Off-screen indicator viewer user interface

Abstract

The surgical robotic system can indicate the location of the surgical tool. The surgical robotic system can include a robotic arm coupled to the surgical tool, a scope, and a viewer for displaying a field of view of the surgical site derived from the scope. The surgical robotic system can be configured to provide an electrical signal for presenting a visual indicator on the viewer indicative of the location of the surgical tool pursuant to a determination that the surgical tool is not within the field of view.

Description

[Technical field]

[0001] The systems and methods disclosed herein relate to devices and methods for indicating the position of a surgical tool, and more particularly, to a surgical robotic system for indicating the position of a surgical tool. [Background technology]

[0002] Robot-enabled medical systems can perform a variety of medical procedures, including both minimally invasive procedures such as laparoscopy, and non-invasive procedures such as endoscopic procedures (e.g., bronchoscopy, ureteroscopy, gastroscopy, etc.).

[0003] Such robotic medical systems may include a robotic arm configured to control the movement of a surgical tool during a given medical procedure. To achieve a desired pose of the surgical tool, the robotic arm may be placed in a specific pose during teleoperation. Some robot-enabled medical systems may include arm supports (e.g., bars) connected to the base of each of the robotic arms and supporting the robotic arms. Summary of the Invention [Means for solving the problem]

[0004] One or more instruments may be coupled to one or more robotic arms of a robotic medical system (e.g., a surgical robotic system) for a medical procedure. For example, an instrument may be coupled to a robotic arm as a starting instrument for performing a procedure or as a replacement instrument during a procedure.

[0005] In a robotic system including multiple robotic arms, at least one robotic arm may be coupled to a camera or scope that provides a surgical field of view. When a medical instrument is within the surgical field of view, a user (e.g., a surgeon or physician's assistant) can identify the location of the instrument from an image of the surgical field of view. However, if the instrument is not within the surgical field of view, movement of the instrument may lead to contact between the instrument and unintended tissue or organs. In addition, if the instrument is not within the surgical field of view, it may take additional time for the user to identify the location of the instrument before beginning to use the instrument, which may prolong the medical procedure.

[0006] Thus, there is a need for a robotic medical system that can facilitate a user to locate an instrument, even when the instrument is positioned outside the surgical field of view.

[0007] As disclosed herein, a robotic medical system (e.g., a surgical robotic system) can include two or more robotic arms, such as a first robotic arm coupled to a surgical tool and a second robotic arm coupled to a scope (or camera). The robotic medical system also includes a viewer for displaying a view of the surgical site. The user interface displayed on the viewer can be configured to include off-screen indicators that indicate the relative position and / or distance to the surgical tool such that a user can locate and / or ascertain the distance to the surgical tool.

[0008] As disclosed herein, the robotic medical system is configured to determine whether a tool is located within the field of view of the camera. Following a determination that the tool is not within the field of view of the camera, the robotic medical system can provide an indication of the location of the tool and / or the distance of the tool from the field of view to the physician and / or physician assistant.

[0009] As disclosed herein, the robotic medical system has knowledge about (e.g., information indicative of) the camera field of view. In some embodiments, the field of view is determined based on an image provided by the camera. In some embodiments, the field of view is determined based on the position and orientation of the camera (e.g., a predefined volume of space in front of the camera).

[0010] As disclosed herein, the robotic medical system is configured to enable movement of the robotic arm. In some embodiments, the robotic medical system can induce robotic movement of the robotic arm. In some embodiments, the robotic medical system can enable manual movement of the robotic arm.

[0011] As disclosed, the robotic medical system is configured to determine the positions and orientations of the robotic arms and, more specifically, their associated tools. In some embodiments, the robotic medical system determines that at least one of the robotic arms has moved (and thus the position of the associated tool has changed) and updates the off-screen indicators to indicate the changed position of the associated tool. In some embodiments, the robotic medical system updates the off-screen indicators in real-time (e.g., while the associated tool is moving) to indicate the changed position of the associated tool.

[0012] Thus, the systems and / or methods disclosed herein advantageously improve the operation of a robotic medical system during surgery. For example, the user can be informed of the location and distance of a tool even if the tool is located outside the field of view of the camera. This leads to a better overall user experience as the user can quickly determine the location of the tool. The ability to determine the location of a tool when the tool is located outside the field of view can also improve the safety of surgery.

[0013] The systems, methods, and devices of the present disclosure each have several innovative aspects, no single one of which is solely responsible for the desirable attributes disclosed herein.

[0014] According to some embodiments of the present disclosure, a robotic system includes a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, and a third robotic arm coupled to a scope. The robotic system also includes a viewer for displaying a view of a surgical site derived from the scope. The robotic system further includes one or more processors and a memory storing instructions executable by the one or more processors. The stored instructions include instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the view and the first surgical tool is not within the view. The first visual indicator indicates a position of the first surgical tool.

[0015] In some embodiments, the stored instructions further include instructions for providing an electrical signal for presenting a first visual indicator at a first location on the viewer to indicate a position of the first surgical tool, and after providing the electrical signal for presenting the first visual indicator at the first location on the viewer, in accordance with a determination that the position of the first surgical tool has changed, providing an electrical signal for presenting the first visual indicator at a second location on the viewer corresponding to the changed position of the first surgical tool.

[0016] In some embodiments, the first visual indicator further indicates a distance from the field of view to the first surgical tool.

[0017] In some embodiments, the stored instructions further include instructions for, after providing the electrical signal for presenting the first visual indicator on the viewer, according to a determination that a distance from the field of view to the first surgical tool has changed, providing an electrical signal for presenting an updated first visual indicator on the viewer indicating the changed distance from the field of view to the first surgical tool.

[0018] In some embodiments, the stored instructions further include instructions for, after providing the electrical signal for presenting the first visual indicator on the viewer, ceasing providing the electrical signal for presenting the first visual indicator on the viewer in accordance with a determination that the first surgical tool is within the field of view.

[0019] In some embodiments, the first visual indicator includes a graphical element having a size indicative of the distance from the field of view to the first surgical tool.

[0020] In some embodiments, the first visual indicator includes information identifying a robotic arm associated with the graphical element.

[0021] In some embodiments, the first visual indicator identifies a type of the first surgical tool.

[0022] In some embodiments, the first visual indicator includes a graphical representation of the first surgical tool.

[0023] In some embodiments, the first visual indicator is displayed simultaneously with the display of a field of view of the surgical site on the viewer.

[0024] In some embodiments, the first visual indicator is displayed around a representation of the field of view of the surgical site.

[0025] In some embodiments, the first visual indicator is displayed over a representation of a field of view of the surgical site.

[0026] In some embodiments, the stored instructions further include instructions for providing an electrical signal to highlight a predetermined area of ​​the representation of the field of view of the surgical site, wherein the first visual indicator is displayed along a periphery of the predetermined area.

[0027] In some embodiments, the stored instructions further include instructions for providing a rendered image including the first visual indicator.

[0028] In some embodiments, the rendered image further includes a second visual indicator indicating the position of the second surgical tool.

[0029] In some embodiments, the first visual indicator includes information identifying a first robotic arm associated with the first surgical tool, and the second visual indicator includes information identifying a second robotic arm associated with the second surgical tool.

[0030] In some embodiments, the first visual indicator includes a graphical representation of a first surgical tool and the second visual indicator includes a graphical representation of a second surgical tool.

[0031] In some embodiments, the stored instructions include instructions for replacing a representation of the field of view with a rendered image.

[0032] In some embodiments, the stored instructions include instructions for partially overlaying the rendered image onto a representation of the field of view.

[0033] In some embodiments, the stored instructions include instructions for providing an electrical signal to present the first visual indicator on the viewer in response to receiving a request for display of the first visual indicator and in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view.

[0034] In some embodiments, the stored instructions include instructions for ceasing providing the electrical signal for presenting the first visual indicator on the viewer in response to determining that a request for display of the first visual indicator has ceased.

[0035] In some embodiments, the first robotic arm and the second robotic arm are positioned on either side of the surgical table.

[0036] In some embodiments, the first robotic arm is supported on a first adjustable arm support and the second robotic arm is supported on a second adjustable arm support.

[0037] In some embodiments, the first robotic arm and the second robotic arm are located on the same side of the surgical table.

[0038] In some embodiments, the first robotic arm and the second robotic arm are supported on adjustable arm supports.

[0039] In some embodiments, the viewer is part of the surgeon console.

