Instrument Roll Control

Abstract

The medical instrument includes an elongate shaft defining a roll axis and a handle coupled to the elongate shaft, the handle including a robotic drive input operable to rotate the elongate shaft relative to the handle about the roll axis, and a lockout mechanism movable between an engaged position, where the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, where the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 150,318, filed February 17, 2021, and entitled “INSTRUMENT ROLL CONTROL,” the disclosure of which is incorporated by reference in its entirety herein. [Background technology]

[0002] Certain robotic medical procedures may involve the use of shaft-type instruments, such as endoscopes, that can be inserted into a patient through an orifice (e.g., a natural orifice) and advanced to a target anatomical site. Such medical instruments may be manually rotatable such that the shaft of the instrument rolls about its axis. [Brief description of the drawings]

[0003] Various embodiments are depicted in the accompanying drawings for illustrative purposes and should not be construed as limiting the scope of the present invention in any way. In addition, various features of different disclosed embodiments may be combined to form further embodiments that are part of this disclosure. Throughout the drawings, reference numbers may be reused to indicate correspondence between referenced elements. [Figure 1] 1 illustrates an embodiment of a robotic medical system including a shaft-type instrument coupled to a robotic end effector, in accordance with one or more embodiments. [Diagram 2] 1 illustrates a robotic system arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. [Diagram 3] 1 illustrates a pedestal-based robotic system in accordance with one or more embodiments. [Figure 4-1] 4 illustrates medical system components that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. [Figure 4-2]4 illustrates medical system components that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. [Diagram 5] 1 illustrates a shaft-type instrument disposed in a portion of a patient's urinary system, according to one or more embodiments. [Figure 6] FIG. 1 illustrates an exploded view of an instrument manipulator assembly associated with a robotic arm, according to one or more embodiments. [Figure 7A] FIG. 1 illustrates a cutaway perspective view of an instrument handle according to one or more embodiments. [Figure 7B] FIG. 1 illustrates a cutaway perspective view of an instrument handle according to one or more embodiments. [Figure 8] FIG. 1 illustrates a cutaway view of an instrument handle, according to one or more embodiments. [Figure 9] FIG. 1 illustrates a cutaway view of an instrument handle, according to one or more embodiments. [Figure 10] 10-1, 10-2, and 10-3 show perspective views of a roll axis assembly according to one or more embodiments. [Figure 10-4] 10-1, 10-2, and 10-3 show exploded views of the roll axis assembly according to one or more embodiments. [Figure 11A] FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in a locked position, according to one or more embodiments. [Figure 11B] FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in a locked position, according to one or more embodiments. [Figure 11C] FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in a locked position, according to one or more embodiments. [Figure 12A] FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in an unlocked position, according to one or more embodiments. [Figure 12B]FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in an unlocked position, according to one or more embodiments. [Figure 12C] FIG. 1 illustrates a perspective view of certain instrument handle components including an axle catch in an unlocked position, according to one or more embodiments. [Figure 13-1] FIG. 1 illustrates a perspective view of certain instrument handle components, including an axle catch, according to one or more embodiments. [Figure 13-2] FIG. 1 illustrates a perspective view of certain instrument handle components, including an axle catch, according to one or more embodiments. [Figure 14-1] 13A-13D illustrate a roll-lock feature for an instrument in an unlocked and locked configuration / state, respectively, in accordance with one or more embodiments. [Figure 14-2] 13A-13D illustrate a roll-lock feature for an instrument in an unlocked and locked configuration / state, respectively, in accordance with one or more embodiments. [Figure 15-1] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 15-2] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 15-3] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 16-1] 15-1, 15-2, and 15-3, respectively, in accordance with one or more embodiments. [Figure 16-2] 15-1, 15-2, and 15-3, respectively, in accordance with one or more embodiments. [Figure 16-3]15-1, 15-2, and 15-3, respectively, in accordance with one or more embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0004] The headings provided herein are merely for convenience and do not necessarily affect the scope or meaning of the claimed invention. Although certain preferred embodiments and examples are disclosed below, the inventive subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or applications, as well as to modifications and equivalents thereof. Thus, the scope of claims that may arise from this specification is not limited by any of the specific embodiments 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. Various operations may be described in sequence as multiple separate operations in a manner that may be helpful in understanding a particular embodiment, however, the order of description should not be construed to imply that these operations are order dependent. Furthermore, 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 necessarily all such aspects or advantages are realized by any particular embodiment. Thus, for example, various embodiments may be performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0005] While certain spatially relative terms, such as "outer," "inner," "superior," "lower," "below," "upper," "vertical," "horizontal," "top," "bottom," "lateral," 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 positional relationships between elements / structures, such as with respect to the illustrated orientations of the drawings. It is understood that the spatially relative terms are intended to encompass different orientations of the elements / structures in use or operation in addition to the orientation shown in the drawings. For example, an element / structure described as being "above" another element / structure 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 with respect to the illustrated orientation of each of the referenced figures.

[0006] Certain reference numbers are reused across different figures of the set of figures of this disclosure for convenience of devices, components, systems, features, and / or modules having features that may be similar in one or more respects. However, with respect to any of the embodiments disclosed herein, the reuse of common reference numbers in the figures does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, one skilled in the art may be informed by the context as to the extent to which the use of common reference numbers may imply similarity between the referenced subject matter. The use of a particular 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 by a common reference number may be interpreted as sharing characteristics or as being entirely independent of each other. In some contexts, features associated with separate figures identified by a common reference number are not related and / or similar with respect to at least certain aspects.

[0007] The present disclosure provides systems, devices, and methods for implementing and controlling the roll of an instrument shaft, such as a medical endoscope. With respect to the medical instruments described in this disclosure, the term "instrument" is used according to its broad and ordinary meaning and may refer to any type of tool, device, assembly, system, subsystem, apparatus, component, etc. In some contexts herein, the term "device" may be used substantially interchangeably with the term "instrument." Additionally, the term "shaft" is used herein according to its broad and ordinary meaning and may refer to any type of elongated cylinder, tube, scope (e.g., endoscope), prism (e.g., rectangular, oval, elliptical, or oval prism), wire, or the like, regardless of cross-sectional shape. It should be understood that any reference herein to a "shaft" or "instrument shaft" may be understood to refer to an endoscope.

[0008] Medical Treatment 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, although such context is provided for convenience and clarity, and it should be understood that the robotic and manual instrument shaft roll concepts disclosed herein are applicable to any suitable medical procedure, such as robotic bronchoscopy. However, as noted, a description of the anatomy of the renal / urinary system and associated medical problems and procedures is presented below to aid in the explanation of the inventive concepts disclosed herein.

[0009] In certain medical procedures, such as ureteroscopy procedures, an elongated medical instrument that accesses the procedure site through an access sheath can be utilized to remove debris, such as kidney stones and stone fragments or other waste or contaminants, from the procedure site. 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 urine flow through the ureter or urethra. Urinary stones may be formed from calcium, magnesium, ammonia, uric acid, cystine, and / or other compounds, or combinations thereof.

[0010] Several methods may be used to treat patients with kidney stones, including observation, medical treatment (such as expulsion therapy), non-invasive treatment (such as extracorporeal shock wave lithotripsy (ESWL)), minimally invasive or surgical treatment (such as ureteroscopy and percutaneous nephrolithotomy (PCNL)), etc. In some approaches (e.g., ureteroscopy and PCNL), a physician gains access to the stone, the stone is broken up into smaller pieces or fragments, and the smaller stone fragments / particles are extracted from within the kidney using a basket device and / or suction.

[0011] In some procedures, a surgeon may insert an endoscope (e.g., a ureteroscope) through the urethra and into the urinary tract to remove urinary stones from the bladder and ureters. Typically, the ureteroscope includes a camera at its distal end configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotripsy device configured to capture or fragment ureteral stones or allow for placement within the working channel of the ureteroscope. During a ureteroscopic procedure, one physician / technologist may control the position of the ureteroscope while another physician / technologist may control the lithotripsy device.

[0012] In some procedures, such as those for removing relatively large stones / fragments, physicians may use percutaneous nephrolithotomy ("PCNL") techniques, which involve inserting a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site to break up and / or remove the stone. The percutaneous access devices (e.g., nephroscopes, sheaths, sheath assemblies, and / or catheters) (and / or direct entry endoscopes) used to provide an access channel to the target anatomical site may include one or more fluid channels for providing irrigation fluid flow to the target site and / or for aspirating fluid from the target site (e.g., through passive outflow and / or active suction).

[0013] In the case of ureteroscopic procedures, physicians may perform procedures to break larger kidney stones into smaller fragments to facilitate their removal. For example, certain instruments may be utilized to break the stone into smaller fragments, such as by laser treatment or through other application of cleavage forces to the kidney stone. According to some procedures, a basket device / system may be used to capture and extract the smaller stone fragments from the treatment site and out of the patient. Generally, when a stone is captured, the surgeon may wish to quickly extract the stone through the ureteral access sheath before opening the basket to deposit / drop the stone into a specimen collection structure or area, after which the basket may be closed and reinserted through the access sheath (e.g., into the working channel of the endoscope / ureteroscope) for the purpose of extracting any remaining stone or stone fragments.

[0014] Robotic assisted ureteroscopic procedures may be performed in connection with a variety of medical procedures, such as kidney stone removal procedures, where robotic tools may enable physicians / urologists to perform endoscopic targeting access as well as percutaneous access / treatment. Advantageously, aspects of the present disclosure relate to systems, devices, and methods for robotically controlling the axial rotation / roll of an endoscope / ureteroscope to improve the efficiency and effectiveness of the procedure.

[0015] Healthcare System FIG. 1 illustrates an example medical system 100 for performing various medical procedures according to aspects of the present disclosure. The medical system 100 may be used, for example, for endoscopic (e.g., ureteroscopic) procedures. As mentioned and described above, certain ureteroscopic procedures involve the treatment / removal of kidney stones. In some implementations, kidney stone treatments may benefit from the assistance of certain robotic techniques / devices. Robotic medical solutions may provide relatively high precision, greater control, and / or better hand-eye coordination for certain instruments compared to strictly manual procedures. For example, robotically assisted ureteroscopic access to the kidney with some procedures may advantageously enable the urologist to perform both endoscope control and basket control separately.

[0016] Although the system 100 of FIG. 1 is presented in the context of a ureteroscopic procedure, it should be understood that the principles disclosed herein may be implemented in any type of endoscopic procedure. Furthermore, some of the examples described herein relate to object removal procedures involving the removal of kidney stones from a kidney. However, the present disclosure is not limited to kidney stone removal alone. For example, the following description is also applicable to other surgical or medical procedures or procedures involving the removal of objects from a patient, including any object that can be removed from a treatment site or patient cavity (e.g., esophagus, ureter, intestine, eye, etc.) via percutaneous and / or endoscopic access, such as gallbladder stone removal, lung (pulmonary / transthoracic) tumor biopsy, or cataract extraction.

[0017] The medical system 100 includes a robotic system 10 (e.g., a mobile robotic cart) configured to engage and / or control a medical instrument 19 (e.g., a ureteroscope) including a proximal handle 31 and a shaft 40 coupled to the handle 31 at its proximal portion, to perform a direct entry procedure on a patient 7. The term "direct entry" is used herein according to its broad and ordinary meaning and may refer to any entry of instrumentation through a natural or artificial opening in a patient's body. For example, with reference to FIG. 1, direct entry of a scope / shaft 40 into the urinary tract of a patient 7 may occur via the urethra 65.

[0018] It should be understood that the direct entry instrument 19 may be any type of shaft-based medical instrument, including an endoscope (such as a ureteroscope), a catheter (such as a steerable or non-steerable catheter), a nephroscope, a laparoscope, or other type of medical instrument. The embodiments of the present disclosure relating to a ureteroscopic procedure for removing a kidney stone through a ureteral access sheath (e.g., ureteral access sheath 90) are also applicable to solutions for removing objects through percutaneous access, such as through a percutaneous access sheath. For example, an instrument may access the kidney percutaneously, such as through a percutaneous access sheath, to capture and remove a kidney stone. The term "percutaneous access" is used herein according to its broad and ordinary meaning and 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 the procedure (e.g., the calyx rete of the kidney 70).

[0019] The medical system 100 includes a control system 50 configured to interface with the robotic system 10 to provide information regarding the procedure and / or perform various other operations. For example, the control system 50 may include one or more displays 56 configured to present certain information to assist the physician 5 and / or other technicians or individuals. The medical system 100 may include a platform 15 configured to hold a patient 7. The system 100 may further include an electromagnetic (EM) field generator 18, which may be carried by one or more of the robotic arms 12 of the robotic system 10 or may be a stand-alone device. While the various robotic arms 12 are shown in various positions and coupled to various tools / devices, it should be understood that such configurations are shown for convenience and illustrative purposes and that such robotic arms may have different configurations over time and / or at different points during a medical procedure. Additionally, the robotic arm 12 may be coupled to different devices / instruments than those shown in FIG. 1, and in some cases or periods, one or more of the arms may not be utilized or coupled to a medical instrument (e.g., an instrument manipulator / coupler). The roll of the shaft 40 may be controlled robotically and / or manually, such as through the movement of an end effector associated with the robotic arm 12a, and such movement may be controlled by the control system 50 and / or the robotic system 10. The term "end effector" is used herein according to its broad and ordinary meaning and may refer to any type of robotic manipulator device, component, and / or assembly. In the case where an adapter, such as a sterile adapter, is coupled to a robotic end effector or other robotic manipulator, the term "end effector" may refer to the adapter (e.g., a sterile adapter) or any other robotic manipulator device, component, or assembly associated and / or coupled to the end effector.In some contexts, the combination of a robotic end effector and an adapter may be referred to as an instrument manipulator assembly, and such an assembly may or may not also include a medical instrument (or instrument handle / base) physically coupled to the adapter and / or end effector. The terms "robotic manipulator" and "robotic manipulator assembly" are used according to their broad and ordinary meanings and may collectively or individually refer to a robotic end effector and / or a sterile adapter or other adapter components coupled to the end effector. For example, a "robotic manipulator" or a "robotic manipulator assembly" may refer to an instrument device manipulator (IDM) that includes one or more drive outputs, whether embodied in a robotic end effector, a sterile adapter, and / or other components.

[0020] In an exemplary use case, if the patient 7 has a kidney stone (or stone fragments) 180 located in the kidney 70, the physician may perform a procedure to remove the stone 180 through the ureter (63, 60, 65). In some embodiments, the physician 5 may interact with the control system 50 and / or the robotic system 10 to cause / control the robotic system 10 to advance and navigate a medical instrument shaft 40 (e.g., a scope) from the urethra 65, through the bladder 60, up the ureter 63, and into the renal pelvis 71 and / or calyx rete of the kidney 70 where the stone 180 is located. The physician 5 may further interact with the control system 50 and / or the robotic system 10 to cause / control the advancement of a basket device 30 through the working channel of the instrument shaft 40, the basket device 30 configured to facilitate capture and removal of the kidney stone or stone fragments. The control system 50 may provide information associated with the medical instrument 40 and / or other instruments of the system 100, such as real-time endoscopic images captured therewith, via the display 56 to assist the physician 5 in navigating / controlling such instruments.

