rollers 538 to facilitate driving the elongated shaft 508. In block 1604, the rollers 538 may be controlled to apply a force to the elongated shaft 508, as shown in block 1605(C). This may prevent the elongated shaft 508 from slipping between the rollers 538 when other actions are performed, such as moving the robotic arm 112(C) away from the robotic arm 112(B), as described in more detail below. For example, this may prevent retraction of the elongated shaft 508 from the patient without commanding / instructing it. This process of applying a force to the elongated shaft 508 may be referred to as an “active pinch.”

[0227] In block 1606 of FIG. 16-2, the process 1600 can include actuating a drive output(s) of the first robotic arm and / or actuating a second robotic arm. For example, the instrument feeder device can include one or more drive inputs configured to control axial movement of the elongated shaft, such as inserting or retracting the shaft, and the one or more drive inputs can be configured to couple to one or more drive outputs of the first robotic arm. In an example, the control circuit can actuate (e.g., rotate) one or more drive outputs of the first robotic arm to cause axial movement of the elongated shaft. Alternatively or additionally, the control circuit can move a second robotic arm coupled to the instrument handle in a direction away from the first robotic arm. The control circuit can actuate one or more drive outputs and / or the second robotic arm by a particular amount, in some cases. In an embodiment, the second robotic arm moves away from the first robotic arm (or vice versa) and / or the instrument feeder device moves the elongate shaft in the insertion direction to such an extent that slack (if any) is removed / reduced and / or tension is applied to the elongate shaft, such tension can be detected by the control circuitry as described below.

[0228] In the example shown in block 1607(A) of FIG. 16-2, the robot arm 112(C) moves in a direction (e.g., a retracting direction) away from the robot arm 112(B). This can be done while the robot arm 112(B) remains relatively stationary and / or without actuating a drive output of the robot arm 112(B) coupled to the instrument feeder device 530 to facilitate rotation of the rollers 538. In some examples, the robot arm 112(C) moves in a direction away from the robot arm 112(B) while the rollers 538 actively clamp / apply a force to the elongated shaft 508. In other words, block 1604 can be implemented when the robot arm 112(C) moves away from the robot arm 112(C). This can prevent undesired retraction (e.g., uncommanded / uninstructed retraction) of the elongated shaft 508 from the patient.

[0229] Further, in the embodiment shown in block 1607(B) of FIG. 16-2, rollers 538 are actuated to move elongated shaft 508 in an insertion direction. This can be done while robotic arm 112(C) remains relatively stationary (e.g., without moving robotic arm 112(C)).

[0230] In block 1608, the process 1600 may include determining a first force applied / applied to (or detected by) the drive output, a second force applied by the second robotic arm, a shape of the elongate shaft, and / or a position of at least a portion of the elongate shaft. For example, the control circuitry may detect a first force (e.g., torque) applied to the implement feeder device by the drive output(s) of the first robotic arm to control axial movement of the elongate shaft. In an example of block 1607(B), the control circuitry may determine / detect a force applied by / applied to the drive output of the robotic arm 112(B) (e.g., a force to maintain or change the rotational position of the roller 538) when the roller 538 is idle or moving. Additionally or alternatively, the control circuitry can detect a second force applied by / to the second robot arm when the second robot arm is idle or moving (e.g., to control the position of the second robot arm). This force can constitute an initial reference force applied by the second robot arm when there is no tension in the elongate shaft, as described in more detail below. In an embodiment of block 1607(A), the control circuitry can determine a force applied by the robot arm 112(C) to maintain (or move) the position of the robot arm 112(C). Furthermore, the control circuitry can receive / generate shape sensing data indicative of a shape of the elongate shaft (which can include data indicative of tensile stress from stress sensing fibers, etc.), position sensor data indicative of a position of at least a portion of the elongate shaft (e.g., a position of a tip of the elongate shaft or another portion of the elongate shaft associated with a sensor), position data indicative of the position of the first / second robot arm, and / or other data.

[0231] In FIG. 16-3, at block 1610, the process 1600 may include determining an amount of slack in the elongate shaft between the first robot arm and the second robot arm. For example, the control circuitry may determine the amount of slack in the elongate shaft based on an amount of a first force applied by / to the drive output (or detected by the drive output), an amount of a second force applied by the second robot arm, a shape indicated by the shape sensing data, and / or a position indicated by the elongate shaft / robot arm position data to control the axial movement of the elongate shaft. In some examples, the control circuitry may determine that the elongate shaft is relatively straight when the first force (the drive output force) exceeds a first threshold amount, the second force (the robot arm force) exceeds a second threshold amount (which may be the same as or different from the first threshold amount), the shape sensing data indicates that the elongate shaft is relatively straight, and / or the elongate shaft / robot arm position data indicates that the elongate shaft is relatively straight.