[0040] In some embodiments, the Surgeon console includes an input device, and the stored instructions include instructions for receiving an input on the input device, and in response to receiving the input on the input device, providing electrical signals to present a bird's-eye view of the first robotic arm, the second robotic arm, and the third robotic arm.

[0041] In some embodiments, the input device includes a foot pedal.

[0042] According to some embodiments, the electronic device is in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer. The electronic device includes one or more processors and a memory storing instructions executed by the one or more processors. The stored instructions include instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view. The first visual indicator indicates a position of the first surgical tool.

[0043] According to some embodiments, a computer-readable storage medium stores instructions for execution by one or more processors in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer. The stored instructions include instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view. The first visual indicator indicates a position of the first surgical tool.

[0044] According to some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer for displaying a view of a surgical site derived from the scope. The robotic system also includes one or more processors and a memory storing instructions for execution by the one or more processors. The stored instructions include instructions for providing an electrical signal for presenting a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator. The first visual indicator indicates a position of the first surgical tool.

[0045] According to some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer for displaying a view of a surgical site derived from the scope. The robotic system also includes one or more processors and a memory storing instructions for execution by the one or more processors. The stored instructions include instructions for providing an electrical signal for presenting a first visual indicator on the viewer. The first visual indicator indicates a position of the first surgical tool.

[0046] According to some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool, a scope, and a viewer for displaying a view of a surgical site derived from the scope. The robotic system also includes one or more processors and a memory storing instructions for execution by the one or more processors. The stored instructions include instructions for providing an electrical signal for presenting a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator. The first visual indicator indicates a position of the first surgical tool.

[0047] According to some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool, a scope, and a viewer for displaying a view of a surgical site derived from the scope. The robotic system also includes one or more processors and a memory storing instructions for execution by the one or more processors. The stored instructions include instructions for providing an electrical signal for presenting a first visual indicator on the viewer. The first visual indicator indicates a position of the first surgical tool.

[0048] It should be noted that the various embodiments described above can be combined with any other embodiment described herein. The features and advantages described herein are not all-inclusive, and in particular many additional features and advantages will be apparent to those skilled in the art upon consideration of the drawings, specification, and claims. Furthermore, it should be noted that the language used in this specification has been selected primarily for readability and instructional purposes, and may not be selected to delineate or limit the subject matter of the present invention. [Brief description of the drawings]

[0049] The disclosed aspects are hereinafter described in conjunction with the accompanying drawings, in which like designations refer to like elements and which illustrate, but do not limit, the disclosed aspects. [Figure 1] 1 illustrates one embodiment of a cart-based robotic system deployed for diagnostic and / or therapeutic bronchoscopy procedures. [Diagram 2] 2 depicts a further embodiment of the robotic system of FIG. 1. [Diagram 3] 2 illustrates an embodiment of the robotic system of FIG. 1 positioned for ureteroscopy. [Figure 4] 2 illustrates one embodiment of the robotic system of FIG. 1 deployed for a vascular procedure. [Diagram 5] 1 illustrates one embodiment of a table-based robotic system positioned for a bronchoscopy procedure. [Figure 6] 6 provides an alternative view of the robotic system of FIG. 5. [Figure 7] 1 illustrates an example system configured to accommodate a robotic arm. [Figure 8] 1 illustrates one embodiment of a table-based robotic system configured for a ureteroscopy procedure. [Figure 9] 1 illustrates one embodiment of a table-based robotic system configured for laparoscopic procedures. [Figure 10] 10 illustrates one embodiment of the table-based robotic system of FIGS. 5-9 with pitch or tilt adjustment. [Figure 11] 5-10 provide detailed illustrations of the interface between the table and column of the table-based robotic system. [Figure 12] 1 illustrates an alternative embodiment of a table-based robotic system. [Figure 13] FIG. 13 illustrates an end view of the table-based robotic system of FIG. [Figure 14] FIG. 1 illustrates an end view of a table-based robotic system with a robotic arm attached. [Figure 15] 1 illustrates an exemplary instrument driver. [Figure 16] 1 illustrates an exemplary medical instrument having a pair of instrument drivers. [Figure 17] 13 illustrates an alternative design of the instrument driver and instrument, where the axis of the drive unit is parallel to the axis of the elongated shaft of the instrument. [Figure 18] 1 illustrates an instrument having an instrument-based insertion architecture. [Figure 19] 1 illustrates an exemplary controller. [Figure 20] 1 depicts a block diagram illustrating a localization system that estimates the location of one or more elements of the robotic system of FIGS. 1-10, such as the location of the instrument of FIGS. 16-18, in accordance with an exemplary embodiment. [Figure 21] 1 illustrates an exemplary robotic system, according to some embodiments. [Figure 22] 1 illustrates another view of an exemplary robotic system, according to some embodiments. [Figure 23] 1 illustrates components of a robotic medical system, according to some embodiments. [Figure 24A] 1 illustrates different views of an exemplary robotic arm, according to some embodiments. [Figure 24B] 1 illustrates different views of an exemplary robotic arm, according to some embodiments. [Figure 24C] 1 illustrates different views of an exemplary robotic arm, according to some embodiments. [Diagram 25] 1 illustrates a perspective view of a robotic medical system according to some embodiments. [Figure 26A] 1 illustrates a camera view in three-dimensional space according to some embodiments. [Figure 26B] 1 illustrates a camera view in three-dimensional space according to some embodiments. [Figure 27A] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27B] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27C] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27D] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27E] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27F] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27G] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Fig. 27H] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27I] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 27J] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 28A] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 28B]1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 28C] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 28D] 1 illustrates an exemplary user interface displayed on a display device, according to some embodiments. [Figure 29A] FIG. 1 illustrates a flowchart of a method implemented by one or more processors of a surgical robotic system, according to some embodiments. [Figure 29B] FIG. 1 illustrates a flowchart of a method implemented by one or more processors of a surgical robotic system, according to some embodiments. [Figure 29C] FIG. 1 illustrates a flowchart of a method implemented by one or more processors of a surgical robotic system, according to some embodiments. [Diagram 30] FIG. 1 is a schematic diagram illustrating electronic components of a robotic medical system according to some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0050] 1. Overview Aspects of the present disclosure may be integrated into a robot-enabled medical system capable of performing a variety of medical procedures, including both minimally invasive procedures such as laparoscopy, and non-invasive procedures such as endoscopy, among other endoscopic procedures, such as bronchoscopy, ureteroscopy, gastroscopy, and the like.

[0051] In addition to performing a wide range of procedures, the system may provide additional benefits such as enhanced imaging and guidance to assist the physician. Furthermore, the system may provide the physician with the ability to perform procedures from an ergonomic position without the need for awkward arm movements and positions. Still further, the system may provide the physician with the ability to perform procedures with improved ease of use, such that even a single user may control one or more of the instruments of the system.

[0052] Various embodiments are described below in conjunction with the drawings for purposes of illustration. It should be understood that many other embodiments of the disclosed concepts are possible, and that various advantages may be achieved in the disclosed embodiments. Headings are included herein for reference and to aid in locating various sections. The headings do not limit the scope of the concepts described therein. Such concepts may be applicable throughout the entire specification.

[0053] A. Robot System - Cart A robot-enabled medical system may be configured in a variety of ways depending on the particular procedure. FIG. 1 illustrates one embodiment of a cart-based robot-enabled system 10 arranged for diagnostic and / or therapeutic bronchoscopy procedures. During bronchoscopy, the system 10 may include a cart 11 having one or more robotic arms 12 for delivering medical instruments, such as a steerable endoscope 13, which may be a procedure-specific bronchoscope for bronchoscopy, to a natural orifice access point (i.e., the mouth of a patient positioned on a table in this example) for delivering diagnostic and / or therapeutic tools. As shown, the cart 11 may be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arms 12 may be actuated to position a bronchoscope relative to the access point. The arrangement of FIG. 1 may also be utilized when performing gastrointestinal (GI) procedures with a gastroscope, an endoscope specialized for GI procedures. FIG. 2 depicts an example embodiment of the cart in more detail.