[0021] Renal anatomy is described herein for reference with respect to certain medical procedures related to aspects of the inventive concept. The kidneys 70, shown generally in a typical anatomical location in FIG. 1, generally comprise two bean-shaped organs located on the left and right sides, respectively, in the retroperitoneal space. In an adult human, the kidneys generally are about 11 cm in height / length. The kidneys receive blood from paired renal arteries 69, and blood leaves the kidneys via paired renal veins 67. Each kidney 70 is fluidly connected to a respective ureter 63, which generally comprises a tube that carries urine drained from the kidney 70 to the bladder 60.

[0022] The kidneys 70 typically sit relatively high in the abdominal cavity, in a retroperitoneal position at a slight oblique angle. Intraperitoneal asymmetries, generally caused by the position of the liver, typically cause the right kidney to be slightly lower and smaller than the left, and slightly more centrally located than the left kidney (as shown in detail in FIG. 1). Above each kidney is an adrenal gland (not shown). The upper portion of the kidney 70 is partially protected by the 11th and 12th ribs (not shown). Each kidney with its adrenal gland is generally surrounded by two layers of fat: perirenal fat, which resides between the renal fascia and the renal capsule, and pararenal fat, which resides above the renal fascia.

[0023] The kidneys 70 are responsible for controlling the volumes of various body fluid compartments, fluid osmolality, acid-base balance, various electrolyte concentrations, and the removal of toxins. The kidneys 70 provide a filtration function by secreting certain substances and reabsorbing others. Examples of substances secreted in urine are hydrogen, ammonium, potassium, and uric acid. In addition, the kidneys also perform various other functions, such as hormone synthesis.

[0024] The recessed area on the concave border of kidney 70 is the renal hilum 181, where the renal artery 69 (not shown in the detailed view of kidney 70) enters kidney 70 and where the renal vein 67 (not shown in the detailed view) and ureter 63 exit. Kidney 70 is surrounded by a tough fibrous tissue, the renal capsule 74, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (back) surface is the transversalis fascia.

[0025] The functional matrix or parenchyma of the kidney 70 is divided into two major structures: the outer renal cortex 77 and the inner renal medulla 187. These structures each take the form of multiple roughly conical renal lobes that contain a renal cortex surrounding a portion of the medulla called the renal pyramids 72. Between the renal pyramids 72 are processes of the cortex called the renal columns 73. The urine-producing functional structures of the kidney, the nephrons (not shown in detail in FIG. 1 ), span the cortex 77 and medulla 187. The initial filtering portion of the nephron is the renal corpuscle, located in the cortex, followed by the nephric duct, which enters the cortex deep into the medullary pyramid. The medullary ray, which is part of the renal cortex, is a collection of tubules that drain into a single collecting duct.

[0026] The tip / apex, or papilla 79, of each renal pyramid drains urine into a respective minor calyx 75, which drains into a major calyx 76, which drains into the renal pelvis 71 where it passes into the ureter 63. The manifold-shaped collection of minor and major calyxes may be referred to herein as the "calyx network" of the kidney. At the renal hilum 181, the ureter 63 and renal vein 67 exit the kidney and the renal artery 69 enters. Hilar fat and lymphatic tissue with lymph nodes surround these structures. The renal hilar fat is adjacent to a fat-filled cavity called the renal sinus. The renal sinus collectively contains the renal pelvis 71 and calyxes 75, 76 and separates these structures from the renal medulla tissue. The funnel-shaped / tubular anatomical structure associated with the calyx may be referred to as the infundibulum. That is, the infundibulum generally provides the terminal end of the calyx where the papilla is exposed within the calyx.

[0027] With further reference to the medical system 100, a medical instrument shaft 40 (e.g., a scope, direct entry instrument, etc.) may be advanced through the urinary tract into the kidney 70. Specifically, a ureteral access sheath 190 may be disposed within the urinary tract to an area near the kidney 70. The shaft 40 may be passed through the ureteral access sheath 190 to access the internal anatomical structure of the kidney 70, as shown. Upon reaching the site of the kidney stone 180 (e.g., within the target calyx 75 of the kidney 70 where the stone 180 is accessible), the medical instrument 19 and / or its shaft 40 may be used to guide / direct the basket device 30 to the target location. Once the stone 180 is captured within the distal basket portion 35 of the basket device 30 / assembly, the kidney stone 180 may be extracted from the patient 7 using the utilized ureteral access pathway.

[0028] Various scope / shaft-type instruments disclosed herein, such as shaft 40 of system 100, can be configured to navigate within the human anatomy, such as within a natural orifice or lumen of the human anatomy. The terms "scope" and "endoscope" are used herein according to their broad and ordinary meaning and may refer to any type of elongated (e.g., shaft-type) medical instrument having imaging, viewing, and / or capturing capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space of the body. Scopes can include, for example, ureteroscopes (e.g., for accessing the urinary tract), laparoscopes, nephroscopes (e.g., for accessing the kidney), bronchoscopes (e.g., for accessing the airways such as the bronchi), colonoscopes (e.g., for accessing the colon), arthroscopes (e.g., for accessing a joint), cystoscopes (e.g., for accessing the bladder), colonoscopes (e.g., for accessing the colon and / or rectum), borescopes, and the like. The scope / endoscope, in some cases, may comprise at least a partially rigid and / or flexible tube and may be sized to be passed through an outer sheath, catheter, introducer, or other luminal device, or may be used without such a device.

[0029] FIG. 2 illustrates a cart-based robotic system 101 arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. During bronchoscopy, the arm 12 of the robotic system 10 can be configured to drive a medical instrument shaft 52, such as a steerable endoscope, which can be a procedure-specific bronchoscope for bronchoscopy, through a natural orifice access point (e.g., the mouth of a patient 7, which in this example is positioned on a table 15) to deliver diagnostic and / or therapeutic tools. As shown, the robotic system 10 (e.g., a cart) can be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arm 12 can be actuated to position the bronchoscope / shaft 52 relative to the access point. The arrangement in FIG. 2 can also be utilized when Gastro-Intestinal (GI) procedures are performed with a gastroscope, which is an endoscope specialized for GI procedures.

[0030] Once the robotic system 10 is properly positioned, the robotic arms 12 may insert the steerable endoscope 52 into the patient robotically, manually, or a combination thereof. The steerable endoscope 52 may comprise at least two nested parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument feeder from a set of instrument feeders and / or instrument handles 111, with each instrument feeder / handle coupled to the distal end of a respective robotic arm 12. This linear arrangement of feeders / handles 111 may create a "virtual rail" 103 that may be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or positions. One or more of the instrument feeders / handles 111 may be configured to implement a robotic roll of the shaft and may be configured according to one or more embodiments disclosed herein for such purpose.

[0031] The endoscope 52 can be directed downstream of the patient's trachea and lungs after insertion using precise commands from the robotic system 10 until it reaches the target surgical site. For example, the endoscope 52 can be directed to deliver a biopsy needle to a target, such as a lesion or nodule in the patient's lung. The needle can be deployed through a working channel that runs the length of the endoscope to obtain a tissue sample that is analyzed by a pathologist. Depending on the results of the pathology, additional tools can be deployed through the working channel of the endoscope for additional biopsies. For example, when a nodule is identified as malignant, the endoscope 52 can deliver a tool endoscopically to ablate the potential cancerous tissue. In some cases, the diagnostic and therapeutic treatments can be delivered in separate procedures. In these situations, the endoscope 52 can also be used to deliver fiducials to "mark" the location of the targeted nodule. In other cases, the diagnostic and therapeutic treatments can be delivered during the same procedure.

[0032] In the system 101, the patient introducer 102 is attached to the patient 7 via a port (not shown, e.g., surgical tubing). The curvature of the introducer 102 may allow the robotic system 10 to manipulate the instruments 52 from a position that is not in direct axial alignment with the patient access port, thereby allowing greater flexibility in placement of the robotic system 10 within a room. Additionally, the curvature of the introducer 102 may allow the robotic arm 12 of the robotic system 10 to be substantially horizontally aligned with the patient introducer 102, which may facilitate manual movement of the robotic arm 12 as needed. The control system 50 and / or the robotic cart 10 may include control circuitry configured to implement scope roll control as described herein.

[0033] 3 illustrates a table-based robotic system 104 in accordance with one or more embodiments of the present disclosure. The system 104 incorporates the robotic components 105 into a table / platform 147, thereby allowing for a reduced amount of capital equipment in the operating room compared to some cart-based robotic systems, which in some cases may allow for greater access to the patient 7. Similar to cart-based systems, the instrument device manipulator assembly associated with the robotic arm 212 of the system 104 may generally comprise an instrument and / or instrument feeder designed to manipulate an elongated medical instrument / shaft, such as a catheter 48, along a virtual rail or path.

[0034] As shown, the robot-enabled table system 104 can include a column 144 coupled to one or more carriages 141 (e.g., a ring-shaped movable structure) from which one or more robotic arms 212 can emanate. The carriage 141 can translate along a vertical column interface over at least a portion of the length of the column 144 to provide different vantage points from which the robotic arms 212 can be positioned to reach the patient 7. The carriage 141 can, in some embodiments, rotate about the column 144 using a mechanical motor positioned within the column 144 to provide the robotic arms 212 with access to multiple sides of the table 104. The rotation and / or translation of the carriage 141 can enable the system 104 to align medical instruments, such as endoscopes and catheters, to different access points on the patient. By providing vertical adjustment, the robotic arms 212 can be advantageously configured to be compactly housed under a platform 147 of the table system 104 and then elevated during a procedure.

[0035] The robot arm 212 may be mounted to the carriage 141 through one or more arm mounts 145, which may comprise a series of joints that may be individually rotatable and / or extend telescopically to provide additional configurability for the robot arm 212. The column 144 structurally provides support for the platform 147 and a path for vertical translation of the carriage 141. The column 144 may also transmit power and control signals to the carriage 141 and / or the robot arm 212 mounted thereon. The system 104 may include specific control circuitry configured to control the drive and / or roll of the instrument shaft 240 using an instrument feeder 211, which may be coupled to an end effector of one of the arms 212, and the instrument feeder 211 is controlled to automatically modify the axial drive speed with respect to the elongated instrument (e.g., endoscope) 48 based on a determined position of the distal end of the instrument 48. For example, when the distal end of the instrument 48 is positioned at a predetermined automatic pause location, the instrument feeder 211 may be controlled / driven to automatically pause / stop axial retraction to allow for specimen collection, as described in detail herein.

[0036] 1-3 and 4-1, which illustrates an exemplary embodiment of a control system of any of the above, an associated control system 50 may be configured to provide various functions to assist in performing a medical procedure. In some embodiments, the control system 50 may be coupled to the robotic system 10 and may operate in cooperation with the robotic system 10 to perform a medical procedure on a patient 7. For example, the control system 50 may communicate with the robotic system 10 via a wireless or wired connection (e.g., to control the robotic system 10). Additionally, in some embodiments, the control system 50 may communicate with the robotic system 10 to receive therefrom positional data regarding the position of the distal end of the scope 40, the access sheath 90, or the basket device 30. Such positional data regarding the position of the scope 40, the access sheath 90, or the basket device 30 may be derived at least in part using one or more electromagnetic sensors associated with the respective components, scope image processing capabilities, and / or based on robotic system data (e.g., arm position data, known parameters / dimensions of various system components, etc.). Additionally, in some embodiments, the control system 50 may be in communication with the table 15 to position the table 15 in a particular orientation or otherwise control the table 15. In some embodiments, the control system 50 may be in communication with the EM field generator 18 to control the generation of the EM field around the patient 7 and / or in the area of ​​the instrument feeder 11.

[0037] FIG. 4-1 further illustrates an exemplary embodiment of the robotic system of any of FIGS. 1-3. The robotic system 10 can be configured to at least partially facilitate the performance of a medical procedure. The robotic system 10 can be arranged in various ways depending on the particular procedure. The robotic system 10 can include one or more robotic arms 12 configured to engage and / or control, for example, a scope 40 and / or a basket device / system 30 to perform one or more aspects of the procedure. As shown, each robotic arm 12 can include multiple arm segments 23 coupled to joints 24 that can provide multiple degrees of movement / freedom. In the example of FIG. 1, the robotic system 10 is positioned proximate to a patient's leg, and the robotic arm 12 is actuated to engage and position the scope 40 for access within an access opening, such as the urethra 65 of the patient 7. Once the robotic system 10 is properly positioned, the scope 40 can be inserted into the patient 7 robotically using the robotic arm 12, manually by the physician 5, or a combination thereof. 1, a scope-driver / feeder instrument coupler 11 (i.e., an instrument device manipulator (IDM)) may be attached to the distal end effector 22 of one of the arms 12b to facilitate robotic control / advancement of the scope 40. Another of the arms 12a may be associated with an instrument coupler / manipulator 19 configured to facilitate advancement and movement of a basket device 30. The instrument coupler 19 may further provide a handle 31 for the scope 40, which is physically coupled to the handle 31 at a proximal end of the scope 40. The scope 40 may include one or more working channels through which additional tools, such as a lithotriptor, basket device, forceps, etc., may be introduced to the treatment site.

[0038] The robotic system 10 may be coupled to any component of the medical system 100, such as the control system 50, the platform 15, the EM field generator 18, the scope 40, the basket system 30, and / or any type of percutaneous access instrument (e.g., needle, catheter, nephroscope, etc.). In some embodiments, the robotic system 10 is communicatively coupled to the control system 50. For example, the robotic system 10 may be configured to receive control signals from the control system 50 to perform certain operations, such as positioning one or more of the robotic arms 12 in a particular manner, manipulating the scope 40, manipulating the basket system 30, etc. In response, the robotic system 10 may use certain control circuits 211, actuators 217, and / or other components of the robotic system 10 to control the components of the robotic system 10 to perform the operations. For example, the control circuit 211 may control the roll of the shaft / scope 40 by actuating the drive output 402 of the end effector 22 coupled to the instrument handle 31. In some embodiments, the robotic system 10 and / or control system 50 are configured to receive images and / or image data from the scope 40 representing the internal anatomical structure of the patient 7 and / or portions of the access sheath or other device components.

[0039] The robotic system 10 generally includes an elongated support structure 14 (also referred to as a "column"), a robotic system base 25, and a console 13 at the top of the column 14. The column 14 may include one or more arm supports 17 (also referred to as a "carriage") to support the deployment of one or more robotic arms 12 (three are shown in FIG. 1). The arm supports 17 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arms 12 for more desired positioning relative to the patient.

[0040] The arm support 17 can be configured to translate vertically along the column 14. In some embodiments, the arm support 17 can be connected to the column 14 through slots 20 positioned on either side of the column 14 to guide the vertical translation of the arm support 17. The slots 20 accommodate vertical translation interfaces to position and hold the arm support 17 at various vertical heights relative to the robotic system base 25. The vertical translation of the arm support 17 allows the robotic system 10 to adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, an individually configurable arm mount on the arm support 17 can allow the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0041] The robotic arm 12 may generally comprise a robotic arm base 21 and an end effector 22 separated by a series of articulated arm segments 23 connected by a series of joints 24, each joint comprising one or more independent actuators 217. Each actuator may comprise an independently controllable motor. Each independently controllable joint 24 may provide or represent an independent degree of freedom available to the robotic arm. In some embodiments, each of the arms 12 has seven joints, thus providing seven degrees of freedom, including a "redundant" degree of freedom. The redundant degrees of freedom allow the robotic arm 12 to position its respective end effector 22 at a particular position, orientation, and trajectory in space using various link positions and joint angles. This allows the system to position and orient the medical instrument from a desired point in space, while allowing the physician to move the arm joints to a clinically convenient position away from the patient to create greater access while avoiding arm collisions.