[0232] In one example, the control circuitry can use the position data of the elongate shaft to determine a position of the tip of the elongate shaft. The control circuitry can also determine the position of the robot arms (such as the distance between the robot arms) and / or identify a dimension of the elongate shaft (e.g., a known / predetermined length of the shaft). Based on such information, the control circuitry can calculate the length of the elongate shaft between the robot arms. If the length of the elongate shaft between the robot arms is greater than the distance between the robot arms, the control circuitry can determine that there is slack in the elongate shaft. In an example, the control circuitry can use the information described above to calculate the amount of slack between the robot arms.

[0233] At block 1612, process 1600 may include determining whether an amount of slack in the elongate shaft is less than a predetermined amount. For example, the control circuitry may determine whether an amount of slack in the elongate shaft between the first robotic arm and the second robotic arm is relatively small (e.g., zero / no slack in the shaft, the amount of slack is less than a threshold amount, etc.).

[0234] If it is determined that the amount of slack in the elongate shaft is equal to or greater than the predetermined amount, the process 1600 may return to block 1606 of FIG. 16-2 (i.e., the NO branch) and actuate the drive output of the first robotic arm and / or the second robotic arm again, such as by a particular amount. This may be repeated any number of times to remove any slack in the elongate shaft and / or add tension to the elongate shaft. In the example shown in block 1611 of FIG. 16-3, the elongate shaft 508 includes some amount of slack. Thus, block 1611 is associated with returning to block 1606.

[0235] If it is determined that the amount of slack in the elongate shaft is less than a predetermined amount (e.g., there is substantially no slack in the elongate shaft), the process 1600 may proceed to block 1614 (i.e., the YES branch). In the example shown in block 1613 of FIG. 16-3, there is no slack in the elongate shaft 508. Thus, block 1613 is associated with proceeding to block 1614.

[0236] At block 1614, process 1600 may include controlling the instrument feeder device and / or the second robotic arm. For example, the control circuitry may control the instrument feeder device to axially move the elongated shaft and / or cooperatively move the second robotic arm to insert the elongated shaft, such as for any remaining commanded but not yet completed insertion amount. In particular, the instrument feeder device may cause axial movement of the elongated shaft in an insertion direction (e.g., using rollers), while the second robotic arm moves closer to the first robotic arm in a manner that correlates to a speed of the axial movement of the elongated shaft (e.g., rotational speed of the rollers). Such movement may continue until the elongated shaft is inserted up to the determined / commanded amount. Alternatively or additionally, the control circuitry may disengage the instrument feeder device from the elongate shaft, thereby facilitating rotation of the elongate shaft (by implementing intermediate states for the instrument feeder device), movement of the robotic arm in an admittance control mode (by implementing intermediate states for the instrument feeder device), and / or removal of the elongate shaft (by implementing a fully open / disengaged state), etc.

[0237] In some examples, the control circuitry can release tension (e.g., over-tension) on the elongate shaft, such as before performing the operations of block 1614. For example, the control circuitry can cause the drive output of the first robotic arm to axially move the elongate shaft in a rearward direction by a relatively small amount and / or actuate the second robotic arm by a relatively small amount in a direction toward the first robotic arm. Such movement can release tension on the elongate shaft that may have been applied while performing process 1600.

[0238] 17 illustrates an example process 1700 for determining and / or removing slack in an elongate shaft of a medical device in the context of inserting the elongate shaft, according to one or more embodiments. In some examples, process 1700 can begin when a decision is made to insert the elongate shaft, such as when a user input, a system decision to insert the shaft is received, etc.

[0239] At block 1702, process 1700 may include determining an initial force of a first robotic arm coupled to an instrument base of a medical instrument. For example, the control circuitry may determine an initial / baseline force applied by the first robotic arm coupled to the instrument base when there is no tension on the elongate shaft. Such a force may be determined before the elongate shaft is inserted.

[0240] At block 1704, process 1700 may include determining whether to insert an elongate shaft of a medical instrument. For example, the control circuitry may determine whether a user input / input signal requesting that the elongate shaft be inserted is received, whether a decision is made to insert the elongate shaft, etc.

[0241] If a decision is made to insert the elongate shaft, process 1700 may proceed to block 1706 (i.e., the YES branch). Alternatively, if a decision is made not to insert the elongate shaft, process 1700 may return to block 1704 (i.e., the NO branch). Thus, the control circuitry may wait for an insertion command to be received / determined.

[0242] At block 1706, the process 1700 may include determining a drive output force associated with the drive output and / or a robot arm force associated with the robot arm. For example, the control circuitry may determine a drive force (e.g., torque) applied by a drive output(s) coupled to the instrument feeder device to facilitate shaft insertion / retraction. Additionally, the control circuitry may determine a robot arm force applied by a robot arm coupled to the instrument base. In some examples, the robot arm force may constitute a current force applied / implemented to control the position of the robot arm (also referred to as an "external force, net instrument force, or resultant force") and / or an initial / reference force applied by the robot arm (determined at block 1702). For example, the robot arm force may be calculated by subtracting the initial / reference force from the external force (i.e., robot arm force=external force-reference force). The robot arm force may refer to an external force (e.g., sensed by the robot arm) excluding gravity. However, the robot arm force may be calculated in other ways.