[0054] With continued reference to FIG. 1, once the cart 11 is properly positioned, the robotic arm 12 can insert the steerable endoscope 13 into the patient robotically, manually, or a combination thereof. As shown, the steerable endoscope 13 can include at least two nested parts, such as an inner leader section and an outer sheath section, each section coupled to a separate instrument driver from a set of instrument drivers 28, each instrument driver coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers 28, which facilitates coaxial alignment of the leader section with the sheath section, creates a "virtual rail" 29 that can be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or positions. The virtual rails described herein are depicted in the figures using dashed lines, and thus do not depict any physical structure of the system. Translation of the instrument driver 28 along the virtual rail 29 nests the inner leader section relative to the outer sheath section, or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 29 may be adjusted, translated, or pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and position of the virtual rail 29 shown represents a compromise between providing the physician access to the endoscope 13 and minimizing friction that results from bending the endoscope 13 into the patient's mouth.

[0055] The endoscope 13 can be directed downstream of the patient's trachea and lungs after insertion using precise commands from the robotic system until the target destination or surgical site is reached. The endoscope 13 can be manipulated to telescope the inner leader portion from the outer sheath portion to enhance articulation and increase bend radius to enhance navigation through the patient's pulmonary network and / or reach a desired target. The use of a separate instrument driver 28 also allows the leader and sheath portions to be driven independently of one another.

[0056] For example, the endoscope 13 may be directed to deliver a biopsy needle to a target, such as a lesion or nodule in the patient's lung. The needle may be deployed 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 may be deployed through the working channel of the endoscope for additional biopsies. After identifying the nodule as malignant, the endoscope 13 may deliver tools endoscopically to ablate the potential cancerous tissue. In some cases, the diagnostic and therapeutic treatments may be delivered in separate procedures. In these situations, the endoscope 13 may also be used to deliver fiducials to "mark" the location of the targeted nodule. In other cases, the diagnostic and therapeutic treatments may be delivered during the same procedure.

[0057] The system 10 may also include a movable tower 30 that may be connected to the cart 11 via a support cable to provide support for control, electronics, fluidics, optics, sensors, and / or power to the cart 11. Placing such functionality in the tower 30 may reduce the form factor of the cart 11, allowing the operating surgeon and his / her staff to more easily adjust and / or reposition the cart 11. Additionally, the division of functionality between the cart / table and the support tower 30 reduces clutter in the operating room and promotes improved clinical workflow. The cart 11 may be positioned near the patient, while the tower 30 may be housed in a remote location so as not to get in the way during the procedure.

[0058] To support the robotic system described above, the tower 30 may include computer-based control system components that store computer program instructions in a non-transitory computer-readable storage medium, such as, for example, a persistent magnetic storage drive, a solid-state drive, or the like. Execution of these instructions, whether execution occurs in the tower 30 or in the cart 11, may control the entire system or subsystems thereof. For example, when executed by a processor in a computer system, the instructions may cause the robotic system components to actuate the carriage and arm mounts, operate the robotic arm, and control medical instruments. For example, in response to receiving control signals, motors in the joints of the robotic arm may position the arm in a particular pose.

[0059] The tower 30 may also include pumps, flow meters, valve controls, and / or fluid access to provide controlled irrigation and aspiration capabilities to a system that may be deployed through the endoscope 13. These components may also be controlled using the computer system of the tower 30. In some embodiments, irrigation and aspiration capabilities may be provided directly to the endoscope 13 via separate cables.

[0060] The tower 30 may include voltage and surge protection designed to provide filtered, protected power to the cart 11, thereby avoiding the need to place power transformers and other auxiliary power components within the cart 11 and making the cart 11 smaller and more mobile.

[0061] The tower 30 may also include support equipment for sensors deployed throughout the robotic system 10. For example, the tower 30 may include optoelectronic equipment for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In combination with a control system, such optoelectronic equipment may be used to generate real-time images for display on any number of consoles deployed throughout the system, including in the tower 30. Similarly, the tower 30 may also include electronic subsystems for receiving and processing signals from deployed electromagnetic (EM) sensors. The tower 30 may also be used to house and position EM field generators for detection by EM sensors in or on a medical instrument.

[0062] The tower 30 may also include a console 31 in addition to other consoles available to the rest of the system, for example a console mounted on top of a cart. The console 31 may include a user interface and a display screen, such as a touch screen, for the operator physician. The console of the system 10 is typically designed to provide both robotic control and pre-operative and real-time information of the procedure, such as navigation and localization information for the endoscope 13. If the console 31 is not the only console available to the physician, a second operator, such as a nurse, may use the console 31 to monitor the health or vital signs of the patient and the operation of the system, as well as provide procedure-specific data, such as navigation and localization information. In other embodiments, the console 30 is housed in a body separate from the tower 30.

[0063] The tower 30 may be coupled to the cart 11 and endoscope 13 via one or more cables or connections (not shown). In some embodiments, support functions from the tower 30 may be provided to the cart 11 through only one cable, simplifying and decluttering the operating room. In other embodiments, certain functions may be combined in separate wiring and connections. For example, power may be provided to the cart through only one power cable, while support for the controls, optics, fluidics, and / or navigation may be provided through separate cables.

[0064] FIG. 2 provides a detailed illustration of an embodiment of a cart from the cart-based robot-enabled system shown in FIG. The cart 11 generally includes an elongated support structure 14 (often referred to as a "column"), a cart base 15, and a console 16 at the top of the column 14. The column 14 may include one or more carriages, such as a carriage 17 (alternatively an "arm support") for supporting the deployment of one or more robotic arms 12 (three are shown in FIG. 2). The carriage 17 may include individually configurable arm mounts that rotate along orthogonal axes to adjust the base of the arm 12 for better positioning relative to the patient. The carriage 17 also includes a carriage interface 19 that allows the carriage 17 to translate vertically along the column 14.

[0065] The carriage interface 19 is connected to the column 14 through slots, such as slots 20 positioned on either side of the column 14 to guide the vertical translation of the carriage 17. The slots 20 contain the vertical translation interfaces to position and hold the carriage at various vertical heights relative to the cart base 15. The vertical translation of the carriage 17 allows the cart 11 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 carriage 17 allows the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0066] In some embodiments, a slot cover may be added to the slot 20 that is flush and parallel with the slot surface to prevent dirt and fluids from entering the internal chamber of the column 14 and the vertical translation interface as the carriage 17 translates vertically. The slot cover may be deployed through a pair of spring spools positioned near the vertical top and bottom of the slot 20. The cover is coiled within the spools until it deploys to extend and retract from the coiled state as the carriage 17 translates vertically up and down. The spring loading of the spools provides a force to retract the cover onto the spool as the carriage 17 translates towards the spool, while also maintaining a seal as the carriage 17 translates away from the spool. The cover may be connected to the carriage 17 using, for example, a bracket at the carriage interface 19 to ensure that the cover extends and retracts properly as the carriage 17 translates.

[0067] Column 14 may contain mechanisms therein, such as gears and motors, designed to use a vertically aligned leadscrew to mechanically translate carriage 17 in response to control signals generated in response to user input, such as input from console 16.

[0068] The robotic arm 12 may generally include a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24, each joint including an independent actuator, each actuator including an independently controllable motor. Each separately controllable joint represents an independent degree of freedom available to the robotic arm. Each of the arms 12 has seven joints, thus providing seven degrees of freedom. A large number of joints provides a large number of degrees of freedom, allowing for "redundant" degrees of freedom. The redundant degrees of freedom allow the robotic arm 12 to position its respective end effector 22 at a specific position, orientation, and trajectory in space using different 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 advantageous position away from the patient to create greater access while avoiding arm collisions.

[0069] The cart base 15 balances the weight of the column 14, carriage 17, and arm 12 on the floor. Thus, the cart base 15 houses the heavier parts, such as electronics, motors, power supplies, as well as components that allow the cart to be both mobile and / or immobilized. For example, the cart base 15 includes casters 25 in the form of rollable wheels that allow the cart to be easily moved around the room prior to a procedure. Once in the proper position, the casters 25 can be immobilized using wheel locks to hold the cart 11 in place during a procedure.

[0070] The console 16 positioned at the vertical end of the column 14 allows for both a user interface and a display screen (or dual-purpose device, e.g., touch screen 26) for receiving user input to provide both pre-operative and intra-operative data to the physician user. Potential pre-operative data on the touch screen 26 may include pre-operative planning, navigation and mapping data derived from a pre-operative computed tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data on the display may 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 16 may be positioned and tilted to allow the physician to access the console from the side of the column 14 opposite the carriage 17. From this position, the physician can view the console 16, the robotic arm 12, and the patient while operating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 to help manipulate and stabilize the cart 11.