[0042] The robotic system base 25 balances the weight of the column 14, arm support 17, and arm 12 on the floor. Thus, the robotic system base 25 may house certain relatively heavier components such as electronics, motors, power supplies, and components that selectively enable movement or immobilize the robotic system. For example, the robotic system base 25 may include casters 28 in the form of wheels that allow the robotic system to be easily moved around the operating room prior to a procedure. After reaching the proper position, the casters 28 may be immobilized using wheel locks to hold the robotic system 10 in place during a procedure.

[0043] When positioned at the top of the column 14, the console 13 can provide both a user interface for receiving user input and a display screen 16 (or dual-purpose device, e.g., a touch screen) for providing both pre-operative and intra-operative data to the physician / user. Potential pre-operative data on the console / display 16 or display 56 can include pre-operative planning, navigation and mapping data derived from a pre-operative computerized tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data on the display can also include vital patient statistics such as respiration, heart rate, and / or pulse, along with optical information provided from tools, sensor information from sensors, and coordinate information. The console 13 can be positioned and tilted to allow the physician to access the console from the side of the column 14 opposite the arm support 17. From this position, the physician can view the console 13, the robotic arm 12, and the patient while operating the console 13 from behind the robotic system 10. As shown, the console 13 may also include a handle 27 to aid in manipulating and stabilizing the robotic system 10.

[0044] Each end effector 22 of the robotic arm 12 may include or be configured to couple to an instrument device manipulator (IDM) 29, which in some cases may be attached using a sterile adapter component. The combination of the end effector 22 and associated IDM, and any intervening articulations or couplers (e.g., sterile adapters) may be referred to as a manipulator assembly 111. In some embodiments, the IDM 29 may be removed and replaced with a different type of IDM, e.g., a first type of IDM / instrument 11 may be configured to manipulate the endoscope / shaft and a second type of IDM / instrument 19 may be associated with the shaft (e.g., coupled to a proximal portion thereof) and configured to roll and / or articulate the shaft and / or manipulate a basket device. Another type of IDM / instrument may be configured to hold the electromagnetic field generator 18. The IDM may provide a power and control interface. For example, the interface may include connectors for transmitting pneumatic, power, electrical, and / or optical signals from the robotic arm 12 to the IDM. The IDM 29 can be configured to manipulate a medical instrument (e.g., a surgical tool / instrument), such as a scope 40, using techniques including, for example, direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, and the like. In some embodiments, the device manipulator 29 can be attached to a respective one of the robotic arms 12, which are configured to insert or retract a respective coupled medical instrument into or from a treatment site.

[0045] As mentioned above, system 100 may include certain control circuits configured to perform certain functions described herein, including control circuitry 211 of robotic system 10 and control circuitry 251 of control system 50. That is, the control circuitry of systems 100, 101, 104 may be part of robotic system 10, control system 50, or some combination thereof. Thus, all references herein to control circuits may refer to circuitry embodied in a robotic system, a control system, or any other component of a medical system, such as medical systems 100, 101, and 104 shown in FIGS. 1-3, respectively. The term "control circuitry" is used herein according to its broad and ordinary meaning and may refer to any collection of processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connectivity circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, 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-coded and / or operational instructions in the circuits. The control circuitry referred to herein may further include one or more circuit boards (e.g., printed circuit boards), conductive traces and vias, and / or mounting pads, connectors, and / or components. The control circuitry referred to herein may further comprise one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuitry of the device. Such data storage devices may comprise 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 in which the control circuitry comprises hardware and / or software state machines, analog circuits, digital circuits, and / or logic circuits, the data storage devices / registers that store any associated operational instructions may be embedded within or external to the circuitry that comprises the state machines, analog circuits, digital circuits, and / or logic circuits.

[0046] The control circuitry 211, 251 may comprise a computer-readable medium configured to store and / or store hard-coded and / or operational instructions corresponding to at least some of the steps and / or functions illustrated in one or more of the figures and / or described herein. Such computer-readable medium may be included in an article of manufacture in some cases. The control circuitry 211 / 251 may be maintained / disposed entirely locally or may be at least partially remotely located (e.g., indirectly communicatively coupled via a local area network and / or wide area network). Any of the control circuits 211, 251 may be configured to perform any aspect of the various processes disclosed herein, including the processes illustrated in Figures 15-1 and 15-2, as described below.

[0047] With respect to the robotic system 10, at least a portion of the control circuitry 211 may be integrated with the base 25, column 14, and / or console 13 of the robotic system 10, and / or another system communicatively coupled to the robotic system 10. With respect to the control system 50, at least a portion of the control circuitry 251 may be integrated with the console base 51 and / or display unit 56 of the control system 50. It should be understood that any description herein of functional control circuitry or related functionality may also be understood to be embodied at least in part in the robotic system 10, the control system 50, or any combination thereof, and / or in one or more other local or remote systems / devices, such as control circuitry associated with the handle / base of a shaft-type instrument (e.g., an endoscope) according to any of the disclosed embodiments.

[0048] With further reference to FIG. 4-1 , the control system 50 can include various I / O components 258 configured to assist the physician 5 or others in performing a medical procedure. For example, the input / output (I / O) components 258 can be configured to allow user input to control / navigate the scope 40 and / or basket system within the patient 7. In some embodiments, for example, the physician 5 can provide input to the control system 50 and / or the robotic system 10, and in response to such input, can send control signals to the robotic system 10 to operate the scope 40 and / or the catheter basket system 30. The control system 50 can include one or more display devices 56 to provide various information regarding the procedure. For example, the display 56 can provide information regarding the scope 40 and / or the basket system 30. For example, the control system 50 can receive real-time images captured by the scope 40 and display the real-time images via the display 56. Additionally or alternatively, control system 50 may receive signals (e.g., analog, digital, electrical, acoustic / sonic, pneumatic, tactile, hydraulic, etc.) from medical monitors and / or sensors associated with patient 7, and display 56 may present information regarding the health or environment of patient 7. Such information may include, for example, information displayed via a medical monitor, such as information regarding heart rate (e.g., ECG, HRV, etc.), blood pressure / blood velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, brain waves (e.g., EEG), environmental and / or local or core body temperature.

[0049] The various components of the system 100 can be communicatively coupled to one another over a network, which can include wireless and / or wired networks. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), cellular networks, the Internet, personal area networks (PANs), body area networks (BANs), and the like. For example, the various communication interfaces of the system of FIG. 4-1 can be configured to communicate with one or more devices / sensors / systems, such as over wireless and / or wired network connections. In some embodiments, the various communication interfaces can implement wireless technologies, such as Bluetooth, Wi-Fi, near field communication (NFC), and the like. Additionally, in some embodiments, the various components of the system 100 can be connected for data communication, fluid exchange, power exchange, and the like, via one or more supporting cables, tubes, and the like.

[0050] The control system 50 and / or the robotic system 10 may include specific user controls (e.g., controls 55), which may comprise one or more buttons, keys, joysticks, handheld controllers (e.g., video game type controllers), computer mice, track pads, track balls, control pads, and / or any type of user input (and / or output) device or device interface, such as sensors (e.g., motion sensors or cameras) that capture hand and finger gestures, touch screens, and / or interfaces / connectors therefor. Such user controls are communicatively and / or physically coupled to respective control circuits. In some embodiments, a user may engage the user controls 55 to command the robot shaft rotation / roll as described herein.

[0051] FIG. 4-2 illustrates medical system components including a scope 519 and basket 30 device / assembly 519 that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. In some embodiments, the scope assembly 519 includes a handle or base 31 coupled to an endoscope 40. For example, the endoscope (i.e., "scope" or "shaft") may include an elongated shaft that includes one or more lights 49 and one or more cameras or other imaging devices 48. The scope 40 may further include one or more working channels 44 that may run the length of the scope 40. In some embodiments, such channels may be utilized to provide access for elongated basket wires / tines through the scope 40.

[0052] The basket assembly 30 can include a basket 35 formed from one or more wire tines 36. For example, the basket system 30 can include four wire tines disposed within a basket sheath 37 over its length, with the tines protruding from a distal end of the sheath 37 to form a basket shape 35. The tines 36 extend further from a proximal end of the sheath 37. The tines 36 can be configured to be slidable within the basket sheath 37 with some frictional resistance. The tines 36 and sheath 37 can be coupled to respective actuators 195 of the basket cartridge component 32. The basket cartridge 32 can be physically and / or communicatively coupled to a handle portion / component 31 of the scope assembly 519. The handle component 31 can be configured to be used to assist in basket and / or scope control, either manually or through robotic control.

[0053] The scope assembly 519 may be powered through a power interface 79 and / or controlled through a control interface 78, each or both of which may interface with a robotic arm / component of the robotic system 10. The scope assembly 519 may further include one or more sensors 72, such as pressure and / or other force reading sensors, which may be configured to generate signals indicative of forces experienced at / by one or more of the actuators 195 and / or other couplings of the scope / basket system 519.

[0054] The scope assembly 519 includes a specific mechanism for rolling the shaft 40 about its axis (e.g., rolling about the axis of the shaft at its base / proximal end). For example, the shaft 40 may be associated with a roll gear component 45 at its proximal portion. Such roll gear 45 may have one or more teeth or other features configured to mesh or engage with an actuator component associated with the handle 31 of the scope assembly 519. The scope assembly shaft 40 may be rolled / rotated by actuating the roll gear 45 using one or more actuator components (e.g., gears, belts, axles, etc.) associated with the handle 31. In some embodiments, the scope / shaft 40 includes a strain relief component 43, which may include a rubber cone or other feature / material configured to reduce strain on the proximal portion / end of the shaft from bending of the shaft and / or to reduce the bend angle at the proximal portion of the shaft.

[0055] The roll gear 45 of the shaft 40 may be at least partially disposed within the housing 80 of the handle 31. Additionally, additional components configured to cause the roll gear 45 and the shaft 40 to roll / rotate may be at least partially disposed within the housing 80. In some embodiments, the handle 31 is associated with an externally accessible / actuable roll axis 85 that may include a drive input configured to rotate about an axis when engaged with a drive output of a robot end effector and / or an adapter associated therewith. In some embodiments, the roll axis 85 has an axis that is transverse, orthogonal, and / or perpendicular to the axis of the roll gear 45 and / or the shaft 40. Thus, the handle 31 may further include an angle conversion gear 89 that may be configured to transfer / convert the rotation of the roll axis 85 to an axis that is parallel to the axis of the roll gear 45. The angle conversion gear 89 may be, for example, a bevel gear that is in meshing engagement with the roll axis 85 or the roll gear 45. The rotation / roll transmission 83 may be configured to transmit the rotation of the roll shaft 85 to the rotation of the roll gear 45 through some type of direct or indirect physical coupling between the roll shaft 85 and the roll gear 45. For example, the roll transmission 83 may include one or more belts, cables, rods, etc. In some embodiments, the roll shaft 85 is accessible through an opening on the underside of the handle 31.

[0056] The scope assembly may further include a roll axis catch or locking means / mechanism 90, which may comprise a structure configured to be actuated to assume a locked configuration in which its key component 95 is engaged with a mating feature of the roll axis 85, or an unlocked position in which the key component 95 is not engaged with a mating feature of the roll axis 85. The roll axis catch 90 may further include an actuator component 91, which may be of integral form with the body and / or key feature 95 of the roll axis 90. The actuator 91 may be accessible through an opening or other access 81 in the housing 80, which allows actuation of the roll axis catch actuator 91 from outside the handle 31 and / or housing 80. The various components of the scope assembly 519 are described in more detail below.

[0057] Scoped Roles FIG. 5 illustrates a ureteroscope 40 disposed in a portion of a patient's urinary system, according to one or more embodiments. As mentioned above, ureteroscopic procedures can be performed to investigate and / or treat abnormalities within a human ureter. For example, ureteroscopic procedures can be performed to treat and / or remove kidney stones. Such procedures can be performed at least in part manually and / or at least in part using robotic techniques. For example, the use of robotic devices and / or systems for certain endoscopic procedures can provide relatively greater precision, control, and / or coordination compared to strictly manual procedures. In some embodiments, the scope 40 includes a working channel 44 for deploying the basket device 30 (e.g., basket component 35) into a working area at the distal end of the scope 40.

[0058] The scope / shaft (e.g., endoscope / ureteroscope) 40 may comprise a tubular and flexible medical shaft / instrument configured to be inserted into a patient's anatomy to capture images of the anatomy and to perform a specific task using its one or more working channels. In some embodiments, the scope 40 may house an optical assembly that may include an imaging device 48, such as an optical camera, and wires and / or optical fibers for transmitting signals to / from the distal end 42 of the scope 40. The scope 40 may further include a light source 49, such as an LED or fiber optic light source / lens.

[0059] The scope shaft 40 may be advanced to the target location through the access sheath 190. The access sheath 190 may be advanced through the ureter 63 to a position near the renal pelvis 71 and / or ureteropelvic junction 71. The distal end of the access sheath 190 may be placed at a position within the ureter 63 and / or renal pelvis 71. The access sheath 190 may be placed as deep within the renal anatomy as possible, as permitted by the urinary pathway, which may be somewhat tortuous within that particular portion. Generally, the access sheath 190 may not be articulatable to the extent that the scope 40 may be articulated, and therefore it may not be practical to navigate / drive the access sheath 190 into the kidney.

[0060] The scope 40 may be articulatable, such as with respect to at least a distal portion 230 of the scope 40, such that the scope 40 may be maneuvered within the human anatomy. In some embodiments, the scope 40 is configured to be articulated with six degrees of freedom, including, for example, XYZ coordinate translation, as well as pitch, yaw, and roll. Certain position sensors (e.g., electromagnetic sensors) of the scope 40, if implemented, may have similar degrees of freedom with respect to the position information they generate / provide.

[0061] In the case of a robotic implementation, a robotic arm of the robotic system may be configured / configurable to manipulate the scope 40. For example, an instrument device manipulator (e.g., a scope handle) may be coupled to an end effector of the robotic arm and may manipulate the scope 40 using an elongated movement member. The elongated movement member may include one or more pull wires (e.g., pull or push wires), cables, fibers, and / or flexible shafts. For example, the robotic arm may be configured to actuate multiple pull wires (not shown) coupled to the scope 40 to deflect the tip 42 of the scope 40. 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 40 is configured to exhibit non-linear behavior in response to forces applied by the elongated movement members. The non-linear behavior may be based on the stiffness and compressibility of the scope and the slack or stiffness variability between different elongated movement members.

[0062] A camera / imaging device 48 can be used to capture images of internal anatomical spaces, such as the internal cupule of kidney 70. Scope 40 can be further configured to house an optical fiber for carrying light from a proximally located light source, such as a light emitting diode, to the distal end 42 of the scope. In some embodiments, scope 40 is configured to be controlled by a robotic system similar in one or more respects to robotic systems 100, 101, and 104 shown in Figures 1, 2, and 3, respectively.