[0243] At block 1708, process 1700 may include determining whether the drive output force is greater than a first threshold and / or whether the robot arm force is greater than a second threshold. The second threshold may be the same or different than the first threshold. For example, the control circuit may determine whether the drive output force determined at block 1706 and / or the robot arm force determined at block 1706 are greater than their respective thresholds, which may indicate that there is tension on the elongate shaft between the first and second robot arms. Although two thresholds are used in this example, the technique may be implemented with a single threshold, and the drive output force and the robot arm force may be combined and compared to a single threshold.

[0244] If it is determined that the force of the drive output is greater than the first threshold and / or the force of the robot arm is greater than the second threshold, the process 1700 may proceed to block 1712 (i.e., the YES branch). Alternatively, if it is determined that the force of the drive output is less than or equal to the first threshold and / or the force of the robot arm is less than or equal to the second threshold, the process 1700 may proceed to block 1710 (i.e., the NO branch).

[0245] At block 1710, process 1700 may include controlling the instrument feeder device to insert the elongated shaft without actuating a first robotic arm coupled to the instrument base. For example, the control circuitry may control the drive output to cause the instrument feeder device to insert the elongated shaft while preventing the first robotic arm coupled to the instrument base from being actuated beyond a threshold amount (e.g., while allowing the first robotic arm to move less than a threshold amount). That is, the control circuitry may not actively move the first robotic arm, but may allow the first robotic arm to move a relatively small amount (e.g., less than a threshold amount) if some amount of force is exerted on the first robotic arm, for example, due to tension applied to the elongated shaft. In any case, the control circuitry may cause the elongated shaft to be inserted a particular amount, which may be an incremental amount that is within an insertion limit defined by user input / processing. Operation 1710 may be repeated any number of times until tension on the elongated shaft exceeds a threshold (as determined at block 1708) and / or until the insertion limit is reached. Thus, the elongate shaft generally cannot be inserted any more than is required by user input and / or the system.

[0246] At block 1712, process 1700 can include controlling an instrument feeder device and a first robotic arm coupled to the instrument base. For example, the control circuitry can control the instrument feeder device to move the elongate shaft axially in an insertion direction and move the first robotic arm (coupled to the instrument base) in the insertion direction to insert / continue to insert the elongate shaft, such as for any remaining insertion amount commanded but not yet completed. The instrument feeder device and the first robotic arm can operate cooperatively to insert the elongate shaft.

[0247] In some examples, the control circuitry can release tension (e.g., over-tension) on the elongate shaft, such as before performing the operations of block 1712. For example, the control circuitry can control the instrument feeder device to cause the drive output of the second robotic arm to axially move the elongate shaft in a rearward direction by a relatively small amount and / or actuate the first robotic arm coupled to the instrument handle by a relatively small amount in a direction toward the second robotic arm. Such movement can release tension on the elongate shaft that could have been applied while performing process 1700. In an example, tension can be released during insertion, for example, by causing the instrument feeder device to insert the elongate shaft at a first speed and moving the first robotic arm coupled to the instrument handle toward the second robotic arm at a second speed that is faster than the first speed.

[0248] In an embodiment, process 1700 can be implemented to remove slack in an elongate shaft of a medical instrument. Thereafter, when an insert / retract command is received, the control circuit can control an instrument feeder device and a robotic arm coupled to the instrument base to cooperatively move to insert / retract the elongate shaft.

[0249] 18-1 and 18-2 illustrate an example process 1800 for determining and / or removing slack in an elongate shaft of a medical instrument in association with enabling an admittance control mode and / or rotating the elongate shaft, according to one or more embodiments. In some examples, process 1800 may be initiated when it is determined to disengage the instrument feeder device from the elongate shaft (e.g., transitioning to an intermediate state, a fully open / disengaged state, etc.), when an input is received to enable an admittance control mode of a robotic arm, when an input is received to rotate the elongate shaft, etc. However, process 1800 may be initiated at other times and / or for other situations in which the elongate shaft may include slack.

[0250] In FIG. 18-1, at block 1802, process 1800 can include controlling a medical instrument. For example, the medical instrument can include an elongated shaft coupled to a first robotic arm (via an instrument feeder device) and / or a handle / base coupled to a second robotic arm. The control circuitry can control the first robotic arm, the second robotic arm, and / or another component during normal operation of the medical instrument, such as to manipulate the elongated shaft and / or handle of the medical instrument.

[0251] At block 1804, process 1800 may include determining whether an admittance control signal and / or a rotation signal is received. For example, the control circuitry may receive a signal to enable an admittance control mode of a robotic arm (e.g., coupled to the instrument feeder device) and / or a signal to rotate an elongated shaft of a medical instrument. Based on such signals, the control circuitry may determine to transition the instrument feeder device to a disengaged state (e.g., an intermediate state, a fully open / disengaged state, etc.).

[0252] If the admittance control signal and / or rotation signal are received, the process may proceed to block 1806 (i.e., the YES branch). Alternatively, if the admittance control signal and / or rotation signal are not received, the process 1800 may return to block 1802 (i.e., the NO branch) and proceed with normal control / actuation of the medical instrument.