[0071] FIG. 3 illustrates one embodiment of the robot-enabled system 10 positioned for ureteroscopy. In a ureteroscopy procedure, the cart 11 can be positioned to deliver a ureteroscope 32, a procedure-specific endoscope designed to follow the patient's urethra and ureters, to the patient's lower abdominal region. In a ureteroscopy, it may be desirable for the ureteroscope 32 to be aligned directly with the patient's urethra to reduce friction and forces on the sensitive anatomical structures in that area. As shown, the cart 11 can be aligned to the table legs to allow the robotic arm 12 to position the ureteroscope 32 for direct linear access to the patient's urethra. From the table legs, the robotic arm 12 can insert the ureteroscope 32 along a virtual rail 33 directly through the urethra into the patient's lower abdomen.

[0072] After insertion into the urethra using control techniques similar to those in bronchoscopy, the ureteroscope 32 can be navigated to the bladder, ureters, and / or kidneys for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 can be directed to the ureter and kidney to fragment accumulated kidney stones using a laser lithotriptor or ultrasonic lithotriptor device deployed through the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed through the ureteroscope 32.

[0073] FIG. 4 illustrates an embodiment of a robot-enabled system similarly positioned for a vascular procedure. In a vascular procedure, the system 10 may be configured such that the cart 11 can deliver a medical instrument 34, such as a steerable catheter, to an access point in the femoral artery in the patient's leg. The femoral artery presents both a larger diameter for navigation as well as a less circuitous and tortuous path to the patient's heart, simplifying navigation. As in a ureteroscopy procedure, the cart 11 may be positioned toward the patient's leg and lower abdomen to enable the robotic arm 12 to provide a virtual rail 35 with direct linear access to the femoral artery access point in the patient's thigh / hip region. After insertion into the artery, the medical instrument 34 may be oriented and inserted by translating the instrument driver 28. Alternatively, the cart may be positioned around the patient's upper abdomen to reach alternative vascular access points, such as the carotid and brachial arteries near the shoulder and wrist.

[0074] B. Robot System - Table An embodiment of a robot-enabled medical system can also incorporate a patient table. The incorporation of a table reduces the amount of capital equipment in the operating room by removing the cart and allows better access to the patient. FIG. 5 illustrates one embodiment of such a robot-enabled system deployed for a bronchoscopy procedure. The system 36 includes a support structure or column 37 for supporting a platform 38 (shown as a "table" or "bed") across the floor. Much like a cart-based system, the end effector of the robotic arm 39 of the system 36 includes an instrument driver 42 that is designed to manipulate an elongated medical instrument, such as the bronchoscope 40 of FIG. 5, through or along a virtual rail 41 formed from the linear alignment of the instrument driver 42. In practice, a C-arm for providing fluoroscopic imaging can be positioned across the patient's upper abdominal region by placing emitters and detectors around the table 38.

[0075] FIG. 6 provides an alternative view of the system 36 without the patient and medical instruments for discussion purposes. As shown, the column 37 may include one or more carriages 43, shown as a ring shape, in the system 36, which may be the base for one or more robotic arms 39. The carriages 43 may translate along a vertical column interface 44 that runs the length of the column 37 to provide different vantage points from which the robotic arms 39 may be positioned to reach the patient. The carriages 43 may rotate about the column 37 using a mechanical motor positioned within the column 37 to allow the robotic arms 39 to access multiple sides of the table 38, such as both sides of the patient. In embodiments having multiple carriages, the carriages may be positioned separately on the column and may translate and / or rotate independently of the other carriages. The carriages 43 do not have to surround the column 37 or even be circular, although the ring shape shown facilitates rotation of the carriages 43 about the column 37 while maintaining structural balance. Rotation and translation of carriage 43 allows the system to align medical instruments such as endoscopes and laparoscopes to different access points on the patient. In other embodiments (not shown), system 36 may include a patient table or bed with an adjustable arm support in the form of a bar or rail extending alongside it. One or more robotic arms 39 may be attached to the adjustable arm support that can be adjusted vertically (e.g., via a shoulder with an elbow joint). By providing vertical adjustment, robotic arms 39 may advantageously be stored compactly under a patient table or bed and then raised during a procedure.

[0076] The arm 39 may be attached to the carriage via a set of arm mounts 45, which include a series of joints that may individually rotate and / or telescope to provide additional configurability to the robotic arm 39. Additionally, the arm mounts 45 may be positioned on the carriage 43 such that when the carriage 43 is appropriately rotated, the arm mounts 45 may be positioned on either the same side of the table 38 (as shown in FIG. 6), on opposite sides of the table 38 (as shown in FIG. 9), or on adjacent sides of the table 38 (not shown).

[0077] The column 37 structurally provides support for the table 38 and a path for the vertical translation of the carriage. Internally, the column 37 may be equipped with a lead screw for guiding the vertical translation of the carriage and a motor for mechanizing the translation of that carriage based on the lead screw. The column 37 may transmit power and control signals to the carriage 43 and to a robotic arm 39 attached thereto.

[0078] The table base 46 functions similarly to the cart base 15 of the cart 11 shown in FIG. 2, housing the heavier components to counterbalance the table / bed 38, column 37, carriage 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during the procedure. The casters extend from the bottom of the table base 46 in opposite directions on either side of the base 46 and may be retracted when the system 36 needs to be moved.

[0079] Continuing with FIG. 6, the system 36 may also include a tower (not shown) that divides the functionality of the system 36 between the table and the tower to reduce the form factor and bulk of the table. As seen in the previously disclosed embodiments, the tower may provide various support functions to the table, such as processing, computing, and control capabilities, power, fluidics, and / or optical and sensor processing. The tower may also be mobile for positioning away from the patient to improve physician access and keep the operating room clutter-free. Additionally, placing components in the tower allows for more storage space in the table base for possible accommodation of a robotic arm. The tower may also include a master controller or console that provides both a user interface for user input, such as a keyboard and / or pendant, and a display screen (or touch screen) for pre-operative and intra-operative information, such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also include a holder for a gas tank used for ventilation.

[0080] In some embodiments, the table base may house and store the robot arm when not in use. Figure 7 illustrates a system 47 for housing the robot arm in one embodiment of a table-based system. In the system 47, the carriage 48 may be vertically translated into the base 49 to house the robot arm 50, arm mount 51, and carriage 48 within the base 49. The base cover 52 may be translated and retracted open to deploy the carriage 48, arm mount 51, and arm 50 about a column 53, and closed to store and protect them when not in use. The base cover 52 may be sealed with a membrane 54 along the edge of its opening to prevent dirt and fluid ingress when closed.

[0081] FIG. 8 illustrates one embodiment of a robotic table-based system configured for a ureteroscopy procedure. For ureteroscopy, the table 38 may include a swivel 55 for positioning the patient at an off angle from the column 37 and table base 46. The swivel 55 may rotate or pivot about a pivot point (e.g., located below the patient's head) to position the bottom of the swivel 55 away from the column 37. For example, pivoting the swivel 55 may position a C-arm (not shown) over the patient's lower abdomen without competing for space with the column (not shown) below the table 38. By rotating the carriage 35 (not shown) about the column 37, the robotic arm 39 may insert the ureteroscope 56 directly into the patient's groin area along a virtual rail 57 to reach the urethra. For ureteroscopy, stirrups 58 may be secured to swivel portion 55 of table 38 to support the position of the patient's legs during the procedure and allow clear access to the patient's groin area.

[0082] In a laparoscopic procedure, minimally invasive instruments may be inserted into a patient's anatomy through small incisions in the patient's abdominal wall. In some embodiments, the minimally invasive instruments include an elongated rigid member, such as a shaft, that is used to access anatomy within the patient. After distension of the patient's abdominal cavity, the instruments may be oriented to perform a surgical or medical task, such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may include a scope, such as a laparoscope. FIG. 9 illustrates one embodiment of a robotic table-based system configured for laparoscopic procedures. As shown in FIG. 9, the carriage 43 of the system 36 may be rotated and vertically adjusted to position a pair of robotic arms 39 on either side of the table 38 such that the instruments 59 may be positioned using the arm mounts 45 to pass through minimal incisions on either side of the patient to reach the patient's abdominal cavity.

[0083] To accommodate laparoscopic procedures, the robotic-enabled table system may also tilt the platform to a desired angle. FIG. 10 illustrates one embodiment of a robotic-enabled medical system with pitch or tilt adjustment. As shown in FIG. 10, the system 36 accommodates the tilt of the table 38 to position one portion of the table higher off the floor than another portion. Additionally, the arm mount 45 may rotate to match the tilt such that the arm 39 maintains the same planar relationship as the table 38. To accommodate steeper angles, the column 37 may also include a telescoping portion 60 that allows for vertical extension of the column 37 to prevent the table 38 from contacting the floor or colliding with the base 46.