[0063] In some embodiments, the shaft (e.g., scope) 40 includes a sensor configured to generate and / or transmit sensor position data to another device or to generate a detectable distortion or signature in the electromagnetic field. The sensor position data can be indicative of the position and / or orientation of the medical instrument 40 (e.g., its distal end 42) and / or can be used to determine / estimate the position / orientation of the medical instrument. For example, the sensor (sometimes referred to as a "position sensor") can include an electromagnetic (EM) sensor having a coil of conductive material or other form / embodiment of an antenna.

[0064] Embodiments of the present disclosure relate to the implementation of robotically controlled shaft roll and locking of the shaft roll function when an instrument is undocked from a robotic system. Such robotic shaft roll can be restricted to a limited angle of rotation, which can prevent instrument damage. When a medical instrument and / or its handle is unlatched, undocked, or otherwise separated from a robotic end effector and / or its associated adapter (e.g., sterile adapter) component, the medical instrument and / or its handle may be considered "off the robot," whereas when a medical instrument and / or its handle is latched, docked, or otherwise coupled to a robotic end effector and / or its associated adapter (e.g., sterile adapter) component, the medical instrument and / or its handle may be considered "on robot."

[0065] The instrument base / handle 31 may be configured to be attached, mounted, or otherwise connected or coupled to the robot end effector 6. For example, the robot arm may include an instrument drive mechanism / assembly with an end effector and / or a sterile adapter, and the instrument base / handle 31 may be attached to the instrument drive mechanism / assembly. The instrument drive mechanism may include a drive output configured to engage and actuate a corresponding drive input on the instrument base / handle 31 to manipulate the medical instrument 19. For example, one or more drive outputs of the robot end effector 6 may be configured to control shaft roll, as described in detail herein. The drive output of the end effector may be coupled to one or more drive couplings of an adapter (e.g., a sterile adapter) configured to transfer drive torque from the drive output of the end effector to the drive output of the adapter. References herein to a robot end effector and / or drive output or other features may be understood to refer to an adapter (e.g., a sterile adapter) coupled to the end effector and / or a drive output of the adapter. For example, a description of docking an instrument onto an end effector should be understood to refer to docking the instrument onto the adapter when the adapter is coupled to the end effector.

[0066] In some configurations, the elongated shaft 40 of the medical instrument 19 is arranged to form a service loop 43 between the instrument handle 31 and the instrument feeder 11 and / or an associated robotic arm. The service loop 43 may include the length of the shaft 40 between the instrument base 31 / handle and the feeder device 11. The length of the shaft 40 may be greater than or equal to the distance D between the instrument base / handle 31 and the feeder device 11. a(see FIG. 1 ), the shaft 40 may droop (and / or to the side) and a service loop 43 may be formed between the instrument base / handle 31 and the feeder device 11. The service loop 43 may provide slack in the shaft 40 that may be used to allow for faster insertion and / or retraction of the shaft 40. For example, during insertion, slack in the service loop 49 may be addressed (shortening or contracting the service loop 49). During retraction, the service loop 49 may be created (increasing or expanding in length).

[0067] The scope 40 is the first / primary plane P p The scope 40 may also be deflectable in one or two directions within the primary plane P p A second / secondary plane P that can be perpendicular to s For example, it may be desirable for at least the distal portion 230 of the scope 40 to be deflectable in two or more planes to reach a desired area, such as a particular forward or rearward facing cup. p and secondary deflection surface P s is shown in a particular configuration, the illustrated quadratic plane P s is the first plane P p It should be understood that it may be the case, and vice versa.

[0068] In some embodiments, the scope 40 comprises a distal articulation portion 230. One or more cables, pull wires, or pull wire segments can run along the exterior surface of the shaft 40. Additionally, one or more cables can run along a central lumen of the shaft 40. Manipulation of the one or more cables results in actuation or deflection of the articulation portion 230. Manipulation of the one or more cables can be controlled via one or more instrument drivers positioned within or connected to the instrument base / handle 31.

[0069] The instrument base / handle 31 may generally include a mounting interface having one or more mechanical inputs (e.g., receptacles, pulleys, spools, female inputs, etc.) designed to reciprocately mate with one or more torque couplers on a mounting surface of the instrument driver. The instrument handle 31 may include multiple drive inputs. Multiple control cables may be coupled to the multiple drive inputs and extend along the flexible shaft 40. The multiple drive inputs may be configured to control or apply tension to multiple pull wires or control cables in response to a drive output from the medical robotic system.

[0070] To navigate the scope 40 through the anatomy, the articulation 230 of the scope 40 is aligned in a primary plane P p The distal portion of the articulation portion 230 can be deflectable in a secondary plane P s The distal portion of the articulation 230 may be further deflectable in two directions within the secondary plane P. Thus, the distal portion of the articulation 230 may be deflectable in two planes and four directions (e.g., left / right and up / down). The bending radius of the scope 40 may be deflectable in the secondary plane P. s (e.g., less than 180° in either direction) p (e.g., up to 270° or more in either direction). This therefore allows the primary plane P p is the kidney plane P k It may be desirable for the handle 31 to be aligned with the end effector 6. The physician may attempt to achieve such alignment manually through manual manipulation of the handle 31 prior to docking with the end effector 6. After manual alignment, the physician may dock the handle 31 onto the end effector 6, which may result in, for example, a roll / rotation of the shaft of approximately 90°. Embodiments of the present disclosure allow for compensation for such out-of-alignment rotation / roll through robot roll control, which in some implementations may be performed automatically after docking of the handle 31.

[0071] Robotic roll control according to aspects of the present disclosure can involve rotation of the elongated shaft 40 relative to the instrument handle 31 about the longitudinal axis of the elongated shaft 40, at least at its proximal end. Any reference herein to shaft roll / rotation about its axis should be understood to refer to rotation of the shaft about its axis, at least at the proximal end or portion of the shaft. Rotation of the shaft 40 relative to the handle 31 can be performed relative to the renal plane P, which may be the patient's superior-inferior plane. k The scope 40 may be operable to align the shaft 40 within the kidney 70. For example, the kidney 70 may be variable in shape, size, and configuration, but can be roughly generalized as a generally planar structure having an upper pole, a middle pole, and an lower pole. From each of these poles stems a series of calyces that point forward or backward. The scope 40 may be rotated / rolled to align the articulation 230 with the direction of the target calyx.

[0072] FIG. 6 illustrates an exploded view of an instrument device manipulator assembly 150 associated with a robotic arm 12, according to one or more embodiments. The instrument device manipulator assembly 150 includes an end effector 6 associated with a distal end of the robotic arm 12. The instrument manipulator assembly 150 further includes a handle 31 of a shaft-type instrument 19. The instrument handle 31 may incorporate mechanical (and / or electrical) means for rolling / rotating a shaft component associated therewith, such as an endoscope or other shaft-type instrument. Descriptions herein of upper and lower oriented surfaces, plates, faces, components, and / or other features or structures may be understood with reference to the particular orientation of the instrument device manipulator assembly 150 illustrated in FIG. 6 when assembled (rather than the tilted, exploded orientation shown). That is, while the end effector 6 may generally be configurable to face and / or be oriented in a range of directions and orientations, for convenience, descriptions of such components herein (and components / devices directly or indirectly attached / latched thereto) may be within the context of a generally vertically facing orientation of the end effector 6 shown in FIG. 6.

[0073] In some embodiments, the instrument device manipulator assembly 150 further includes an adapter component 8 mountable to the end effector 6 and configured to provide a driver interface between the end effector 6 and the instrument handle 31. The adapter 8 and / or the instrument handle 31 may be removable or detachable from the robot arm 12 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 assemblies and sensitive electronics of medical instruments. Thus, the instrument handle 31 and / or the adapter 8 may be designed to be detached, removed, and replaced from the end effector 6 (and thus the system) for individual sterilization or disposal. In contrast, the end effector 6, in some cases, does not need to be replaced or sterilized and may be covered (e.g., using a drape 301) for protection.

[0074] In some embodiments, the adapter 8 can include connectors for transmitting air pressure, power, electrical signals, and / or optical signals from the robotic arm 12 and / or end effector 6 to the instrument handle 31. The robotic arm 12 can advance / insert or retract the coupled instrument handle 31 into and out of a treatment site. In some embodiments, the instrument handle 31 can be removed and replaced with a different type of instrument. The end effector 6 of the robotic arm 12 can include various components / elements configured to connect and / or align with components of the adapter 8, the instrument handle, and / or the shaft 40. For example, the end effector 6 may include a drive output 302 (e.g., a drive spline, gear, or rotatable disk with mating features) for controlling / articulating the medical instrument, a reader 304 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 306 for attaching the instrument handle 31 and / or the adapter 8 to the end effector 6, and a marker 308 for aligning with an instrument (e.g., an access sheath) that is manually attached to the patient and / or for defining a front face of the device manipulator assembly 150. In some embodiments, a portion (e.g., a plate) 315 of the adapter 8 may be configured to rotate / spin independently of one or more other components of the adapter 8 and / or the end effector 6 when coupled to the end effector 6. The adapter 8 may include one or more outputs 309 configured to mate / couple with a corresponding input 602 of the handle 31.

[0075] In some configurations, a sterile drape 301, such as a plastic sheet, may be disposed between the end effector 6 and the adapter 8 to provide a sterile barrier between the robotic arm 12 and the instrument handle 31. For example, the drape 301 may be coupled to the adapter 8 in such a manner to allow for the transmission of mechanical torque from the end effector 6 to the adapter 8. The adapter 8 may generally be configured to maintain a seal around its working components such that the adapter 8 itself provides a sterile barrier. The use of the drape 301 coupled to the adapter 8 and / or more other components of the device manipulator assembly (i.e., the "robot manipulator" or "robot manipulator assembly") 150 may provide a sterile barrier between the robotic arm 12 and a surgical field, thereby enabling the use of a robotic cart associated with the arm 12 in a sterile surgical field. The end effector 6 may be configured to be coupled to various types of sterile adapters that may be loaded onto and / or removed from the end effector 6 of the robotic arm 12. With the arm 12 covered in plastic, a physician and / or other technician may interact with the arm 12 and / or other components of the robotic cart (e.g., a screen) during a procedure. The draping may further protect against biohazard contamination of equipment and / or minimize post-procedure cleaning.

[0076] The instrument handle 31 may include multiple drive inputs 602, 87 on the underside 336 of the housing 80 of the instrument handle 31. In the illustrated embodiment, the driver 31 includes three drive inputs 602, 87, although in other embodiments another number of drive inputs may be included. The drive inputs may be at fixed spaced locations along the underside mating surface 336 of the instrument handle 31, facilitating coupling of the drive inputs 602, 87 to corresponding drive outputs 302 of the end effector 6, which may be at fixed spaced locations along a corresponding mating surface designed for modular use to attach a variety of other instruments. The handle 31 may include a latch clip 719 or other latching feature / means for physically coupling to corresponding structure of the adapter 8 and / or end effector 6.

[0077] A mechanical assembly within the instrument handle 31 can enable the drive input 602 to be used to drive articulation of the shaft 40, while the drive input 87 can be used to drive roll of the shaft 40. Each of the drive inputs 602, 87 can be configured to engage a corresponding drive output 302 on the end effector 6. For example, each drive input 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 a corresponding rotation of the drive input to control various functions of the instrument handle 31.

[0078] 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 150 shown in FIG. 6, including the robotic arm, the end effector of the robotic arm, an adapter configured to be coupled to the robotic end effector, an instrument base / handle configured to be coupled to the end effector and / or adapter, and / or other actuator components, means, and / or mechanisms associated with the instrument base / handle. Additionally, it should be understood that references herein to an "actuator" may refer to any component of assembly 150 shown in FIG. 6 that directly or indirectly affects or causes movement of an instrument / component engaged with, coupled to, or otherwise actuable by a component of assembly 150. For example, according to embodiments disclosed herein, an "actuator" may comprise any set or subset of the following devices or components: feed rollers, shaft actuation wheels / rollers, feed roller channels, instrument feeder drive inputs, adapter drive outputs, adapter drive inputs, pulleys, belts, gears, pegs, pins, end effector drive outputs, and / or structures and / or control circuits configured to cause actuation thereof. For example, an actuator may be any component, device, or structure configured to cause a corresponding movement in another component, device, or structure, whether that movement is integrated with or separate from the actuator.

[0079] 7A-7B show cross-sectional perspective views of an instrument handle configured to implement robotic shaft roll, according to one or more embodiments of the present disclosure. Unlike certain solutions in which shaft roll is limited to manual rolling of the shaft and / or handle, some embodiments of the present disclosure advantageously allow for robotic shaft roll control that may be implemented using one or more mechanical gears and / or other rotation-translation means / mechanisms.

[0080] The handle 31 is associated with one or more mechanisms that allow the instrument shaft 40 to be robotically rolled / rotated. For example, such mechanisms may be configured to transmit the rotation of the robot end effector output drive to the handle / base 31 and further to the base (e.g., proximal end) 45 of the shaft 40 via a belt 83 or other rotation transmission component. In some embodiments, a bevel gear or other angle conversion gear / component 89 may be attached to the belt 83 and thereby to at least one of the roll axle / gear 85 and / or shaft gear 45. The bevel gear 89 may convert the rotation of the axle / belt gear 85 by 90° or other angle and allow for meshing engagement with the shaft gear 45, causing the shaft gear 45 to rotate and thereby roll the shaft 40.

[0081] The proximal end of the elongate shaft 40 extends from the instrument handle / base 31. In some embodiments, the elongate shaft 40 comprises a flexible shaft and / or an articulating shaft. As mentioned above, pull wires (not shown) can be included in or on the handle 31 and the elongate shaft 40 to control articulation of the elongate shaft 40. The handle 31 is configured to allow for both manual and robotic control of the shaft 40. For example, the instrument handle 31 can be configured to be physically held and manually manipulated to provide manual control, and coupled to an instrument drive mechanism to provide robotic control. In some embodiments, a sterile adapter can be positioned between the instrument handle 31 and the instrument drive mechanism (e.g., a robotic end effector or other robotic manipulator) to maintain a sterile field during a medical procedure.

[0082] As shown, the instrument handle 31 includes a housing 80 that may house one or more of the roll control components / mechanisms described herein. The housing 80 of the instrument handle 31 may be shaped to provide an ergonomic fit to the instrument handle in the user / practitioner's hand and / or to allow for coupling of another instrument thereto. For example, the shape of the housing 80 may allow for the instrument handle 31 to be more easily or comfortably held during manual control, such as for manually rolling the shaft 40 according to aspects of the present disclosure. Additionally, the shape of the housing 80 may provide access (e.g., not block) to one or more robotic drive outputs associated with an adapter and / or end effector to which the handle 31 is physically coupled / latched for use with another instrument / device (e.g., a basket or laser processing cartridge). The instrument handle 31 may include a power access port 714 for connection to a power unit to power one or more instruments (e.g., internal control circuits) of the medical instrument system. The power access port 714 may be configured to provide an electrical and / or visual connection to the shaft 40.