[0253] At block 1806, process 1800 may include determining an initial robotic arm force / reference robotic arm force. For example, the control circuitry may determine an initial force / reference force applied by a second robotic arm coupled to the instrument base when there is no tension on the elongate shaft. Such a force may be determined before admittance control mode is enabled and / or before rotation occurs.

[0254] At block 1808, the process 1800 may include actuating the second robot arm in a direction away from the first robot arm. For example, the control circuitry may move the second robot arm coupled to the instrument handle in a retracted direction away from the first robot arm coupled to the instrument feeder device. In some cases, the control circuitry may actuate the second robot arm by a particular amount. In examples, the second robot arm may move without actuating a drive output of the first robot arm configured to control the axial motion of the elongated shaft (e.g., without actively actuating the drive output, as some actuation may naturally occur when the second robot arm moves). Thus, in some cases, the control circuitry may allow the drive output to actuate / rotate less than a threshold amount while the second robot arm moves away from the first robot arm.

[0255] At block 1810, the process 1800 may include determining a drive output force associated with the drive output and / or a robot arm force associated with the robot arm. For example, the control circuitry may determine a drive force (e.g., torque) applied by a drive output(s) coupled to the instrument feeder device to facilitate shaft insertion / retraction. Additionally, the control circuitry may determine a robot arm force applied by a robot arm (e.g., a second robot arm) coupled to the instrument base. In some examples, the robot arm force may constitute a current force (also referred to as an "external force, net instrument force, or resultant force") applied / implemented to control the position of the robot arm and / or an initial / reference force applied by the robot arm (determined at block 1806). For example, the robot arm force may be calculated by subtracting the initial / reference force from the external force (i.e., robot arm force=external force-reference force). However, the robot arm force may be calculated in other ways.

[0256] At block 1812, the process 1800 may include determining whether the second robotic arm (coupled to the instrument handle) has actuated beyond a threshold amount and / or whether a workspace boundary has been reached. For example, the control circuitry may monitor / detect the distance the second robotic arm (coupled to the instrument handle) has traveled from the first robotic arm (coupled to the instrument feeder device) and / or detect the position of the second robotic arm, which may be used to determine whether the second robotic arm has reached a distance limit and / or whether a workspace boundary has been reached. The distance limit and / or workspace boundary may be set / defined to avoid collisions with objects / patients in the environment. For example, the workspace boundary may be a virtual boundary.

[0257] If it is determined that the second robotic arm has actuated beyond a threshold amount and / or has reached a workspace boundary, the process 1800 may proceed to block 1814 (i.e., the YES branch). Alternatively, if it is determined that the second robotic arm has not actuated beyond a threshold amount and / or has not reached a workspace boundary, the process 1800 may proceed to block 1816 (i.e., the NO branch).

[0258] At block 1814, process 1800 may include generating a signal indicating that the second robotic arm has actuated beyond a threshold amount and / or reached a workspace boundary. For example, the control circuitry may generate / send a signal based on the determination at block 1812 that the second robotic arm has actuated beyond a threshold amount and / or reached a workspace boundary. The signal may provide a notification to instruct a user to reload the medical instrument and / or adjust the second robotic arm by removing and reattaching the instrument handle to the second robotic arm, moving the second robotic arm to manually remove the slack, etc. In some examples, the signal may be generated / sent if there is excessive slack in the elongate shaft, such as exceeding a threshold amount that can be removed by the system.

[0259] Although blocks 1812 and 1814 are illustrated in the example of FIG. 18-1, in some examples, such blocks (and / or other blocks of process 1800) may be eliminated.

[0260] At block 1816, process 1800 may include determining whether the drive output force is greater than a first threshold and / or whether the robot arm force is greater than a second threshold. The second threshold may be the same or different than the first threshold. For example, the control circuitry may determine whether the drive output force determined at block 1810 and / or the robot arm force determined at block 1810 are greater than their respective thresholds, which may indicate that there is tension on the elongate shaft between the first and second robot arms. Thus, at block 1816, the control circuitry may determine whether there is less than a predetermined amount of slack in the elongate shaft (e.g., no / zero slack).

[0261] In this example, two thresholds are used, however the technique can be implemented with a single threshold, where the drive output force and the robot arm force can be combined and compared to a single threshold.

[0262] If it is determined that the drive output force is greater than the first threshold and / or the robot arm force is greater than the second threshold, the process 1800 may proceed to block 1818 of FIG. 18-2 (i.e., the YES branch). Alternatively, if it is determined that the drive output force is less than or equal to the first threshold and / or the robot arm force is less than or equal to the second threshold, the process 1800 may return to block 1808 (e.g., the NO branch). The control circuitry may loop through blocks 1808, 1810, and 1812 any number of times as necessary to remove slack in the elongate shaft.