[0084] FIG. 11 provides a detailed illustrative view of the interface between the table 38 and the column 37. The pitch mechanism 61 may be configured to vary the pitch angle of the table 38 relative to the column 37 in multiple degrees of freedom. The pitch mechanism 61 may be enabled by positioning orthogonal axes 1, 2 at the column-table interface, each actuated by a separate motor 3, 4 in response to an electrical pitch command. Rotation along one screw 5 would allow tilt adjustment in one axis 1, while rotation along the other screw 6 would allow tilt adjustment along the other axis 2. In some embodiments, the use of ball joints allows the pitch angle of the table 38 relative to the column 37 to be varied in multiple degrees of freedom.

[0085] For example, pitch adjustment is particularly useful when attempting to position the table in the Trendelenburg position, i.e., positioning the patient's lower abdomen higher off the floor than the patient's lower abdomen for lower abdominal surgery. The Trendelenburg position allows gravity to slide the patient's internal organs down to the patient's upper abdomen, emptying the abdominal cavity for entry of minimally invasive tools to perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

[0086] 12 and 13 illustrate isometric and end views of an alternative embodiment of a table-based surgical robotic system 100. The surgical robotic system 100 includes one or more adjustable arm supports 105 that can be configured to support one or more robotic arms relative to a table 101 (see, e.g., FIG. 14). In the illustrated embodiment, only one adjustable arm support 105 is shown, but additional arm supports can be provided on the opposite side of the table 101. The adjustable arm support 105 can be configured to move relative to the table 101 to adjust and / or change the position of the adjustable arm support 105 and / or any robotic arm attached thereto relative to the table 101. For example, the adjustable arm support 105 can be adjusted with one or more degrees of freedom relative to the table 101. The adjustable arm support 105 provides the system 100 with great versatility, including the ability to easily accommodate one or more adjustable arm supports 105 and any robotic arms attached thereto under the table 101. The adjustable arm support 105 can be raised from a stowed position to a position below the top surface of the table 101. In other embodiments, the adjustable arm support 105 can be raised from a stowed position to a position above the top surface of the table 101.

[0087] The adjustable arm support 105 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment of Figs. 12 and 13, the arm support 105 is configured with four degrees of freedom, which are illustrated by arrows in Fig. 12. The first degree of freedom allows adjustment of the adjustable arm support 105 in the z-direction ("Z-lift"). For example, the adjustable arm support 105 can include a carriage 109 configured to move up and down along or relative to the column 102 that supports the table 101. The second degree of freedom can allow the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 can include a rotational joint, which can allow the adjustable arm support 105 to align with the bed in the Trendelenburg position. The third degree of freedom allows the adjustable arm support 105 to "pivot up," which can be used to adjust the distance between the side of the table 101 and the adjustable arm support 105. A fourth degree of freedom may allow translation of the adjustable arm support 105 along the longitudinal length of the table.

[0088] The surgical robotic system 100 of Figures 12 and 13 may include a table supported by a column 102 mounted to a base 103. The base 103 and column 102 support the table 101 against a support surface. A bed axis 131 and a support axis 133 are shown in Figure 13.

[0089] An adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the table 101 or the base 103. The adjustable arm support 105 can include a carriage 109, a bar or rail connector 111, and a bar or rail 107. In some embodiments, one or more robot arms mounted to the rail 107 can translate and move relative to each other.

[0090] The carriage 109 may be attached to the column 102 by a first joint 113, which allows the carriage 109 to move relative to the column 102 (e.g., up and down a first or vertical axis 123). The first joint 113 may provide a first degree of freedom ("Z-lift") to the adjustable arm support 105. The adjustable arm support 105 may include a second joint 115 that provides a second degree of freedom (tilt) to the adjustable arm support 105. The adjustable arm support 105 may include a third joint 117 that may provide a third degree of freedom ("pivot up") to the adjustable arm support 105. A further joint 119 (shown in FIG. 13) may be provided that mechanically constrains the third joint 117 to maintain the orientation of the rail 107 as the rail connector 111 rotates about a third axis 127. The adjustable arm support 105 may include a fourth joint 121 that may provide a fourth degree of freedom (translation) to the adjustable arm support 105 along a fourth axis 129 .

[0091] FIG. 14 illustrates an end view of a surgical robotic system 140A with two adjustable arm supports 105A, 105B mounted on either side of a table 101. A first robotic arm 142A is attached to a bar or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A attached to the rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can be attached to one or more robotic medical instruments or tools. Similarly, the second robotic arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to attach to one or more robotic medical instruments or tools.

[0092] In some embodiments, one or more of the robotic arms 142A, 142B comprise arms with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B can include eight degrees of freedom, including an insertion axis (one degree of freedom including insertion), wrist (three degrees of freedom including wrist pitch, yaw and roll), elbow (one degree of freedom including elbow pitch), shoulder (two degrees of freedom including shoulder pitch and yaw), and base 144A, 144B (one degree of freedom including translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arms 142A, 142B, while in other embodiments, the instrument itself provides the insertion via an instrument-based insertion architecture.

[0093] C. Instrument Drivers and Interfaces The end effector of the robotic arm of the system includes (i) an instrument driver (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator") that incorporates electromechanical means for actuating the medical instrument, and (ii) a removable or detachable medical instrument that may lack any electromechanical components such as a motor. This dichotomy may be caused by the need to sterilize the medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to the complex mechanical assembly and sensitive electronics of the medical instruments. Thus, the medical instruments may be designed to be detached, removed, and replaced from the instrument driver (and thus the system) upon individual sterilization or disposal by the physician or physician's staff. In contrast, the instrument driver does not need to be replaced or sterilized and may be draped for protection.

[0094] FIG. 15 illustrates an exemplary instrument driver. The instrument driver 62, positioned at the distal end of the robotic arm, is comprised of one or more drive units 63 arranged with parallel axes to provide a controlled torque to the medical instrument via a drive shaft 64. Each drive unit 63 includes an individual drive shaft 64 for interacting with the instrument, a gearhead 65 for converting motor shaft rotation to a desired torque, a motor 66 for generating the drive torque, an encoder 67 for measuring the rotational speed of the motor shaft and providing feedback to the control circuitry, and a control circuit 68 for receiving control signals to operate the drive unit. Each drive unit 63 is controlled and motorized independently of the others, and the instrument driver 62 may provide multiple (four shown in FIG. 15) independent drive outputs to the medical instrument. In operation, the control circuit 68 would receive the control signal, send a motor signal to the motor 66, compare the resulting motor rotational speed measured by the encoder 67 to a desired speed, and modulate the motor signal to generate the desired torque.

[0095] For procedures requiring a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile drape, located between the instrument driver and the medical instrument. The primary purpose of the sterile adapter is to transfer angular motion from the drive shaft of the instrument driver to the drive input of the instrument while maintaining physical separation between the drive shaft and the drive input, and thus sterility. Thus, an example sterile adapter may consist of a set of rotational inputs and outputs intended to mate with the drive shaft of the instrument driver and the drive input to the instrument. The sterile drape, which is connected to the sterile adapter, is composed of a thin flexible material, such as a transparent or translucent plastic, and is designed to cover the instrument driver, the robotic arm, and capital equipment, such as a cart (in a cart-based system) or a table (in a table-based system). The use of the drape allows the capital equipment to be positioned in close proximity to the patient while still being located in an area that does not require sterility (i.e., the non-sterile field). On the other side of the sterile drape, the medical instrument may interface with the patient in an area that requires sterility (i.e., the sterile field).

[0096] D. Medical equipment 16 illustrates an exemplary medical instrument with a paired instrument driver. Similar to other instruments designed for use with a robotic system, the medical instrument 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as an "instrument handle" due to its design intended for manual interaction by a physician, may include a rotary drive input 73, e.g., a receptacle, pulley, or spool, designed to mate with a drive output 74 that passes through a drive interface on an instrument driver 75, typically at the distal end of a robotic arm 76. When physically connected, latched, and / or coupled, the mating drive input 73 of the instrument base 72 may share an axis of rotation with the drive output 74 in the instrument driver 75 to allow for the transfer of torque from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may include a spline designed to mate with a receptacle on the drive input 73.