[0083] In some embodiments, the instrument handle 31 includes a manual roll input that is controllable by the shaft strain relief feature 43. In some embodiments, the elongated shaft 40 extends through the shaft exit strain relief feature 43 and into the housing 80 of the handle 31. The shaft exit strain relief feature 43 may be configured to allow the elongated shaft to rotate relative to the instrument handle 31. As shown, the shaft exit strain relief feature 43 can be a twistable or rotatable handle or grip that can rotate relative to the housing 80. For example, the shaft strain relief feature 43 can rotate in a clockwise and / or counterclockwise motion. The shaft 40 can be rotationally fixed relative to the shaft exit strain relief feature 43 such that rotation of the shaft strain relief feature 43 causes rotation of the shaft 40. The rotation of the shaft 40 can be in the same direction and equal / coincident with the corresponding movement of the strain relief feature 43, although this need not be the case in all embodiments. The shaft 40 may be permitted to rotate (e.g., roll) by at least 90, at least 100, at least 110, at least 120, at least 130, at least 140, at least 150, at least 160, at least 170, at least 180, at least 190, at least 200, at least 210, at least 220, at least 230, at least 240, at least 250, at least 260, at least 270, at least 280, at least 290, at least 300, at least 310, at least 320, at least 330, at least 340, at least 350, or at least 360 degrees in both rotational directions. Such roll may be limited by roll axis rotation limiting features / mechanisms described in detail below with respect to Figures 10-1, 10-2, 10-3, and 10-4.

[0084] The strain relief feature 43 may comprise rubber or other at least partially elastic / flexible material in the shape of a tapered cone, as shown. Such a cone may have a circumferential apex 47 that may provide a visual indication and / or manual / tactile engagement feature indicative of the roll position of the shaft 40. For example, the apex 47 may rotate about the axis of the shaft as the shaft rotates. The configuration of the cone, as may be provided at least in part by the apex feature, may provide a manipulation surface for manual manipulation by a user to manually rotate the shaft 40. Generally, alignment of the apex 47 of the cone 43 with, for example, the side portion 747 or other portion of the handle 31 may be associated with the shaft 40 being rotationally aligned in a home (e.g., zero / lock) position. In some embodiments, the apex 47 may be aligned with a camera and / or a working channel of the shaft 40. In some embodiments, the visual indication of the roll position of the shaft 40 may be indicated by one or more other visual markers in addition to and / or as an alternative to the apex. For example, bands, notches, or other visual markings, strain relief features on the shaft 40 , and / or the side 747 or other portion of the handle 31 may indicate the roll orientation of the shaft 40 .

[0085] 6, 7A, and 7B, the handle 31 can include multiple robot drive inputs 87, 602 (not shown in FIGS. 7A, 7B, see FIG. 6), which can be accessible via one or more input ports 762. A robot drive output of an end effector and / or adapter (see FIG. 6) can engage and transmit torque (e.g., rotate) to the robot endoscope drive inputs 87, 602. For example, the drive input 87 can be associated with a roll axis 85. Any of the drive inputs can be rotatable in both clockwise and counterclockwise directions. The drive inputs 87, 602 can be configured as grooved or keyed recesses and can be configured to engage with the robot drive output 302 (see FIG. 6) configured as a protruding / protruding spline. The robot drive output 302 can be driven by a motor and can rotate in clockwise and counterclockwise directions. When the robotic drive output is engaged with a respective robotic endoscope drive input, the robotic drive output can generally transmit rotational motion to the robotic endoscope drive input. Each of the drive inputs 602 and input ports 762 can be associated with one or more pulleys, gears, and / or other mechanisms configured to cause articulation of the shaft 40.

[0086] The orientation of the shaft 40 may be rotated approximately 90° in the process of manually docking the handle 31 onto the end effector 6 and / or adapter 8. When manually rolling the shaft 40, the physician holds the handle 31 and rotates the entire handle to cause the desired rotation / roll of the shaft 40 to coincide with the plane of articulation P of the shaft 40. p The renal plane P k When the instrument handle 31 is docked to the robotic end effector 6, the embodiment of the present disclosure may align the plane of articulation P of the shaft 40 with the plane of articulation P of the robotic end effector 6 (e.g., the plane that approximately bisects the calyx renal meshwork). p The renal plane P k With respect to the end effector 6, the handle 31 may include a mechanism for aligning the handle 31 with the end effector 6, and such alignment may be at least partially compensated for and / or required by rotation of the handle 31 for purposes of docking to the end effector 6.

[0087] The robot shaft roll may be accomplished by a first bevel gear 89 and a second bevel gear 45. That is, in some embodiments, the shaft gear 45 may be a bevel gear. The first bevel gear 89 may be coupled to the robot drive input 87 and / or the roll axis 85 such that rotation of the drive input 87 and / or the roll axis 85 causes rotation of the first bevel gear 89. The first bevel gear may act as an angle conversion gear to convert the torque / rotation axis of the gear 89, the roll axis 85, and / or the roll drive input 87 to an axis that is parallel and / or coaxial with the base of the shaft 40 and / or the shaft gear 45. The shaft gear 45 (e.g., a bevel gear) may be attached to the proximal end of the shaft 40 such that rotation of the shaft gear 45 may cause rotation of the elongated shaft 40 relative to the instrument handle 31.

[0088] The first and second bevel gears 89, 45 may be engaged / meshed to transmit the rotational motion of the roll axis 85 to the shaft 40. For example, as shown, a drive belt 83 or other rotational transmission means / mechanism may be used to operably couple the first bevel gear 89 to the roll axis 85 from a distance. The roll axis 85 and its drive input feature 87, or its associated roll axis 85 and drive input feature 87, may be proximal to the angle conversion bevel gear 89 and, in some embodiments, disposed between the shaft articulation inputs 602 / 762. Other methods and mechanisms for transmitting the rotational motion of the roll axis 85 to the shaft 40 are also possible. In some embodiments, as the shaft 40 is rolled, the internal components (e.g., one or more coil pipes, pull wires, electrical wires, and / or optical fibers) may tilt to twist due to fixation to both the proximal and distal ends of the shaft 40. The twisting of the internal components can occur throughout the length of the elongate shaft 40, minimizing the resulting force / torque applied to its proximal and distal ends.

[0089] 7A and 7B, and further with reference to FIG. 5, implementation of the shaft roll according to an embodiment of the present disclosure may include aligning the deflection plane of the shaft 40 with the plane P of the kidney 70. k For example, it may be desirable to have a means or mechanism for aligning the primary deflection plane P associated with the shaft 40. p The plane P of the renal calyx of kidney 70 k In addition, a shaft roll may be implemented to align the working channel 44 of the shaft 40 in a position that facilitates utilization of a working instrument disposed within the working channel 44. That is, as shown in the detailed image of FIG. 5, the working channel 44 may not generally be axially centered on the shaft 40, but rather may be radially offset, at least in part, to one side. Thus, if the working channel 44 is misaligned, the ability to utilize an instrument disposed therein for its intended purpose may be limited. Generally, the plane P of the kidney 70 may be aligned with the working channel 44 of the kidney 70. k may correspond to the bisection plane of the kidney, as shown in FIG. 5. However, it should be understood that based on the anatomy of a particular patient, one or more calyces may be slightly out of plane. However, such calyces may not be aligned with the primary plane P of the kidney. k The primary deflection plane P of the shaft 40 may be accessible from a position p and renal plane P k Alignment with can advantageously provide maximum / advantageous reach of shaft 40 within the kidney.

[0090] As mentioned above, in some embodiments, the shaft 40 may be configured such that its articulation in one or more planes may be implemented. For example, in some embodiments, the shaft 40 may be configured such that its articulation in one or more planes may be implemented such that its articulation in a primary deflection plane P p , while the scope may be configured to articulate an amount greater than 180°, such as about 270° or more, relative to the secondary deflection plane P s In the first articulation plane P pFor example, shaft 40 may be configured in some embodiments to articulate up to 90° or less in one or more planes. Shaft roll control according to aspects of the present disclosure advantageously provides control over the primary articulation plane P of shaft 40. p The primary plane P can be aligned with the area of ​​the calyx within the calyx meshwork by the robot to enable navigation to target the kidney stone or other specimen to be extracted. p and the second plane P s Articulation as so described may advantageously be in both / two directions in a given plane of articulation. Generally, the degree of deflection / articulation in a given plane of deflection of the shaft 40 may be limited based on the amount of degrees of freedom provided by the individual structural links of the articulation portion 230 of the shaft 40. In some embodiments, a proximal portion of the shaft 40 at, in, and / or near the handle 31 may be configured to bend in only two directions, while a distal portion of the shaft 40 may be configured to bend in four directions, or vice versa.

[0091] In some implementations, after a certain amount of manual rotation / manipulation, the handle 31 may be placed on the robotic manipulator 6 (see FIG. 6). In such a transition between a manually held position on the endo-robot manipulator (e.g., effector 6 and / or adapter 8) and a docked position, the orientation of the instrument handle 31 and / or shaft 40 may be rotated approximately 90° such that the shaft 40 rolls an amount commensurate with the rotation of the handle 31. Thus, in some cases, a robot roll adjustment may be desirable after docking of the handle 31. For example, the system control circuitry may be configured to drive an associated actuator / maneuver of the handle 31 to roll the shaft 40 to compensate for the 90° (or other) change in shaft roll resulting from docking of the handle 31. Such automatic roll correction may be based at least in part on the position of the patient. Although automatic shaft roll correction is described, it should be understood that such shaft roll correction may be implemented by an operator using certain user input controls (e.g., control device 55 of FIG. 1) as described herein.

[0092] FIG 8 illustrates a cross-sectional view of an instrument handle 831, according to one or more embodiments of the present disclosure. The embodiment of FIG 8 provides an alternative rotational transmission mechanism compared to the embodiments of FIG 7A and FIG 7B for transmitting rotation of the roll axis 885 of the handle 831 with the shaft base / gear 845 to the shaft roll axis rotation. For example, the embodiment of FIG 8 illustrates an axle-based transmission of rotational force from the roll axis 885, where the handle 831 is coupled to the shaft gear 845, and the associated output drive of the robot end effector / adapter, where rotation of the axle 885 transmits rotation to a transverse axis rod 883 via a bevel gear 881 or other angle conversion gear.

[0093] The rotary transmission mechanism of FIG. 8 includes a direct drive rod 883 that may be mechanically coupled to a roll shaft 885 via meshing engagement between the roll shaft 885 and a bevel gear 881 coupled to the rod 883. The rod 883 may be coupled to a distal shaft actuation gear 889. Generally, compared to belts or other solutions, the use of a rod to drive the shaft rolls may advantageously provide relatively fewer losses. That is, a higher percentage of the rotation of the drive gears 885, 881 may generally be transmitted to the working gear 845 than with certain other solutions, such as certain belt-type solutions.

[0094] The distal drive gear 889 and the shaft gear 845 can be spur gears in some embodiments. In some embodiments, the proximal drive gear 881 is a bevel gear configured to allow meshing of the proximal drive gear 881 with a bevel-shaped roll axis 885, which is orthogonal / transverse to the proximal drive gear 881. Implementing spur gears for one or more of the roll axis 885, the proximal drive gear 881, the distal drive gear 889, and / or the shaft gear 845 may be desirable in some cases due to the relatively secure meshing of the spur gear teeth with the bevel gears. That is, the positioning and engagement of bevel gears may require relatively high precision compared to spur gears due to their tendency to bind and / or split. Thus, the use of spur gears for one or more of the gears of the device may provide greater freedom with respect to the position and / or angle of the gears compared to bevel gears and / or other solutions.

[0095] Distal drive gear 889 may be advantageously positioned at a location that allows distal cables (e.g., power cables / wires) to pass through port 814. Compared to belt-type roll control systems as shown in Figures 7A and 7B, cable or rod-based mechanisms may have less play / flex, but may be relatively more difficult to install and / or assemble. Furthermore, with respect to belt-based systems, such systems may be more or less prone to losing tension over time.

[0096] Figure 9 shows a cross-sectional view of an instrument handle 931 having a rod-based rotational transmission mechanism, which may be similar in some respects to the embodiment shown in Figure 8, in accordance with one or more embodiments of the present disclosure. In the embodiment of Figure 9, a distal drive gear 989 is configured to transmit rotation of a rod 983 to a shaft gear 945 via a belt 901 or other rotational transmission engaged to both gears 989, 945.

[0097] 10-1, 10-2, and 10-3 show perspective views of a roll axis assembly 105 according to one or more embodiments of the present disclosure. FIG. 10-4 shows an exploded view of the roll axis assembly 105 shown in FIG. 10-1, 10-2, and 10-3. The roll axis assembly 105 includes a roll axis 85, which may represent one embodiment of any of the roll axes disclosed herein. The roll axis assembly 105 includes the roll axis 85, as well as a rotation-limited slider component / portion 26, and an axis retaining structure 84 having certain rotation-limited features according to aspects of the present disclosure.

[0098] Generally, full 360° or more rotation of the shaft of the medical instrument in either / both directions (i.e., clockwise and counterclockwise) may be desirable. However, for robotically controlled shaft rolls, it may not be desirable to allow infinite rolls, as rolls greater than 360° can cause damage to wires and other components associated with the shaft from twisting due to over-rolling. Thus, it may be desirable to limit the rotation of the shaft 85 to avoid twisting and / or damage to certain pull wires, camera wires, and / or other wires, cables, or other components that may emanate from the proximal end of the shaft and / or shaft gear. That is, it may be desirable to limit the rotation of the shaft 85 to prevent the shaft 85 and / or shaft gear 45 from rotating more than about 360° in either direction (e.g., less than 720° in a full rotation).

[0099] Limiting rotation of the shaft 85 may be accomplished using an open annular channel 118 of the shaft 85 and / or an open annular channel 111 of the shaft retaining structure 84, which may be open toward one another in some embodiments. Although annular channels are shown associated with both the shaft 85 and the retaining structure 84, it should be understood that shaft rotation limitation may be implemented using annular channels in either the shaft 85 or the retaining structure 84, but not both. For example, the shaft 85 may be a generally rotating component, while the shaft retaining structure 84 may be a generally static / stationary component, and rotation of the shaft 85 in one or both directions may be stopped by direct or indirect contact between stop contact surfaces / faces 116, 117 of the shaft 85 exposed in the channel 118 and stop contact surfaces / faces 114, 115 of the shaft retaining structure 84 exposed in the annular channel 111 of the retaining structure 84. Such contact between the shaft 85 and the shaft-retaining structure 84 may be indirect via the slider structure / component 26, which may transmit contact within the annular channel 118 of the shaft 85 to the contact surfaces 114, 115 of the annular channel 111 of the sensor-retaining structure 84. For example, the slider 26 may include a lower engagement feature 125 configured to fit at least partially within the annular channel 118 of the shaft 85 and slidably move therein. The slider 26 may further include an upper engagement feature 127 configured to fit at least partially within the annular channel 111 of the shaft-retaining structure 84 and slidably move therein.

[0100] Rotation of the shaft 85 may be limited by contact of either annular end of the slider 26 with a stop surface of the shaft and a stop surface of the shaft-retaining structure, respectively. For example, such stop surfaces may be exposed in the open annular channels 111, 118 of the shaft 85 and the shaft-retaining structure 84, respectively. That is, as the shaft 85 rotates in a given direction, the lower portion 125 of the slider 26 may be configured to fit within the open annular channel 118 of the shaft 85 and may slide within the channel until it contacts a stop surface of the channel 118 and is exposed within the channel 118. With the slider in contact with the stop surface within the open annular channel 118 of the shaft 85, the shaft may be allowed to continue rotating until the upper portion 127 of the slider 26 reaches a hard stop against and is exposed within the stop surface of the channel 111 of the shaft-retaining structure 84.