[0263] In FIG. 18-2, in block 1818, process 1800 may include releasing tension on the elongate shaft. For example, the control circuitry may move a second robotic arm coupled to the instrument handle closer to the first robotic arm in an insertion direction and / or cause the instrument feeder device to move the elongate shaft in a retraction direction. In some examples, moving the second robotic arm away from the first robotic arm in block 1808 may cause the elongate shaft to be pulled too tight. Thus, the acts of block 1818 may be performed to release (e.g., slightly) such tension.

[0264] At block 1820, the process 1800 may include determining whether the second robotic arm has moved a first predetermined distance and / or whether the elongated shaft has retracted a second predetermined distance. For example, the control circuitry may determine (at block 1818) whether the second robotic arm has moved in the insertion direction (e.g., moved closer to the first robotic arm by a certain amount) by at least a first predetermined amount and / or whether the elongated shaft has moved by the instrument feeder device by at least a second predetermined distance. The second predetermined distance may be the same or different than the first predetermined distance. Additionally or alternatively, at block 1820, the control circuitry may determine whether the amount of force applied by / to the drive output and / or the amount of force implemented / applied by the first robotic arm / second robotic arm used to control the instrument feeder device / engagement assembly / roller has changed by a threshold amount or is below a threshold (e.g., indicating a release of tension).

[0265] If it is determined that the second robotic arm has moved the first predetermined distance and / or the elongate shaft has retracted the second predetermined distance, process 1800 may proceed to block 1822 (i.e., the YES branch). Alternatively, if it is determined that the second robotic arm has not moved the first predetermined distance and / or the elongate shaft has not retracted the second predetermined distance, process 1800 may return to block 1818 (i.e., the NO branch). The operation at block 1818 may be performed any number of times to gradually release the tension on the elongate shaft (e.g., actuating the second robotic arm and / or axially moving the elongate shaft a particular amount each time at block 1818) until one or more criteria are met.

[0266] Although blocks 1818 and 1820 are illustrated in example process 1800, in some examples, such blocks may be eliminated. In one example, block 1818 is implemented in a single instance (e.g., block 1820 is eliminated).

[0267] At block 1822, the process 1800 may include controlling the instrument feeder device to disengage the elongated shaft and / or allow the elongated shaft to rotate. For example, the control circuitry may transition the instrument feeder device to a disengaged state (e.g., an intermediate state in which the elongated shaft is held, a fully open / disengaged state, or another disengaged state). In one example, the instrument feeder device may transition to an intermediate state in which the rollers / actuators are disengaged from the elongated shaft and the cover / retention mechanism is closed. This may enable an admittance control mode (e.g., for manual adjustment of a first robotic arm coupled to the instrument feeder device) and / or allow the elongated shaft to rotate (e.g., move freely within the channel while being held within the instrument feeder device).

[0268] Further embodiments Depending on the embodiment, certain acts, events, or functions of any of the algorithms or processes described herein may be performed in a different order, may be added, merged, or omitted entirely, and thus, in a particular embodiment, not all of the described acts or events are necessary to the execution of a process.

[0269] In particular, conditional language used herein, such as "can," "could," "might," "may," "eg," and the like, unless specifically stated otherwise or understood otherwise within the context in which it is used, is intended to have its ordinary meaning and is generally intended to convey that certain embodiments include certain features, elements, and / or steps, while other embodiments do not. Thus, such conditional language is not generally intended to suggest that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining whether those features, elements, and / or steps are included or performed in any particular embodiment, with or without author input or prompting. Terms such as "comprising," "including," "having," and the like, are used in their ordinary sense and are used inclusively in a non-limiting manner and do not exclude additional elements, features, acts, operations, etc. Also, when the term "or" is used, for example, to connect a list of elements, the term "or" is used in its inclusive sense (and not its exclusive sense) to mean one, some, or all of the listed elements. Unless specifically stated otherwise, connective language such as the phrase "at least one of X, Y, and Z" is understood in the context as it is commonly used to convey that an item, term, element, etc. can be either X, Y, or Z. Thus, such connective language is not generally intended to imply that a particular embodiment requires that at least one of X, at least one of Y, and at least one of Z, each be present.

[0270] In the above description of the embodiments, it should be understood that various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure and aiding in the understanding of one or more of the various inventive aspects. However, the method of the disclosure should not be interpreted as reflecting an intention that any claim requires more features than are expressly recited in that claim. Moreover, any component, feature, or step illustrated and / or described in a particular embodiment herein may be applied to or used in conjunction with any other embodiment(s). Moreover, no component, feature, step, or group of components, features, or steps is necessary or essential for each embodiment. Thus, it is intended that the scope of the disclosure herein should not be limited by the specific embodiments described above, but should be determined solely by a fair reading of the following claims.

[0271] It should be understood that certain ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply physical characteristics or ordering. Thus, as used herein, ordinal terms (e.g., "first," "second," "third," etc.) used to modify elements, such as structures, components, operations, etc., do not necessarily indicate a priority or order of the element relative to any other elements, but rather may generally distinguish the element from other elements having similar or identical names (apart from the use of the ordinal term). In addition, as used herein, the indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Furthermore, an operation performed "based on" a condition or event may also be performed based on one or more other conditions or events not expressly recited.