[0097] The elongated shaft 71 is designed to be delivered through either an anatomical opening or lumen, such as in an endoscope, or a minimally invasive incision, such as in a laparoscopy. The elongated shaft 71 can be either flexible (e.g., having properties similar to an endoscope) or rigid (e.g., having properties similar to a laparoscope), or can include a customized combination of both flexible and rigid sections. If designed for laparoscopy, the distal end of the rigid elongated shaft can be connected to an end effector extending from an articulating wrist formed from a clevis having at least one degree of freedom, and to a surgical tool or medical instrument, such as a grasper or scissors, that can be actuated based on a force from a tendon as the drive input rotates in response to a torque received from the drive output 74 of the instrument driver 75. If designed for endoscopy, the distal end of the flexible elongated shaft can include a steerable or controllable bend that can be articulated and bent based on a torque received from the drive output 74 of the instrument driver 75.

[0098] Torque from the instrument driver 75 is transmitted downstream of the elongated shaft 71 using tendons along the shaft 71. These individual tendons, such as pull wires, can be individually secured to individual drive inputs 73 in the instrument handle 72. From the handle 72, the tendons pass along the elongated shaft 71 through one or more pull lumens and are secured to a distal portion of the elongated shaft 71 or are secured to a wrist at the distal portion of the elongated shaft. During a surgical procedure, such as a laparoscopic, endoscopic, or hybrid procedure, these tendons can be coupled to a distally mounted end effector, such as a wrist, grasper, or scissors. In such an arrangement, torque exerted on the drive input 73 would transmit tension to the tendons, thereby actuating the end effector in some manner. In some embodiments, the tendons can rotate a joint about an axis to move the end effector in one direction or another during a surgical procedure. Alternatively, the tendon may be connected to one or more jaws of a grasper at the distal end of the elongate shaft 71 such that tension from the tendon causes the grasper to close.

[0099] In endoscopy, the tendons may be coupled to a bend or articulating section positioned along (e.g., at the distal end) of the elongate shaft 71 via adhesive, control rings, or other mechanical fixation. When fixedly attached to the distal end of the bend section, torque exerted on the drive input 73 is transferred to the tendons, causing the softer bend section (sometimes referred to as the articulating section or articulating region) to bend or articulate. Along the non-bend section, it may be convenient to helical or spiral the individual pull lumens that direct the individual tendons along (or inwardly) the wall of the endoscope shaft to counterbalance the radial forces resulting from tension in the pull wires. The angle of the helix and / or spacing between them may be altered or engineered for specific purposes, with narrower helices exhibiting poor shaft compression under load forces, while lesser helices provide superior shaft compression under load forces, but also limited bending. At the other end of the spectrum, orienting the pull lumen parallel to the longitudinal axis of the elongate shaft 71 can allow for controlled articulation at the desired bend or articulation.

[0100] In endoscopy, the elongated shaft 71 houses several components that aid in robotic procedures. The elongated shaft may be configured with a working channel for deploying surgical tools (or medical instruments), irrigation, and / or suction to a surgical site at the distal end of the shaft 71. The elongated shaft 71 may also house wires and / or optical fibers that carry signals at the distal tip to / from an optical assembly that may include an optical camera. The shaft 71 may also house optical fibers for carrying light from a proximally located light source, such as a light emitting diode, to the distal end of the shaft.

[0101] At the distal end of the instrument 70, the distal tip may include a working channel opening for delivering tools to the surgical site for diagnosis and / or treatment, irrigation, and aspiration. The distal tip may also include a port for a camera, such as a fiberscope or digital camera, to capture images of the internal anatomical space. In this regard, the distal tip may also include a port for a light source to illuminate the anatomical space when the camera is in use.

[0102] 16, the drive shaft axis, and therefore the drive input axis, is orthogonal to the axis of the elongated shaft. However, this arrangement complicates the roll ability of the elongated shaft 71. Rolling the elongated shaft 71 along its axis while holding the drive input 73 stationary results in undesirable entanglement of the tendons as they exit the drive input 73 and enter the pull lumen within the elongated shaft 71. Such resulting entanglement of tendons may frustrate any control algorithms aimed at predicting the movement of a flexible elongated shaft during an endoscopic procedure.

[0103] FIG. 17 illustrates an alternative design of the instrument driver and instrument, in which the axis of the drive unit is parallel to the axis of the elongated shaft of the instrument. As shown, a circular instrument driver 80 includes four drive units with their drive outputs 81 aligned in parallel at the end of a robotic arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument driver 80 that is driven by one of the drive units in that assembly 83. In response to torque provided by the rotating drive units, the rotating assembly 83 rotates along a circular bearing that connects the rotating assembly 83 to a non-rotating portion 84 of the instrument driver. Power and control signals may be transferred to the rotating assembly 83 from the non-rotating portion 84 of the instrument driver 80 via electrical contacts and may be maintained throughout the rotation by a brushed slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be responsive to a separate drive unit that is integrated into the non-rotatable portion 84 and thus not parallel to the other drive units. The rotation mechanism 83 enables the instrument driver 80 to rotate the drive units and their respective drive outputs 81 as a single unit about the instrument driver axis 85 .

[0104] Similar to the previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown with a transparent exterior skin for purposes of discussion) that includes a number of drive inputs 89 (such as receptacles, pulleys, and spools) configured to receive the drive outputs 81 in the instrument driver 80. Unlike the previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87, with the axis being substantially parallel to the axis of the drive inputs 89, rather than orthogonal as seen in the design of FIG.

[0105] When coupled to the rotating assembly 83 of the instrument driver 80, the medical instrument 86, including the instrument base 87 and the instrument shaft 88, rotates with the rotating assembly 83 about the instrument driver axis 85. Because the instrument shaft 88 is positioned in the center of the instrument base 87, the instrument shaft 88 is coaxial with the instrument driver axis 85 when attached. Rotation of the rotating assembly 83 therefore causes the instrument shaft 88 to rotate about its own longitudinal axis. Also, because the instrument base 87 rotates with the instrument shaft 88, any tendons connected to the drive input 89 at the instrument base 87 do not become entangled during rotation. Thus, the parallelism of the axes of the drive output 81, drive input 89, and instrument shaft 88 allows shaft rotation without entangling any of the control tendons.

[0106] FIG. 18 illustrates an instrument having an instrument-based insertion architecture, according to some embodiments. The instrument 150 can be coupled to any of the instrument drivers discussed above. The instrument 150 includes an elongated shaft 152, an end effector 162 connected to the elongated shaft 152, and a handle 170 coupled to the elongated shaft 152. The elongated shaft 152 includes a tubular member having a proximal portion 154 and a distal portion 156. The elongated shaft 152 includes one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180. Thus, the one or more cables 180 run along the outer surface of the elongated shaft 152. In other embodiments, the cables 180 can run through the elongated shaft 152. Manipulation of one or more of the cables 180 (e.g., via an instrument driver) results in actuation of the end effector 162.

[0107] The instrument handle 170, sometimes referred to as the instrument base, may typically include a mounting interface 172 having one or more mechanical inputs 174, e.g., receptacles, pulleys or spools, designed to intermate with one or more torque couplers on a mounting surface of the instrument driver.

[0108] In some embodiments, instrument 150 includes a series of pulleys or cables that allow elongated shaft 152 to translate relative to handle 170. In other words, instrument 150 itself constitutes an instrument-based insertion architecture that accommodates the insertion of the instrument, thereby minimizing reliance on a robotic arm to effect the insertion of instrument 150. In other embodiments, the robotic arm may be significantly involved in the insertion of the instrument.

[0109] E. Controller Any of the robotic systems described herein can include an input device or controller for manipulating an instrument attached to the robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electrically, wirelessly, and / or mechanically) to the instrument such that manipulation of the controller causes a corresponding manipulation of the instrument, e.g., via master-slave control.

[0110] 19 is a perspective view of one embodiment of the controller 182. In this embodiment, the controller 182 includes a hybrid controller that can include both impedance control and admittance control. In other embodiments, the controller 182 can only utilize impedance control, i.e., passive control. In other embodiments, the controller 182 can only utilize admittance control. Advantageously, being a hybrid controller allows the controller 182 to have a lower perceived inertia during use.

[0111] In the illustrated embodiment, the controller 182 is configured to enable operation of two medical instruments and includes two handles 184. Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.