[0101] The slider 26 can advantageously extend the rotational range of the shaft 85 through sliding motion within the annular channel 111 of the sensor-retaining structure 84. For example, when rotating the shaft 85 in a given direction, such rotation can be stopped by a hard stop caused by the contact surfaces of the slider 26 and the shaft channel 118 contacting each other, and after contacting the stop surface of the shaft channel 118 and after the shaft rotates further in the same direction, the contact surface on the opposite end of the slider can also contact a hard stop surface of the open channel 111 of the shaft-retaining structure 84. As an exemplary use case, FIG. 10-1 shows the roll shaft 85 at its furthest allowed clockwise rotation. FIG. 10-2 shows the roll axle 85 rotated counterclockwise (compared to the configuration of FIG. 10-1) to a contact position with the opposite end of the slider 26, with the side 112 and / or inner side 129 of the slider 26 in the area associated with the lower portion 125 of the slider 26 contacting the stop surface 117 in the channel 118 of the axle 85. In FIG. 10-2, the axle 85 can continue to rotate counterclockwise until the side 113 of the upper portion 127 of the slider 26 is stopped by the inner stop contact surface 115 of the annular channel 111 of the retaining structure 84, a configuration shown in FIG. 10-3.

[0102] The slider 26 advantageously extends effective contact of the shaft 85 into the annular channel 118 of the shaft-retaining structure 84 and the arc length L of the channel 111. c1 from the arc length L of the slider 26 s The allowable rotation of the shaft can be extended beyond the limitations of the shaft channel 111 by allowing the shaft 85 to rotate an additional amount equal to minus the arc length L of the shaft channel 118. Thus, the total amount of allowable rotation of the shaft 85 is c1 and the arc length L of the retaining structure channel 111 c2 From the sum of the degrees of the slider, the arc length L s The arc length of the slider, L, can be approximately equal to (or proportional to) the arc length of the slider minus twice the s may need to be considered in terms of the space occupied in both the shaft channel 118 and the retaining structure channel 111. In some embodiments, the shaft channel 118 may allow for an amount of rotation less than 360°, but additional engagement of the slider 26 with the shaft channel 111 of the retaining structure 84 can extend the range of rotation of the shaft even beyond 360°.

[0103] Circular / arc length L of slider channel 118 of axis 85 c1 may be limited, at least in part, by the presence of a mating feature / channel 88, which may provide a keyway / locking side / area for the shaft 85, as described in more detail below. That is, in some embodiments, the size of the mating feature / channel 88 occupies space away from the usable annular length of the channel 118 of the shaft 85.

[0104] The rotation range of the roll shaft 85 is the arc length L of the slider 26. s That is, the arc length L of the slider 26 s However, the longer it is in terms of the amount of annular length within channel 118 of shaft 85 and channel 111 of retaining structure 84 that is occupied by the respective portions of the slider, the smaller the range of rotation that is permitted.

[0105] Generally, the radial thickness T of the slider 26 s and arc length L smay be determined to provide the slider 26 with a desired structural stability with respect to the tendency of the slider 26 to bind within one or more channels and / or withstand hard stop forces with respect to the respective stop surfaces. For example, when the slider 26 has an annular length L s and / or the radial thickness T s If the annular length L of the slider 26 is too narrow, fracture and / or shearing can occur from hard stop forces thereon. However, such dimensions may limit rotation of the shaft 85 and / or require a larger size / space. Thus, the design of the slider involves a trade-off between structural stability and size. For example, it may be desirable to design the slider 26 to be relatively robust to facilitate sliding within and provide a convenient fit within the annular channel 118 of the shaft 85 and the annular channel 111 of the retaining structure 84. Furthermore, a relatively long annular length L of the slider 26 may be desirable to provide a relatively long annular length L of the slider 26. s may facilitate sliding within their respective channels and reduce the risk of the slider 26 tipping over, binding within the channel, or otherwise becoming skewed within the channel.

[0106] The assembly 105 of shaft 85, slider 26, and retaining structure 84 shown in Figures 10-1-10-4 provides a solution for increasing the rotation range of a rotation-limited shaft that may be suitable for certain applications. In conjunction with the embodiments of the present disclosure, additional solutions for increasing the rotation range of the roll axis may be implemented, such as by changing the gear diameter associated with one or more of the roll control gears associated with the associated handle / instrument. For example, decreasing the gear diameter of the shaft gear associated with the proximal end of the instrument shaft may increase the allowable rotation of the shaft. Additionally, increasing the diameter of the distal drive gear may increase the rotation of the shaft relative to the rotation of the roll axis, thereby increasing the operable range of the roll. The particular assembly shown in Figures 10-1-10-4 may be suitable for providing a desired shaft roll range in an environment limited by space constraints, such as within a handle, as shown in various figures of the present disclosure.

[0107] In some implementations, embodiments of the present disclosure allow shaft-type instruments to be used both manually and robotically. As may be desirable in such implementations, certain embodiments of the present disclosure relate to instrument handles configured to automatically lock or secure shaft rotation in place when the handle is manually manipulated. For example, such instrument handles may be configured such that when the handle is docked to a robotic end effector, shaft rotation / roll is automatically unlocked and allowed to be controlled robotically via the end effector (and / or an attached adapter) and one or more components associated with the instrument handle. It should be understood that any reference herein to an end effector and / or its components or features may refer to similar components or features associated with an adapter coupled to the end effector, rather than the end effector itself.

[0108] 11A, 11B, and 11C show perspective views of certain instrument handle components including axle catch 90 in a locked position where rotation of roll shaft 85 is limited / restricted by axle catch 90, in accordance with one or more embodiments of the present disclosure. FIGURES 12A, 12B, and 12C show perspective views of the instrument handle components shown in FIGURES 11A-11C, with the axle catch in an unlocked position where an actuator engagement boss 9 of an adapter or end effector device engages catch 90 and causes vertical translation of catch 90, thereby lifting / moving key feature 95 of catch 90 away from mating feature 88 of roll shaft 85, thereby allowing roll shaft 85 to freely rotate in response to a drive input. Any of the following descriptions may be understood with reference to FIGURES 11A-11C and / or 12A-12C.

[0109] As mentioned above, in some cases, a physician or other operator / technician may perform an instrument shaft roll by holding the handle of the instrument in their hand and rotating their arm and / or hand to rotate the handle and the shaft coupled thereto together as a unit. That is, with respect to any of the figures / embodiments of the present disclosure, when manually rolling the shaft 40 of the instrument 19, it may be necessary or desirable to limit / lock the roll of the shaft 40 relative to the handle 31 to allow the rotation of the handle 31 to be transmitted to the shaft 40. Generally, handheld manual roll / rotate implementations may allow for rotations of approximately 180°, with such rotations being limited by the physical constraints of the arm and / or hand / wrist, which may vary to some extent across users.

[0110] The instrument handle 31 of Figures 11A-11C and 12A-12C includes a roll axis locking structure / catch 90 that may be configured to translate and key with the roll axis 85. The term "catch" is used herein according to its broad and ordinary meaning and may refer to any type of lock, stop, blocking, impeding, or interference structure that may be understood with respect to a rotation axis component, feature, or device. When the instrument is used manually such that the handle 31 is manually held / operated by a user, a spring or other biasing feature 93 may bias the catch structure 90 towards the roll axis 85 in such a way that a key component 95 of the catch 90 engages a mating feature 88 (e.g., a keyway) of the roll axis 85. For example, when a user manually rotates shaft 40 (not shown in FIGS. 11A-11C ) to align a mating feature on roll axis 85 with a key feature 95 on axis catch 90, biasing catch 90 toward the plane of roll axis 85 can cause key feature 95 to engage keyway mating feature 88, thereby locking in place the rotation of roll axis 85. In such a locked state, shaft 40 may not be allowed to rotate freely and / or be actuated via a robotic drive.

[0111] 11A-11B and 12A-12B, the roll axis 85 has been rotated to a home / zero position where the mating feature 88 is rotationally aligned with the key feature 95 such that the key feature 95 can move in and out of the mating feature 88. If the roll axis 85 is not in a home rotation position, which may be associated with a predefined angular position with respect to the shaft 40 about its roll axis and / or the roll axis 85 about its rotation axis, it may not be possible to implement the shaft roll lock as described herein. Therefore, it may be necessary or desirable to rotate the shaft 40 and / or the axis 85 to the home position to enable the shaft roll lock before latching or unlatching the handle 31 from the robotic system. For example, if the shaft 40 and / or the axis 85 are rotated to the home position before unlatching / undocking the handle 31, such unlatching / undocking may cause the catch 90 to automatically lock the axis 85. In some implementations, the system control circuitry is configured to automatically roll the shaft 40 and / or axis 85 to the home position prior to undocking of the handle 31. In some implementations, unlatching / undocking may be limited / locked unless and until the shaft 40 and / or axis 85 are in the home position. Whether the shaft roll is in the home position may be determined electronically and / or mechanically.

[0112] 6 , the robot end effector 6 and / or its associated adapter component 8 may include a catch actuation boss 9 or other feature configured to depress an actuator feature 91 of the catch 90 when the handle 31 is docked to the end effector / adapter 8, such actuator engagement may serve to disengage a lockout mechanism of the catch 90 by translating a key feature 95 of the catch 90 from a mating feature (e.g., keyway) 88 of the shaft 85. That is, by depressing the handle 31 onto the adapter 8 to latch the handle 31 to the adapter 8, the catch actuation boss / boss 9 may automatically depress an actuator contact surface 98 to move / translate the shaft catch 90 vertically (with respect to the orientation shown) from its locked position to remove the key 95 from the mating feature 88 of the shaft 85. Thus, embodiments of the present disclosure provide a solution that allows a user to unlock a shaft roll control mechanism associated with an instrument handle by docking the handle onto the end effector and / or adapter 8 (or other type of robotic manipulator). In such an unlocked state, the handle may be free to operate to roll the instrument shaft in response to particular control signals and / or drive inputs.

[0113] The key feature 95 provides a locking feature for the shaft 85. In some embodiments, the key feature 95 keys into the mating feature 88 of the shaft 85 in a locked position where rotation of the shaft 85 is restricted. The fit of the key 95 in the mating feature 88 may advantageously be tight enough to prevent backlash / ejection of the key feature 95 when restricting the roll / rotation of the shaft, but not too tight to cause binding friction when actuating the catch into and / or out of mating engagement with the mating feature 88. For example, the catch actuator component 91 may be positioned at a separate end 501 of the catch 90 relative to the key feature 95 such that actuation of the catch actuator 91 (e.g., its vertical translation) may result in the catch 90 tending to bind due to applying uneven forces to the catch 90. Thus, some clearance around the key feature 95 may be desirable. However, any amount of clearance between the key features 95 within the mating feature 88 may convey allowable rotation of the shaft 85 when the key 95 is in the locked position. Thus, the key 95 may fit relatively snugly within the mating feature 88 in some embodiments.

[0114] In some embodiments, the axis A of the shaft 85 a With respect to the axis catch 90, the axis A is aligned with the axis A so that the key 95 is elevated from the mating feature 88. a 11A-11C and 12A-12B). The axle retaining structure 84 (not shown in FIGS. 11A-11C and 12A-12B for clarity) can present a limit to the distance the catch 90 can translate vertically. Referring also to FIGS. 10-1-10-4, the axle cover / retaining feature 84 can serve to align the roll axle 85 with its associated drive input. In some embodiments, a pin 181 is disposed within the axial cup 119 of the axle 85 and within a corresponding opposing cup 120 of the axle retaining structure 84. Alternatively, the alignment pin 181 can be an integral feature of the cover 94. The pin 181 can advantageously be capable of rotation thereabout by the axle 85.

[0115] The axle 85 may be biased in a locked position shown in FIGS. 11A-11C, with the axle catch 90 positioned such that the key 95 engages the mating feature 88 of the axle 85. In some embodiments, such biasing may be implemented using one or more springs 122 or other biasing features. For example, the spring 122 may push the axle catch 90 downward (with respect to the orientation shown) to bias the key feature 95 downward into the mating feature / channel 88. In some embodiments, the spring 122 pushes against an underside / surface of one or more components of the handle housing, such as the underside of the axle retaining structure 84 or other structure. In some embodiments, the axle catch 90 includes a spring retaining feature 93, such as a cup or recessed feature, as shown in FIGS. 11A and 11B. For example, the spring retaining feature 93 may have an open cylindrical shape with a seat 94 against which the spring 122 can apply a biasing force. Although a cup-shaped spring retention feature is shown, it should be understood that any type of spring retention configuration or structure may be implemented, such as an attachment means or mechanism for securing the spring 122 to the catch 90 (e.g., one or more hooks, clips, adhesives, etc.).

[0116] Using one or more alignment pins 121, the axis A of the shaft 50 aThat is, the pin 121 can be configured to control / guide the direction and / or orientation of the movement of the catch 90, thereby keeping the catch 90 in-plane (e.g., with respect to the flat upper surface of the catch 90) as it translates. For example, in embodiments in which the biasing component (e.g., spring) 122 is disposed relatively close to one end 501 of the catch 90, the biasing force provided thereby can be biased to tilt and / or bind the catch 90 as it translates. The pin 121 can prevent / reduce such tilting / binding. In some embodiments, the catch 90 includes one or more openings or other features 92 configured for the pin 121 to be disposed in to provide a track / guide for the catch 90 with respect to the pin 121. Pin 121 may be secured to housing 80 in some manner, may be integrated with other structure of the handle, or may be a separate component that is secured in place by nesting with one or more retaining features of the housing and / or shaft retaining structure 84.

[0117] Referring back to FIG. 6 , the adapter component 8 includes a catch actuator engagement feature / boss 9 configured to engage the actuator 91 when the handle 31 is latched to the adapter 8 and / or end effector 6. For example, when the handle 31 is latched / docked to the adapter 8 and / or end effector 6, the boss 9 can be configured to press against an engagement surface 98 of the actuator 91, thereby translating the catch actuator 91 and associated / integrated catch 90 in a direction that is generally parallel to the axis of the boss 9, the actuator 91, and / or the catch actuator access channel 176. By such means, the boss 9 can be configured to unlock the shaft 85 by translating the catch 90 such that the key 95 exits the mating feature 88 of the shaft 85. Such unlocking can be performed from outside the housing 30 of the handle 31. In some embodiments, the shaft actuator 91 is axially aligned with the spring retaining cup 93, as shown in FIG. 11C.

[0118] In some embodiments, the catch actuator 91 (e.g., a plug, pin, button, peg, plunger, or other actuator means or feature) protrudes into and / or through the actuator access channel 176 of the handle housing 80. In some embodiments, the actuator 91 includes an annular gap or space 96 that may house an O-ring or other type of sealing component configured to prevent fluid ingress through the actuator channel 176 and into the handle housing 80. In some embodiments, the annular gap / channel 96 does not have a sealing feature disposed therein, but rather provides a void in which any fluid passing around the periphery of the actuator may generally collect within the gap space 96.