[0272] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the exemplary embodiments belong. It is further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning consistent with their meaning in the context of the relevant art, and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

[0273] Spatially relative terms such as "outer", "inner", "upper", "lower", "below", "upper", "vertical", "horizontal", and similar terms may be used herein for ease of description to describe the relationship between one element or component and another element or component as illustrated in the figures. It should be understood that the spatially relative terms are intended to encompass different orientations of the device during use or operation in addition to the orientation shown in the figures. For example, if the device shown in the figures is inverted, a device positioned "below" or "below" another device may be positioned "above" another device. Thus, the illustrative term "lower" may include both lower and upper positions. Devices may also be oriented in other directions, and thus the spatially relative terms may be interpreted differently depending on the orientation.

[0274] Unless otherwise specified, comparative and / or quantitative terms such as "less," "more," "greater than," and the like are intended to encompass the notion of equality. For example, "less" can mean not only "less than" in the strict mathematical sense, but also "less than or equal to."

[0275] [Embodiment] (1) A system comprising: an instrument feeder device configured to couple to the drive output and including an engagement assembly configured to engage an elongate shaft of a medical instrument; A control circuit comprising: actuating the engagement assembly on the drive output; and determining a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output. (2) The system of embodiment 1, wherein the control circuit is configured to determine the state of the engagement assembly based on at least one of a comparison of the amount of force applied by the drive output with one or more threshold values, or a comparison of the position of the drive output with one or more reference positions. (3) The system of embodiment 1, wherein the engagement assembly includes an actuator configured to axially move the elongated shaft and a channel configured to receive the elongated shaft. (4) The system of claim 3, wherein the state of the engagement assembly indicates whether the actuator is engaged with the elongate shaft. (5) The system of claim 3, wherein the state of the engagement assembly indicates whether the elongated shaft is properly positioned within the channel.

[0276] (6) The control circuit causing the drive output to actuate the engagement assembly from an engaged state in which the actuator is engaged to a disengaged state in which the actuator is disengaged; The system of embodiment 3, configured to determine a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state, wherein the first change in force is greater than a first threshold value. (7) The control circuit causing the drive output to actuate the engagement assembly from the disengaged state to the engaged state; The system of embodiment 6, configured to determine a second position of the drive output associated with a second change in force applied by the drive output, the second change in force being greater than the first threshold or a second threshold. (8) The control circuit identifying a third position of the drive output associated with an intermediate state in which the actuator is disengaged from the elongate shaft; and determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position and the third position; and controlling the instrument feeder device based at least in part on the determination of whether the elongated shaft is properly received within the channel. (9) The control circuit Detecting at least one of: (i) the instrument feeder device is coupled to a robotic system associated with the drive output; (ii) the medical instrument is coupled to the robotic system; (iii) rotation of the elongate shaft is commanded; or (iv) manual movement of a robotic arm of the robotic system is enabled; 2. The system of claim 1, further configured to actuate the engagement assembly to the drive output based at least in part on the detection. (10) A system comprising: A medical device including an elongated shaft; an instrument feeder including an engagement assembly configured to receive the elongate shaft and axially move the elongate shaft, the instrument feeder configured to couple to a robotic arm including a drive output; A control circuit comprising: actuating the drive output to move the engagement assembly; and determining a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output.

[0277] (11) The system of claim 10, wherein the engagement assembly includes an actuator configured to axially move the elongated shaft and a channel configured to receive the elongated shaft. (12) The system of claim 11, wherein the instrument feeder device is configured to bias the actuator to an engaged or disengaged state. (13) The system of claim 11, wherein the state of the engagement assembly indicates whether the actuator is engaged with the elongate shaft. (14) The system of claim 11, wherein the state of the engagement assembly indicates whether the elongate shaft is properly positioned within the channel. (15) The control circuit causing the drive output to actuate the engagement assembly from an engaged state in which the actuator is engaged to a disengaged state in which the actuator is disengaged; and determining a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state.

[0278] (16) The control circuit causing the drive output to actuate the engagement assembly from the disengaged state toward the engaged state; and determining a second position of the drive output associated with a second change in force. (17) The control circuit determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position; and controlling the instrument feeder device based at least in part on the determination of whether the elongated shaft is properly received within the channel. (18) The control circuit determining at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the second position relative to the first position; and The system of embodiment 16, wherein the system is configured to cause the drive output to actuate the engagement assembly to the disengaged state based at least in part on at least one of the determinations that the elongated shaft is not received within the engagement assembly or is not properly received within the engagement assembly. (19) The engagement assembly further includes a retention mechanism configured to selectively open and close the channel, and the control circuitry further includes: identifying a third position of the drive output associated with an intermediate state in which the retention mechanism is closed and the actuator is disengaged from the elongate shaft; determining at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the second position relative to the first position and the third position; and The system of embodiment 16, wherein the system is configured to cause the drive output to actuate the engagement assembly to the disengaged state based at least in part on at least one of the determinations that the elongated shaft is not received within the engagement assembly or is not properly received within the engagement assembly. (20) controlling a drive output to cause actuation of an instrument feeder device configured to couple to a medical instrument; determining at least one of an amount of force applied by the drive output or a position of the drive output; and determining an engagement state of the instrument feeder device and the medical instrument based on at least one of the amount of force output by the drive output or the position of the drive output.