[0112] 19, each positioning platform 188 includes a SCARA arm (Selectively Compliant Assembly Robot Arm) 198 coupled to a column 194 by a prismatic joint 196. The prismatic joint 196 is configured to translate along the column 194 (e.g., along a rail 197) to allow each of the handles 184 to translate in the z-direction, providing a first degree of freedom. The SCARA arm 198 is configured to allow movement of the handles 184 in the xy-plane, providing an additional two degrees of freedom.

[0113] In some embodiments, one or more load cells are positioned within the controller. For example, in some embodiments, a load cell (not shown) is positioned on the body of each of the gimbals 186. By providing a load cell, a portion of the controller 182 can operate under admittance control, thereby advantageously reducing the perceived inertia of the controller during use. In some embodiments, the positioning platform 188 is configured for admittance control while the gimbal 186 is configured for impedance control. In other embodiments, the positioning platform 188 is configured for impedance control while the gimbal 186 is configured for admittance control. Thus, in some embodiments, the translational or positional degree of freedom of the positioning platform 188 can rely on admittance control, while the rotational degree of freedom of the gimbal 186 is determined by impedance control.

[0114] F. Navigation and Control Traditional endoscopy may involve the use of fluoroscopy (e.g., as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide intraluminal guidance to the operator-physician. In contrast, the robotic system contemplated by the present disclosure may provide non-radiation-based navigation and localization means to reduce the physician's exposure to radiation and reduce the amount of equipment in the operating room. As used herein, the term "localization" may refer to determining and / or monitoring the position of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to achieve a radiation-free surgical environment. In other cases where radiation-based imaging modalities are still used, preoperative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to improve information available only through radiation-based imaging modalities.

[0115] FIG. 20 is a block diagram illustrating a localization system 90 for estimating the position of one or more elements of a robotic system, such as the position of an instrument, according to an exemplary embodiment. The localization system 90 may be a set of one or more computing devices configured to execute one or more instructions. The computing devices may be embodied by a processor (or processors) and computer readable memory in one or more of the components discussed above. By way of example, and not limitation, the computing devices may be in the tower 30 shown in FIG. 1, the cart shown in FIGS. 1-4, or the bed shown in FIGS. 5-14.

[0116] 20, the localization system 90 may include a localization module 95 that processes the input data 91-94 to generate position data 96 of the distal tip of the medical instrument. The position data 96 may be data or logic that represents the location and / or orientation of the distal tip of the instrument relative to a frame of reference. The frame of reference may be relative to the patient's anatomy or relative to a known object such as an EM field generator (see discussion of EM field generators below).

[0117] The various input data 91-94 will now be described in more detail. Pre-operative mapping can be accomplished through the use of acquisition of low-dose CT scans. The pre-operative CT scans are reconstructed into three-dimensional images that are visualized, for example, as cutaway "slices" of the patient's internal anatomy. When analyzed as a whole, image-based models can be developed that cover the anatomical cavities, anatomical spaces, and anatomical structures of the patient's anatomy, such as the patient's pulmonary network. Techniques such as centerline geometry can be determined and approximated from the CT images to create a three-dimensional volume of the patient's anatomy, referred to as model data 91 (also referred to as "pre-operative model data" when developed using only pre-operative CT scans). The use of centerline geometry is discussed in U.S. Patent Application Serial No. 14 / 523,760, the contents of which are incorporated herein in their entirety. Network topological models can also be derived from CT images and are particularly suitable for bronchoscopy.

[0118] In some embodiments, the instrument may be equipped with a camera to provide visual data 92. A localization module 95 may process the visual data to enable one or more vision-based location tracking. For example, pre-operative model data may be used in conjunction with the visual data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope, or an instrument advancing through a working channel of the endoscope). For example, using the pre-operative model data 91, the robotic system may generate a model-based predicted endoscopic image library based on the expected path of travel of the endoscope, with each image linked to a location in the model. During surgery, this library may be referenced by the robotic system to compare real-time images captured by a camera (e.g., a camera at the distal end of the endoscope) to those in the image library to aid in localization.

[0119] Other computer vision based tracking techniques use feature tracking to determine the motion of the camera and therefore the endoscope. Some features of the localization module 95 may identify a circular geometry in the pre-operative model data 91 that corresponds to an anatomical lumen and track changes in that geometry to ascertain which anatomical lumen has been selected and the relative rotational and / or translational motion of the camera. The use of a phase map may further enhance vision-based algorithms or techniques.

[0120] Optical flow, another computer vision based technique, may analyze the displacement and translation of image pixels in a video sequence in the visual data 92 to infer camera movement. Examples of optical flow techniques may include motion detection, object segmentation computations, luminance, motion compensated coding, stereo disparity measurements, etc. By comparing multiple frames over multiple iterations, the movement and location of the camera (and therefore the endoscope) may be determined.

[0121] The localization module 95 may use real-time EM tracking to generate a real-time position of the endoscope in a global coordinate system that may be registered to the patient's anatomy represented by the pre-operative model. In EM tracking, an EM sensor (or tracker), consisting of one or more sensor coils embedded in a medical instrument (e.g., an endoscopic instrument) at one or more locations and orientations, measures the variations in the EM field produced by one or more static EM field generators positioned at known locations. The location information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) may be placed near the patient to produce a low-intensity magnetic field that the embedded sensor can detect. The magnetic field induces a small current in the sensor coil of the EM sensor, which may be analyzed to determine the spacing and angle between the EM sensor and the EM field generator. These spacings and orientations may be "registered" intraoperatively to the patient's anatomy (e.g., the pre-operative model) to ascertain a geometric transformation that aligns only one location in the coordinate system with a location in the pre-operative model of the patient's anatomy. Once registered, an EM tracker embedded at one or more locations on the medical instrument (e.g., the distal tip of an endoscope) can provide a real-time indication of the medical instrument's progression through the patient's anatomy.

[0122] The robotic commands and kinematic data 94 may also be used by a localization module 95 to provide localization data 96 for the robotic system. During pre-operative calibration, the device pitch and yaw resulting from the articulation commands may be determined. Intra-operatively, these calibration measurements may be used in combination with known insertion depth information to estimate the position of the instrument. Alternatively, these calculations may be analyzed in combination with EM, vision, and / or phase modeling to estimate the position of the medical instrument within the network.

[0123] As Fig. 20 illustrates, several other input data may be used by the localization module 95. For example, although not shown in Fig. 20, an instrument utilizing shape sensing fibers may provide shape data that the localization module 95 can use to ascertain the position and shape of the instrument.

[0124] The localization module 95 may use a combination of the input data 91-94. In some cases, such combination may use a probabilistic approach in which the localization module 95 assigns confidence weights to the locations identified from each of the input data 91-94. Thus, if the EM data is unreliable (such as in the presence of EM interference), the reliability of the locations identified by the EM data 93 may be reduced, and the localization module 95 may rely more heavily on the vision data 92 and / or the robot command and kinematics data 94.

[0125] As discussed above, the robotic systems discussed herein can be designed to incorporate one or a combination of two or more of the above-mentioned technologies. The computer-based control system of the tower, bed, and / or cart-based robotic system may store, for example, in a non-transitory computer-readable storage medium, such as a persistent magnetic storage drive, solid-state drive, etc., computer program instructions that, when executed, cause the system to receive and analyze sensor data and user commands, generate system-wide control signals, and display navigation and localization data, such as instrument position within a global coordinate system, anatomical maps, etc.

[0126] 2. Off-screen indicators The present application discloses a robotic medical system that determines if a tool is located outside of a surgical field of view provided by a camera. Based on this data, the system can provide an indication of the tool's location.

[0127] In some embodiments, the robotic medical system can provide instructions via a user interface or display of the robotic medical system, for example, in some embodiments, the robotic medical system provides a visual indication of the location (or relative orientation) of the tool.

[0128] In some embodiments, the robotic medical system updates the visual display in response to determining that the tool has changed its location (e.g., the tool has changed its relative orientation to the field of view or its distance to the field of view).

[0129] In some embodiments, the visual indication is provided only when at least one tool is located outside the field of view. In some embodiments, the visual indication is provided regardless of whether any tools are located outside the field of view. In some embodiments, the robotic medical system provides the visual indication in response to (or while) receiving a request to provide the visual indication. In some embodiments, the robotic medical system stops providing the visual indication in response to determining that the request to provide the visual indication has stopped or in response to receiving a request to stop displaying the visual indication.