[0119] The catch 90 may have a height dimension H1 corresponding to the height of the area of ​​the catch including the alignment pin channel 92, which provides a surface area around the alignment pin 121 to facilitate its alignment and to keep the alignment channel 92 substantially parallel to the alignment pin. For example, it may be advantageous to allow the catch 90 to rock / tilt when translated, and such inclination to rock / tilt may depend at least in part on the height dimension H1 and / or the clearance around the pin within the alignment channel 92. Thus, to reduce rocking / tilting, the alignment channel 92 may advantageously fit relatively closely around the alignment pin 121 with little clearance, but allow some clearance to avoid friction binding for the catch 90 around the pin when axially translated. Furthermore, the height H1 of the catch in the area of ​​the alignment channel 92 may be as large as possible given the relevant space constraints within the housing 80. For example, pulleys, wires, and / or other components of the handle 31 may be disposed at least partially above the catch 90 within the housing 80, with the catch 90 not occupying such space during the unlocked or locked configurations. The underside topology of the catch 90 may advantageously fill available space within the housing 80 to provide one or more bearing surfaces that allow the catch 90 to contact a structural component at the base of the housing 80 with its underside when the catch 90 is in the locked position, thereby allowing the catch 90 to rest in the locked position. The catch 90 may have an overall height H2 including the actuator 91 that is greater than the height H1 of the body of the catch 90.

[0120] The actuator engagement boss 9 of the adapter 8 (and / or end effector 6) may be limited in height to avoid contact with instrument components when an instrument other than the handle 31 is touched thereto. For example, the adapter 8 may be configured to accommodate various types of instruments, including catheter-type instruments, etc. In some embodiments, the pins have a height of about 2.2 mm or less. In some embodiments, the pins are greater than 2.2 mm in height.

[0121] The catch 90 may have a length dimension L and a width dimension W, as shown, with the length dimension L being greater than the width dimension W. For example, the width dimension W may be generally parallel to the projection dimension of the key 95, while the length dimension L may be transverse / orthogonal to the width dimension W. The ends 501, 502 of the catch 90 may be considered to be half or one third of the length of the catch 90, and in some embodiments the key 95 may be part of or otherwise associated with the longitudinal side / end 502 of the catch 90 opposite the actuator 91 and / or the spring 122 and spring retaining cup 93. At least one alignment pin 121 and / or associated alignment pin channel 92 may be associated with a longitudinal mid-portion of the catch 90 between the opposing ends 501, 502.

[0122] Although a single actuator peg / feature 91, channel 176, and actuator boss 9 are shown and described above, it should be understood that the catch 90, housing 80, and / or adapter 8 may be implemented with any number of actuators, actuator access channels, and / or actuator pin components. For example, by including two catch actuators, stability of the catch 90 during translation may be improved. For example, such multiple actuators and associated components / features may be associated with and / or between separate sides / ends 501, 502 of the catch 90. In general, the location of the actuator 91 in the end region 501 may not be ideal from a translational alignment standpoint. However, due to certain physical / positional constraints associated with the handle housing 80, the configurations shown in Figures 11A-11C and 12A-12C may be necessary or desirable, and any alignment imperfections presented by the position / location of the actuator 91 may be compensated for using one or more of the alignment pin channel 92, the spring retaining cup 93, the height / thickness dimensions H1, H2, and the key shaft engagement features.

[0123] 13-1 and 13-2 show perspective views of certain instrument handle components including an axial catch 146, according to one or more embodiments. Compared to the embodiments shown in FIGS. 11A-11C and 12A-12C, the use of a rotational catch rather than a vertical translational catch can provide certain advantages. For example, with respect to a vertically translating catch structure, certain contaminants may become trapped within the associated actuator channel, which may be relatively difficult to disinfect / clean. For example, with respect to the plug-type actuator embodiment of FIGS. 11A-11C and 12A-12C, the area between the actuator contact surface 98 and the base of the actuator plug 91 may be difficult to clean and / or access. With respect to the rotational actuator of FIGS. 13A-13C, contaminants may not be prone to passing around the actuator 140 due to the actuator simply rotating in place, as opposed to physically translating along an axis and / or into the housing of the handle.

[0124] In some embodiments, the actuator 140 of the catch 146 is a cam actuator. In such a system, the adapter and / or end effector 147 to which the handle 131 is attached can include an actuator engagement protrusion / boss 143, which can have any suitable or desired shape or be configured to actuate the cam socket 141 of the actuator 140. For example, the actuator engagement protrusion / boss 143 can have a rectangular / oval cross-sectional shape as shown. By forcing the actuator engagement protrusion / boss 143 into the cam socket 141, the angled / curved cam surface / groove 142 of the cam socket 141 aligns the axis catch 146 with the axis A of the actuator 140. c , causing a bent projection 149 of the catch 146 to be rotated out of a mating feature 148 of the shaft 145. The catch 146 may be biased in a locked position in which an end 144 of the bent projection 149 protrudes into a mating feature 148 associated with a side of the shaft 145, thereby locking the shaft against rotation.

[0125] The catch 146 may be biased toward the roll axis 145 via a torsion spring or some other biasing device / mechanism, and the catch 146 is configured to automatically rotate away from the roll axis 145 when docked to an end effector and / or its associated adapter.

[0126] With respect to the cam actuator 140, the more aggressive the angle of the angled / curved cam surface / groove 142 is, the more rotations are imparted to the catch 146 per unit of distance projected into the cam socket 141 of the actuator 140 by the actuator engagement boss 143, which may increase the probability that a successful unlatch / unlock can be achieved when the handle 131 is docked onto the adapter / end effector 147. Generally, the actuator engagement boss 143 may need to overcome a biasing force (e.g., a spring force) to effect rotation of the cam catch 146.

[0127] The rotating shaft catch 146 is configured to rotate to engage keying features 148 of the shaft 145, rather than translating vertically to engage and disengage from mating features on the shaft. Rotation may be accomplished using cam features formed on and / or associated in some manner with the catch 146. The rotating catch embodiment of Figures 13-1 and 13-2 may be suitable for preventing fluid ingress.

[0128] 14-1 and 14-2 show a roll-lock feature 163 for an instrument having an instrument handle 175 and shaft 40 component, according to one or more embodiments. The roll-lock feature 163 may comprise a forked shaft rotation stop, which in some embodiments may be disposed generally radially outward of an adapter and / or end effector component to which the instrument handle 175 is attached. The stop 163 may be configured to lock the shaft 440 by directly contacting the shaft 440 and / or the base 151 or strain relief feature 153 associated therewith. The shaft roll stop 163 may extend distally from a distal portion of the instrument handle 175.

[0129] The stopper 163 may include a strip 166 or area having a high coefficient of friction material configured to increase roll resistance when the strip 166 and a component / portion of the shaft 440 are in contact. References herein to the shaft 440 may refer to the elongated tubular shaft portion 440 itself and / or either or both of the shaft base 151 and the strain relief feature 153. In some embodiments, the stopper feature 163 includes a key feature (not shown) configured to key into a corresponding engagement feature associated with the shaft 440, the strain relief feature 153, and / or its base 151.

[0130] The base 151 of the shaft 440 may be coupled to and / or integral with the shaft 440 in such a manner that the shaft 440 and the base rotate together. In some embodiments, the base 151 comprises a rigid cylindrical base structure 151 of the shaft 440, which in some embodiments may be proximal to the strain relief feature 153 (if present) and may provide an engagement surface for the stop feature 163. For example, the forked portion 162 of the stop 163 may be configured to engage / contact an outer surface of the base portion 151 to provide roll stop resistance / traction for the shaft 440.

[0131] The stopper 163 may include a generally straight and / or elongated base portion 160, as shown in FIGS. 14-1 and 14-2, or may have any other suitable or desired shape configured to allow vertical sliding or other movement (e.g., rotation) of the stopper 163 to contact its contact surface 166 with a portion of the shaft 440 (e.g., shaft base 151). In some embodiments, the base portion 160 includes a slot 161 or other feature configured to facilitate translation / sliding of the stopper 163. For example, the pin 152 or other feature / component may be at least partially inserted / disposed within the slot 161 to retain the stopper 163 while allowing for translation of the stopper 163 corresponding to movement of the stopper such that the pin 152 slides within the slot 161 between a locked position and an unlocked position. For example, in the unlocked position (FIG. 14-1), the pin 152 may be at or near the top of the slot 161, while in the locked position (FIG. 14-2), the pin 152 may be at or near the bottom of the slot 161. FIG. 14-1 shows the stopper 163 in the unlocked position, where the stopper fits within the housing 170 such that the contact area / strip 166 does not contact the shaft 440 or a component associated therewith (e.g., the shaft base 151).

[0132] FIG. 14-2 shows the stopper 163 in a locked position, in which the stopper 163 has been vertically translated / actuated to exert a force at contact area 166 against components of the shaft 440, such as the shaft base 151, the strain relief component 153, and / or the shaft body 440. Actuation of the stopper 163 between the locked and unlocked positions can be accomplished using any suitable or desired actuator means or mechanism. In some embodiments, the stopper 163 is biased in either the locked or unlocked position, such as through the use of one or more springs or other biasing devices. In some embodiments, the stopper 163 is configured to be robotically actuated in some manner. While the forked portion 162 of the stopper 163 is illustrated as having a semicircular shape / configuration, it should be understood that such components / portions can have any suitable or desired shape and / or contact surface / area.

[0133] Shaft Roll Process 15-1, 15-2, and 15-3 provide a flow diagram for a process 1500 for rolling an instrument shaft 154, according to one or more embodiments. FIGs. 16-1, 16-2, and 16-3 show certain images corresponding to various blocks, states, and / or operations associated with the process 1500 of FIGs. 15-1, 15-2, and 15-3, respectively, according to one or more embodiments. The process 1500 may be performed, at least in part, by certain robotic system control circuitry, as described herein.

[0134] Process 1500 may be performed in connection with a medical procedure, such as a kidney stone removal procedure, or other procedure that may be performed using a shaft-type medical instrument 159, such as an endoscope, ureteroscope, etc. That is, process 1500 may be performed, at least in part, following placement of a distal end of a shaft 154 of a shaft-type medical instrument 159 (e.g., an endoscope) within a particular target anatomical structure of a patient, such as the calyx renal meshwork of the patient's kidney. One or more operations of process 1500 may be performed prior to accessing the target anatomical structure by the distal end of the medical instrument shaft.

[0135] At block 1502, the process 1500 involves manually rotating the shaft 154 of the medical instrument 159 relative to its handle 151 to bring the shaft 154 to a home position, where a shaft roll lock mechanism of the handle 151 may be configured to engage / lock when the shaft is manually rotated to the home position, as shown in image 1602. For example, the handle 151 may be associated with one or more markings or features that indicate the alignment of the shaft 154 relative to the handle 151. For example, a strain relief feature 153, such as a cone-shaped feature as described in detail herein, may have one or more features, such as a circumferential apex or other feature, that indicate the orientation of the shaft 154. For example, the marker / indicator may be aligned with a working channel or other feature of the shaft 154. In some implementations, the action associated with block 1502 of process 1500 can involve manually holding or gripping a strain relief feature 153 associated with a proximal end portion of the shaft 154 and rotating such feature / feature 153 to the home position shown, thereby causing a roll lock catch or other feature to engage with the roll axis of the handle 151, thereby locking the relative roll between the shaft 154 and the handle 151 of the medical instrument 159.

[0136] At block 1504, the process 1500 involves manually rolling / rotating the shaft 154 of the medical instrument 159 by manually rotating the handle 151 with the shaft 154 in a relative locked-roll configuration implemented by a shaft roll lock bias (e.g., a spring load on the shaft lock / catch biasing the shaft lock / catch in a locked configuration) as described herein. For example, the shaft 154 may be associated with the handle 151, which may be coupled to a proximal portion of the shaft 154. Due to an automatic roll lock, the medical instrument 159 may be configured such that rotation of the handle 151 is transferred to rotation of the shaft 154. That is, the shaft 154 may not be free to rotate relative to the handle 151, but rather may have a locked rotation relative to the handle 151. For example, the handle 151 may have a roll locking catch feature associated therewith, as described in detail herein, which may be biased in a locked position to prevent relative rotation between the shaft 154 and the handle 151 when the instrument 159 is manually manipulated / operated. Manual rolling of the handle 151 of the medical instrument 159 relative to the block 1504 may be performed to align the plane of deflection of the shaft 154 and / or its distal end portion with the plane of the particular anatomy in which the shaft is disposed. For example, manual manipulation and rotation of the medical instrument handle 159 may be performed to align the shaft 154 with a patient's kidney for renal surgery.

[0137] At block 1506, the process 1500 involves docking the handle 151 of the medical instrument 159 onto a robotic end effector / system 158. For example, the handle 151 may be docked onto an adapter, such as a sterile adapter as described in detail herein, and then physically coupled to an end effector of a robotic arm of a robotic system (e.g., a cart system). Docking the handle 151 may involve rotating the handle longitudinally approximately 90 degrees to align the handle 31 with an engagement surface of the robotic instrument manipulator assembly 158 (e.g., the adapter and / or the end effector).

[0138] At block 1508, the process 1500 entails unlocking a roll axis of (e.g., in) the handle 151 of the medical instrument 159. For example, such unlocking may occur substantially automatically when the handle 151 is latched onto the end effector / adapter 158. For example, one or more features of the end effector / adapter 158 may be configured to actuate an axis catch component of the handle 151 when the handle 151 is placed and / or pressed onto the end effector / adapter 158.

[0139] At block 1510, the process 1500 entails robotically rolling the shaft 154 relative to the handle 151 of the medical instrument 159. For example, one or more drive outputs of the robotic system 158 may be implemented to cause shaft roll through engagement with a drive input of the instrument handle 151. At block 1512, the process 1500 may entail returning the shaft 154 to a home position with respect to its roll orientation relative to the handle. Such an operation may be performed robotically or manually and may occur before or after undocking of the handle / instrument 151 from the robotic system 158.

[0140] At block 1514, the process 1500 entails unlatching / undocking the handle 151 from the end effector / adapter 158, thereby locking the rotation of the shaft 154 relative to the handle 151. If the shaft 154 has not already been moved to the home position, it may be necessary to manually rotate the shaft 154 relative to the handle 151 to move the shaft 154 to the home roll position, thereby enabling the shaft 154 roll lock through the bias of the handle 151 axial catch.

[0141] Described herein are systems, devices, and methods that facilitate robotic roll of a shaft of a medical instrument, as well as limiting and / or restricting such roll in association with a particular medical procedure. In particular, systems, devices, and methods according to one or more aspects of the present disclosure can facilitate locking of a robotic shaft roll, which may be performed automatically in association with undocking the instrument from a robotic end effector or other system component. Robotic shaft roll, shaft roll locking, and shaft roll limiting / restriction according to various embodiments disclosed herein can advantageously reduce certain risks and / or inefficiencies associated with rolling of an instrument.

[0142] In some implementations, the present disclosure relates to a medical instrument that includes an elongate shaft defining a roll axis and a handle coupled to the elongate shaft, the handle including a robotic drive input operable to rotate the elongate shaft relative to the handle about the roll axis, and a lockout mechanism movable between an engaged position, where the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, where the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis.

[0143] The lockout mechanism may be configured to move to the engaged position in a configuration in which the handle is away from the robot, hi some embodiments, the lockout mechanism is configured to move to the engaged position in a configuration in which the handle is away from the robot and the elongate shaft is at a predefined angular position about the roll axis.

[0144] The medical instrument may further comprise a shaft having a first axis, a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis, and a bevel gear having a third axis parallel to the first axis, the bevel gear in meshing arrangement with the shaft gear. The bevel gear may be coupled to the shaft by a belt configured to impart rotational motion of the shaft to the bevel gear.