[0279] (21) The method of claim 20, wherein the state of the implement feeder device is determined based on at least one of: a comparison of the amount of force applied by the drive output to one or more thresholds; or a comparison of the position of the drive output to one or more reference positions. (22) The method of claim 20, wherein the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft. (23) The method of claim 22, wherein the state of the instrument feeder device indicates at least one of whether the actuator is engaged with the elongate shaft or whether the elongate shaft is properly positioned within the channel. (24) controlling the drive output to actuate the engagement assembly to a disengaged state in which the actuator is disengaged; determining a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly to the disengaged state; controlling the drive output to actuate the engagement assembly from the disengaged state toward an engaged state in which the actuator is engaged; determining a second position of the drive output associated with a second change in force; and 23. The method of claim 22, further comprising determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position. (25) further comprising identifying a third position of the drive output associated with a state in which the actuator is disengaged from the elongate shaft and a retention mechanism of the engagement assembly is closed; 25. The method of claim 24, wherein the determination of whether the elongate shaft is received within the channel is based at least in part on the second position relative to the first position and the third position.

[0280] (26) A robot system comprising: A robot arm; an end effector associated with a distal end of the robotic arm, the end effector including a first drive output configured to actuate a first drive input of an instrument feeder to control engagement of the instrument feeder with an elongate shaft of an instrument; and a control circuit communicatively coupled to the robotic arm and configured to determine a state of an implement feeder device based on at least one of an amount of force applied by the first drive output or a position of the first drive output. (27) The robotic system of claim 26, wherein the end effector further includes a second drive output configured to actuate a second drive input of the instrument feeder to cause axial movement of the elongate shaft. (28) The robotic system of claim 26, wherein the instrument feeder includes an actuator configured to axially move the elongated shaft, a channel configured to receive the elongated shaft, and a retaining mechanism configured to selectively open and close the channel. (29) The robotic system of claim 28, wherein the state of the instrument feeder device indicates at least one of whether the actuator is engaged with the elongate shaft, whether the retention mechanism is closed, or whether the elongate shaft is properly positioned within the channel. (30) The control circuit transitioning the implement feeder to a disengaged state in which the actuator is disengaged; moving the implement feeder toward an engaged state; determining a first position of the drive output associated with a first change in force applied by the first drive output that occurs while moving the implement feeder toward the engaged condition; Identifying a second position of the drive output associated with at least one of: (i) a second change in force applied by the first drive output; or (ii) the actuator being disengaged from the elongate shaft and the retention mechanism being closed; and 29. The robotic system of claim 28, further configured to: determine whether the elongated shaft is properly received within the channel based at least in part on the first position relative to the second position.

Claims

1. 1. A system comprising: an instrument feeder device configured to couple to the drive output and including an engagement assembly configured to engage an elongate shaft of a medical instrument; A control circuit comprising: actuating the engagement assembly on the drive output; and determining a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output.

2. 2. The system of claim 1, wherein the control circuitry is configured to determine the state of the engagement assembly based on at least one of a comparison of the amount of force applied by the drive output to one or more threshold values ​​or a comparison of the position of the drive output to one or more reference positions.

3. The system of claim 1 , wherein the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft.

4. The system of claim 3 , wherein the state of the engagement assembly indicates whether the actuator is engaged with the elongate shaft.

5. The system of claim 3 , wherein the state of the engagement assembly indicates whether the elongate shaft is properly positioned within the channel.

6. The control circuit includes: causing the drive output to actuate the engagement assembly from an engaged state in which the actuator is engaged to a disengaged state in which the actuator is disengaged; 4. The system of claim 3, configured to determine a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state, the first change in force being greater than a first threshold value.

7. The control circuit includes: causing the drive output to actuate the engagement assembly from the disengaged state to the engaged state; 7. The system of claim 6, configured to determine a second position of the drive output associated with a second change in force applied by the drive output, the second change in force being greater than the first threshold or a second threshold.

8. The control circuit includes: identifying a third position of the drive output associated with an intermediate state in which the actuator is disengaged from the elongate shaft; and determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position and the third position; and controlling the instrument feeder device based at least in part on the determination whether the elongate shaft is properly received within the channel.

9. The control circuit includes: Detecting at least one of: (i) the instrument feeder device is coupled to a robotic system associated with the drive output; (ii) the medical instrument is coupled to the robotic system; (iii) rotation of the elongate shaft is commanded; or (iv) manual movement of a robotic arm of the robotic system is enabled; and actuating the engagement assembly on the drive output based at least in part on the detection.

10. 1. A system comprising: A medical device including an elongated shaft; an instrument feeder including an engagement assembly configured to receive the elongate shaft and axially move the elongate shaft, the instrument feeder configured to couple to a robotic arm including a drive output; A control circuit comprising: actuating the drive output to move the engagement assembly; and determining a state of the engagement assembly based on at least one of an amount of force applied by the drive output or a position of the drive output.

11. The system of claim 10 , wherein the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft.

12. The system of claim 11 , wherein the implement feeder is configured to bias the actuator into an engaged or disengaged state.

13. The system of claim 11 , wherein the state of the engagement assembly indicates whether the actuator is engaged with the elongate shaft.

14. The system of claim 11 , wherein the state of the engagement assembly indicates whether the elongate shaft is properly positioned within the channel.

15. The control circuit includes: causing the drive output to actuate the engagement assembly from an engaged state in which the actuator is engaged to a disengaged state in which the actuator is disengaged; and determining a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly from the engaged state to the disengaged state.

16. The control circuit includes: causing the drive output to actuate the engagement assembly from the disengaged state toward the engaged state; and determining a second position of the drive output associated with a second change in force.

17. The control circuit includes: determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position; and controlling the instrument feeder based at least in part on the determination whether the elongate shaft is properly received within the channel.

18. The control circuit includes: determining at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the second position relative to the first position; and and causing the drive output to actuate the engagement assembly to the disengaged state based at least in part on the determination that the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly.

19. The engagement assembly further includes a retention mechanism configured to selectively open and close the channel, and the control circuitry further comprises: identifying a third position of the drive output associated with an intermediate state in which the retention mechanism is closed and the actuator is disengaged from the elongate shaft; determining at least one of: the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly based at least in part on the first position and the second position relative to the third position; and and causing the drive output to actuate the engagement assembly to the disengaged state based at least in part on the determination that the elongate shaft is not received within the engagement assembly or is not properly received within the engagement assembly.

20. controlling the drive output to cause actuation of an instrument feeder device including an engagement assembly and configured to couple to a medical instrument including an elongate shaft; determining at least one of an amount of force applied by the drive output or a position of the drive output; determining an engagement state of the instrument feeder device and the medical instrument based on at least one of the amount of force output by the drive output or the position of the drive output.

21. 21. The method of claim 20, wherein the engagement state of the implement feeder device is determined based on at least one of: a comparison of the amount of force applied by the drive output to one or more thresholds, or a comparison of the position of the drive output to one or more reference positions.

22. The method of claim 20 , wherein the engagement assembly includes an actuator configured to axially move the elongate shaft and a channel configured to receive the elongate shaft.

23. 23. The method of claim 22, wherein the engagement state of the instrument feeder device indicates at least one of whether the actuator is engaged with the elongate shaft or whether the elongate shaft is properly positioned within the channel.

24. controlling the drive output to actuate the engagement assembly to a disengaged state in which the actuator is disengaged; determining a first position of the drive output associated with a first change in force applied by the drive output that occurs while moving the engagement assembly to the disengaged state; controlling the drive output to actuate the engagement assembly from the disengaged state toward an engaged state in which the actuator is engaged; determining a second position of the drive output associated with a second change in force; and 23. The method of claim 22, further comprising determining whether the elongate shaft is properly received within the channel based at least in part on the second position relative to the first position.

25. identifying a third position of the drive output associated with a state in which the actuator is disengaged from the elongate shaft and a retention feature of the engagement assembly is closed; 25. The method of claim 24, wherein the determination of whether the elongate shaft is received within the channel is based at least in part on the second position relative to the first position and the third position.

26. 1. A robot system comprising: A robot arm; an end effector associated with a distal end of the robotic arm, the end effector including a first drive output configured to actuate a first drive input of an instrument feeder to control engagement of the instrument feeder with an elongate shaft of an instrument; and a control circuit communicatively coupled to the robotic arm and configured to determine a state of an implement feeder device based on at least one of an amount of force applied by the first drive output or a position of the first drive output.

27. 27. The robotic system of claim 26, wherein the end effector further comprises a second drive output configured to actuate a second drive input of the instrument feeder to cause axial movement of the elongate shaft.

28. 27. The robotic system of claim 26, wherein the instrument feeder includes an actuator configured to axially move the elongate shaft, a channel configured to receive the elongate shaft, and a retention mechanism configured to selectively open and close the channel.

29. 30. The robotic system of claim 28, wherein the state of the instrument feeder indicates at least one of: whether the actuator is engaged with the elongate shaft, whether the retention mechanism is closed, or whether the elongate shaft is properly positioned within the channel.

30. The control circuit includes: transitioning the implement feeder to a disengaged state in which the actuator is disengaged; moving the implement feeder toward an engaged state; determining a first position of the first drive output associated with a first change in force applied by the first drive output that occurs while moving the implement feeder toward the engaged state; Identifying a second position of the first drive output associated with at least one of: (i) a second change in force applied by the first drive output; or (ii) the actuator being disengaged from the elongate shaft and the retention mechanism being closed; and and determining whether the elongate shaft is properly received within the channel based at least in part on the first position relative to the second position.

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