[0145] The medical instrument may further include a shaft having a first axis, a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis, a bevel gear disposed within the handle in meshing arrangement with the shaft, the bevel gear configured to rotate about a third axis parallel to the second axis, and a rod coupled to and coaxial with the bevel gear. The rod may be configured to rotate the shaft gear.

[0146] The medical instrument may further comprise a shaft actuable by a robotic drive input and a shaft retaining structure at least partially disposed on the shaft and configured to limit rotation of the shaft. In some embodiments, the shaft retaining structure includes a first open annular channel and one or more first stop surfaces exposed in the first open annular channel and configured to limit rotation of the shaft. For example, the shaft may include a second open annular channel at least partially open to the first open annular channel and one or more second stop surfaces exposed in the second open annular channel and configured to limit rotation of the shaft. The medical instrument may further comprise a slider configuration including a first portion at least partially disposed in the first open annular channel and configured to contact the one or more first stop surfaces, and a second portion at least partially disposed in the second open annular channel and configured to contact the one or more second stop surfaces.

[0147] In some implementations, the present disclosure relates to a robotic medical system comprising a robotic manipulator comprising a plurality of drive outputs and a boss. The robotic medical system further comprises a medical instrument comprising a handle mountable to an adapter and an elongate shaft insertable into a patient, the handle comprising a plurality of drive inputs and a lockout mechanism configured to selectively allow or prevent rotation of the elongate shaft relative to the handle. The boss is configured to disengage the lockout mechanism upon mounting the handle to the adapter.

[0148] In some embodiments, a robotic manipulator assembly includes a robotic end effector including a plurality of drive outputs, and an adapter mountable to the robotic end effector and including a plurality of drive couplers and a boss. The boss can be configured to vertically translate at least a portion of the lockout mechanism. In some embodiments, the boss is configured to rotate at least a portion of the lockout mechanism.

[0149] In some implementations, the present disclosure relates to a medical instrument comprising an elongate shaft, a handle coupled to a proximal portion of the elongate shaft, a shaft associated with the handle, where rotation of the shaft is configured to rotate the elongate shaft about an axis of the elongate shaft, and a shaft catch at least partially disposed within the handle and configured to operate to prevent rotation of the shaft.

[0150] In some embodiments, the axle catch comprises a key configured to engage a mating feature of the axle. For example, when the key is at least partially disposed within the mating feature of the axle, rotation of the axle may be limited. The key of the axle catch may be configured to enter the mating feature of the axle axially with respect to the axis of the axle. In some embodiments, the axle catch is configured to be actuated in a direction that is parallel to the axis of the axle. For example, the axle catch may include one or more alignment pin channels, the one or more alignment pin channels configured to have an axis that is parallel to the axis of the axle and have a respective alignment pin at least partially disposed therein, each alignment pin directing actuation of the axle catch in a direction that is parallel to the axis of the axle. The key of the axle catch may be configured to enter the mating feature of the axle through a side portion of the axle. For example, the axle catch may be configured to rotate about an axis that is parallel to the axis of the axle. In some embodiments, the key comprises a bent protrusion.

[0151] The axial catch can include a catch actuator. For example, the catch actuator can be integral with the axial catch. In some embodiments, the catch actuator is associated with a first longitudinal end of the axial catch and the catch actuator is associated with a second longitudinal end of the axial catch. In some embodiments, the catch actuator is accessible from outside the handle. For example, the catch actuator can include a plug configured to be at least partially disposed within an open feature of the handle. Alternatively, the catch actuator can include a cam structure, the cam structure configured to rotate about an axis of the cam structure.

[0152] In some implementations, the present disclosure relates to a shaft catch that is biased into a locked configuration in which rotation of the shaft is prevented. The medical instrument can further include a spring at least partially disposed within the cup form of the shaft catch and configured to exert a force on the shaft catch biasing the shaft catch into the locked configuration. In some embodiments, the medical instrument further includes a shaft retainer structure disposed within the handle, the shaft retainer structure axially locking the shaft in place, and the spring configured to press against an underside of the shaft retainer structure when at least partially disposed within the cup form.

[0153] For purposes of summarizing the disclosure, certain aspects, advantages, and novel features have been 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 performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other advantages that may be taught or suggested herein.

[0154] 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, 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.

[0155] 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 a particular embodiment includes certain features, elements, and / or steps, while other embodiments do not. Thus, such conditional language is not intended to imply that features, elements, and / or steps are generally 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 synonymous and 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, conjunctive 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 conjunctive language is generally not 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.

[0156] 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 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. 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 invention disclosed herein and claimed below should not be limited by the specific embodiments described above, but should be determined solely by a fair reading of the following claims.

[0157] 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 an element, such as a structure, component, operation, etc., do not necessarily indicate a priority or order of the element with respect to any other elements, but rather may generally distinguish the element from another element having a similar or identical name (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.

[0158] 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 example 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.

[0159] 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 drawings. 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 depicted in the drawings. For example, if the devices shown in the drawings are inverted, a device positioned "below" or "under" another device may be positioned "above" the other 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.

[0160] 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."

[0161] [Embodiment] (1) A medical device, an elongated shaft defining a roll axis; a handle coupled to the elongate shaft, the handle comprising: a robot drive input operable to rotate the elongate shaft relative to the handle about the roll axis; 1. A medical instrument comprising: a lockout mechanism movable between an engaged position, in which the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, in which the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis. (2) The medical instrument of embodiment 1, wherein the lockout mechanism is configured to move to the engaged position in a configuration in which the handle is away from the robot. (3) The medical instrument of any one of claims 1 to 2, wherein the lockout mechanism is configured to move to the engaged position in a configuration in which the handle is away from the robot and the elongated shaft is at a predefined angular position about the roll axis. (4) a shaft having a first axis; a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis; a bevel gear having a third axis parallel to the first axis, the bevel gear being in meshing arrangement with the shaft gear; 4. The medical instrument of any one of claims 1 to 3, wherein the bevel gear is coupled to the shaft by a belt configured to transmit rotational motion of the shaft to the bevel gear. (5) a shaft having a first axis; a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis; a bevel gear disposed within the handle in meshing engagement with the shaft, the bevel gear configured to rotate about a third axis that is parallel to the second axis; a rod coupled to and coaxial with the bevel gear, 5. The medical instrument of any one of claims 1 to 4, wherein the rod is configured to rotate the shaft gear.

[0162] (6) a shaft actuable by the robot drive input; 6. The medical instrument of any one of claims 1 to 5, further comprising a shaft retaining structure disposed at least partially on the shaft, the shaft retaining structure being configured to limit rotation of the shaft. (7) The shaft holding structure is a first open annular channel; and 7. The medical device of embodiment 6, comprising: one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft. (8) The shaft is a second open annular channel at least partially open to the first open annular channel; 8. The medical device of claim 7, further comprising: one or more second stop surfaces exposed within the second open annular channel and configured to limit rotation of the shaft. (9) A slider configuration is further provided, the slider configuration being: a first portion disposed at least partially within the first open annular channel and configured to contact the one or more first stopper surfaces; A medical device as described in embodiment 8, comprising a second portion at least partially disposed within the second open annular channel and configured to contact the one or more second stopper surfaces. (10) A robotic medical system, comprising: a robot manipulator having a plurality of drive outputs and a boss; a medical instrument comprising a handle mountable to the robotic manipulator and an elongate shaft insertable into a patient, the handle comprising a plurality of drive inputs and a lockout mechanism configured to selectively allow or prevent rotation of the elongate shaft relative to the handle; The boss is configured to disengage the lockout mechanism when the handle is mounted to an adapter.

[0163] (11) A robot manipulator assembly comprising: a robot end effector including a plurality of drive outputs; The robotic medical system of embodiment 10, further comprising: an adapter mountable to the robot end effector and comprising a plurality of drive couplers and the boss. (12) The robot system of claim 10 or 11, wherein the boss is configured to vertically translate at least a portion of the lockout mechanism. (13) The robot system according to any one of embodiments 10 to 12, wherein the boss is configured to rotate at least a portion of the lockout mechanism. (14) A medical device comprising: A long, slender shaft and a handle coupled to a proximal portion of the elongate shaft; a shaft associated with the handle, the rotation of the shaft being configured to rotate the elongate shaft about an axis of the elongate shaft; a shaft catch disposed at least partially within the handle and configured to operate to prevent rotation of the shaft. (15) The shaft catch includes a key configured to engage a mating feature of the shaft; 15. The medical instrument of claim 14, wherein rotation of the shaft is limited when the key is at least partially disposed within the mating feature of the shaft.

[0164] (16) The medical instrument of claim 15, wherein the key of the shaft catch is configured to enter the mating feature of the shaft axially relative to an axis of the shaft. (17) The medical instrument of claim 15, wherein the shaft catch is configured to actuate in a direction that is parallel to an axis of the shaft. (18) The medical instrument of embodiment 17, wherein the axial catch includes one or more alignment pin channels, the one or more alignment pin channels having an axis parallel to the axis of the shaft and configured to have a respective alignment pin at least partially disposed therein, the respective alignment pins directing actuation of the axial catch in the direction parallel to the axis of the shaft. (19) The medical instrument of claim 17, wherein the key of the shaft catch is configured to pass through a side portion of the shaft and enter the mating feature of the shaft. (20) The medical instrument of embodiment 19, wherein the shaft catch is configured to rotate about an axis that is parallel to an axis of the shaft.

[0165] (21) The medical device of claim 20, wherein the key has a bending protrusion. (22) The medical device according to any one of embodiments 14 to 21, wherein the shaft catch comprises a catch actuator. (23) The medical instrument of claim 22, wherein the catch actuator is integral with the shaft catch. (24) The catch actuator is associated with a first longitudinal end of the shaft catch; 23. The medical instrument of claim 22, wherein the catch actuator is associated with a second longitudinal end of the axial catch. (25) The medical instrument of claim 22, wherein the catch actuator is accessible from outside the handle.

[0166] (26) The medical instrument of claim 25, wherein the catch actuator comprises a plug configured to be at least partially disposed within the open feature of the handle. (27) The medical instrument of embodiment 25, wherein the catch actuator comprises a cam structure, the cam structure configured to rotate about an axis of the cam structure. (28) The medical instrument according to any one of embodiments 14 to 27, wherein the shaft catch is biased into a locked configuration in which rotation of the shaft is prevented. (29) The medical instrument of claim 28, further comprising a spring disposed at least partially within the cup-shaped body of the axle catch and configured to exert a force on the axle catch biasing the axle catch into the locked configuration. (30) A shaft retainer structure disposed within the handle, the shaft retainer structure axially secures the shaft in place; 30. The medical instrument of claim 29, wherein the spring is configured to press against an underside of the axial retainer structure when at least partially disposed within the cup-shaped body.

Claims

1. A medical device comprising: an elongated shaft defining a roll axis; a handle coupled to the elongate shaft, the handle comprising: a robot drive input operable to rotate the elongate shaft relative to the handle about the roll axis; a shaft actuable by the robot drive input; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; and one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft.

2. The shaft includes a second open annular channel facing the first open annular channel of the shaft retaining structure, the second open annular channel including two second stop surfaces; the shaft includes a radial locking mating channel disposed between the two second stop surfaces; The medical instrument of claim 1 , further comprising a locking mechanism configured to mate with the radial locking mating channel of the shaft.

3. 3. The medical instrument of claim 2, wherein the locking mechanism is configured to automatically move from a disengaged position to an engaged position with the radial locking mating channel when the elongated shaft is manually rotated to a predefined angular position about the roll axis.

4. A shaft gear coupled to a proximal end of the elongated shaft, the shaft gear having a first axis that is transverse to a second axis of the shaft; a bevel gear having a third axis parallel to the second axis, the bevel gear being in meshing arrangement with the shaft gear; The medical instrument of claim 1 , wherein the bevel gear is coupled to the shaft by a belt configured to transmit rotational motion of the shaft to the bevel gear.

5. A shaft gear coupled to a proximal end of the elongated shaft, the shaft gear having a first axis that is transverse to a second axis of the shaft; a bevel gear disposed within the handle in meshing engagement with the shaft, the bevel gear configured to rotate about a third axis that is parallel to the first axis; a rod coupled to and coaxial with the bevel gear, The medical instrument of claim 1 , wherein the rod is configured to rotate the shaft gear.

6. The medical instrument of claim 1, wherein the shaft retaining structure is fixed to the handle, while the shaft is rotatable relative to the handle.

7. The axis is a second open annular channel at least partially open to the first open annular channel; and one or more second stop surfaces exposed within the second open annular channel and configured to limit rotation of the shaft.

8. The slider configuration further comprises: a first portion slidingly disposed at least partially within the first open annular channel and configured to contact the one or more first stop surfaces; and a second portion slidingly disposed at least partially within the second open annular channel and configured to contact the one or more second stop surfaces.

9. 1. A robot system comprising: a robotic manipulator assembly including one or more drive outputs and a boss; 1. An instrument comprising a handle mountable to the robotic manipulator assembly and an elongate shaft insertable into a patient, the handle comprising: A plurality of drive inputs; a shaft actuatable by one of the plurality of drive inputs; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; a shaft retaining structure comprising one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft; and an instrument.

10. The robotic manipulator assembly comprising: a robot end effector including a plurality of drive outputs; 10. The robot system of claim 9, further comprising: an adapter mountable to the robot end effector, the adapter comprising a plurality of drive couplers and the boss.

11. The robotic system of claim 9 , wherein the boss is configured to activate a lock configured to engage the shaft and limit rotation of the shaft.

12. A medical device comprising: A long, slender shaft and a handle coupled to a proximal portion of the elongate shaft; a shaft coupled to the handle, the rotation of the shaft configured to rotate the elongate shaft about an axis of the elongate shaft; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; and one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft.

13. Further comprising an axle catch disposed at least partially within the handle, the axle catch configured to move between an unlocked position in which the axle catch permits rotation of the axle and a locked position in which the axle catch restricts rotation of the axle; the shaft catch comprising a key configured to engage a mating feature of the shaft; The medical instrument of claim 12 , wherein rotation of the shaft is limited when the key is at least partially disposed within the mating feature of the shaft.

14. The medical instrument of claim 13 , wherein the key of the shaft catch is configured to enter the mating feature of the shaft axially relative to an axis of the shaft.

15. The medical instrument of claim 13 , wherein the shaft catch is configured to actuate in a direction that is parallel to an axis of the shaft.

16. 16. The medical instrument of claim 15, wherein the axial catch includes one or more alignment pin channels configured to have an axis that is parallel to the axis of the shaft and to have a respective alignment pin at least partially disposed therein, the respective alignment pins directing linear translation of the axial catch in the direction that is parallel to the axis of the shaft.

17. The medical instrument of claim 13 , wherein the key of the shaft catch is configured to pass through a side portion of the shaft and into the mating feature of the shaft.

18. 18. The medical instrument of claim 17, wherein the shaft catch is configured to rotate about an axis that is parallel to an axis of the shaft.

19. The shaft includes a second open annular channel opening toward the first open annular channel of the shaft retaining structure; 13. The medical instrument of claim 12, wherein the medical instrument comprises an arcuate slider including a first portion configured to slide within the first open annular channel and a second portion configured to slide within the second open annular channel.

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