[0130] A. Robot System FIG. 21 illustrates an exemplary robotic medical system 200 according to some embodiments. In some embodiments, the robotic medical system 200 is a robotic surgery system. In the example of FIG. 21, the robotic medical system 200 includes a patient support platform 202 (e.g., a patient platform, a table, a bed, etc.). Two ends along the length of the patient support platform 202 are referred to as the "head" and the "foot", respectively. Two sides of the patient support platform 202 are referred to as the "left" and the "right", respectively. The patient support platform 202 includes a support 204 (e.g., a rigid frame) for the patient support platform 202.

[0131] The robotic medical system 200 also includes a base 206 for supporting the robotic medical system 200. The base 206 includes wheels 208 that allow the robotic medical system 200 to be easily movable or repositionable in a physical environment. In some embodiments, the wheels 208 are omitted from the robotic medical system 200 or can be retracted so that the base 206 can rest directly on the ground or floor. In some embodiments, the wheels 208 are replaced by feet.

[0132] The robotic medical system 200 includes one or more robotic arms 210. The robotic arms 210 can be configured to perform the robotic medical procedures described above with reference to Figures 1-20. Although Figure 21 shows five robotic arms 210, it should be understood that the robotic medical system 200 can include any number of robotic arms, including less than five, or six or more.

[0133] The robotic medical system 200 also includes one or more bars 220 (e.g., adjustable arm supports or adjustable bars) that support the robotic arms 210. Each of the robotic arms 210 is supported on and movably coupled to the bar 220 by the robotic arm's respective base joint. In some embodiments, the bar 220 can provide several degrees of freedom, including lift, lateral translation, tilt, etc., as described in FIG. 12. In some embodiments, each of the robotic arms 210 and / or adjustable arm supports 220 is also referred to as a respective kinematic chain.

[0134] 21 shows three robotic arms 210 supported by a bar 220 within the field of view of the figure. The remaining two robotic arms are supported by another bar located across the other length of the patient support platform 202.

[0135] In some embodiments, the adjustable arm support 220 may be configured to provide a home position for one or more of the robotic arms 210 for a robotic medical procedure. The robotic arm 210 may be positioned relative to the patient support platform 202 by translating the robotic arm 210 along the length of the underlying bar 220 and / or by adjusting the position and / or orientation of the robotic arm 210 via one or more joints and / or links (see, e.g., FIG. 23 ). In some embodiments, the bar pose may be changed via manual, remote, and / or power-assisted movement.

[0136] In some embodiments, the adjustable arm support 220 can be translated along the length of the patient support platform 202. In some embodiments, translation of the bar 220 along the length of the patient support platform 202 causes one or more of the robotic arms 210 supported by the bar 220 to translate simultaneously with or relative to the bar. In some embodiments, the bar 220 can be translated while one or more of the robotic arms remain stationary relative to the base 206 of the robotic medical system 200.

[0137] 21 , the adjustable arm support 220 is located along the length of the patient support platform 202. In some embodiments, the adjustable arm support 220 may extend across a partial length or the entire length of the patient support platform 202 and / or across a partial width or the entire width of the patient support platform 202.

[0138] According to some embodiments, during a robotic medical procedure, one or more of the robotic arms 210 can also be configured to hold an instrument 212 (e.g., a robotically controlled medical instrument or tool, such as an endoscope and / or any other instrument that may be used during surgery (e.g., a sensor, a lighting instrument, a cutting instrument, etc.)) and / or can be coupled to one or more accessories, including one or more cannulas.

[0139] FIG. 22 illustrates another view of the exemplary robotic medical system 200 of FIG. 21 according to some embodiments. In this example, the robotic medical system 200 includes six robotic arms 210-1, 210-2, 210-3, 210-4, 210-5, and 210-6. The patient platform 202 is supported by columns 214 extending between the base 206 and the patient platform 202. In some embodiments, the patient platform 202 includes a tilt mechanism 216. The tilt mechanism 216 can be positioned between the columns 214 and the patient platform 202 to allow the patient platform 202 to pivot, rotate, or tilt relative to the columns 214. The tilt mechanism 216 can be configured to allow lateral and / or longitudinal tilt of the patient platform 202. In some embodiments, the tilt mechanism 216 allows simultaneous lateral and longitudinal tilt of the patient platform 202.

[0140] FIG. 22 shows the patient platform 202 in a non-tilted state or position. In some embodiments, the non-tilted state or position is the default position of the patient platform 202. In some embodiments, the default position of the patient platform 202 is a substantially horizontal position as shown in FIG. 22. As illustrated, in the non-tilted state, the patient platform 202 can be positioned horizontally or parallel to the surface (e.g., the ground or floor) supporting the robotic medical system 200. In some embodiments, the term "non-tilted" refers to a state in which the angle between the default position and the current position is less than a threshold angle (e.g., less than 5 degrees, or less than an angle that would cause the patient to shift on the patient platform, etc.). In some embodiments, the term "non-tilted" refers to a state in which the patient platform is substantially perpendicular to the direction of gravity, regardless of the angle formed with respect to gravity by the surface supporting the robotic medical system.

[0141] 22 , in the illustrated example of the robotic medical system 200, the patient platform 202 includes a support 204. In some embodiments, the support 204 includes a rigid support structure or frame and can support one or more surfaces, pads, or cushions 222. The upper surface of the patient platform 202 can include a support surface 224. A patient can be placed on the support surface 224 during a medical procedure.

[0142] 22 shows the robotic arm 210 and adjustable arm support 220 in an exemplary deployed configuration, where the robotic arm 210 reaches above the patient platform 202. In some embodiments, the configuration of the robotic medical system 200 allows for storage of different components below the patient platform 202, allowing the robotic arm 210 and arm support 220 to occupy space below the patient platform 202. Thus, in some embodiments, the tilt mechanism 216 has a low profile and / or low volume to increase the space available for storage below.

[0143] FIG. 22 also illustrates an exemplary x, y, and z coordinate system that may be used to describe certain features of the embodiments disclosed herein. It is understood that this coordinate system is provided for purposes of illustration and explanation only, and other coordinate systems may be used. In the illustrated example, the x-direction or x-axis extends laterally across the patient platform 202 when the patient platform 202 is in a non-tilted state. In some configurations, the x-direction extends across the patient platform 202 from one lateral side (e.g., right side) to the other lateral side (e.g., left side) when the patient platform 202 is in a non-tilted state. The y-direction or y-axis extends longitudinally along the patient platform 202 when the patient platform 202 is in a non-tilted state. That is, the y-direction extends along the patient platform 202 from one longitudinal end (e.g., head end) to the other longitudinal end (e.g., foot end) when the patient platform 202 is in a non-tilted state. In the non-tilted state, the patient platform 202 may be in or parallel to an xy plane, which may be parallel to a floor or ground. In the illustrated example, the z direction or z axis extends vertically along the column 214. In some embodiments, the tilt mechanism 216 is configured to laterally tilt the patient platform 202 by rotating the patient platform 202 about a lateral tilt axis parallel to the y axis. The tilt mechanism 216 may further be configured to longitudinally tilt the patient platform 202 by rotating the patient platform 202 about a longitudinal tilt axis parallel to the x axis.

[0144] In some embodiments, the robotic medical system 200 includes a tower 230 (e.g., a tower viewer) or a physician console 240 (or both), as illustrated in FIG. 23 . The tower 230 may correspond to the tower 30 described above and may provide support for control, electronics, fluidics, optics, sensors, and / or power for the patient support platform 202 and the physician console 240. In some embodiments, the tower 230 includes a display device 232. The display device 232 may include a user interface for displaying a surgical view acquired by one or more cameras 606 of the robotic medical system and / or one or more notifications to an operator of the robotic medical system 200. In some embodiments, the physician console 240 may include a display device 242 having a user interface used by the physician operator to operate the patient support platform 202. For example, the display device 242 may include a user interface for displaying a surgical view acquired by one or more cameras 606 of the robotic medical system and / or one or more notifications to an operator of the robotic medical system 200. The physician console 240 can provide the physician operator with both robotic control and pre-operative and real-time information of the medical procedure. In some embodiments, the physician console 240 includes one or more input devices, such as a foot pedal 244 (e.g., buttons, switches, touch-sensitive surfaces, gimbals, etc.).

[0145] B. Robot arm 24A-24C illustrate different views of an exemplary robotic arm 210, according to some embodiments.

[0146] 24A shows that the robot arm 210 includes multiple links (e.g., linkages) 302. The links 302 (e.g., 302-1 to 302-4) are connected by one or more joints 304 (e.g., 304-1 to 304-5). Each of the joints 304 includes one or more degrees of freedom (DoF).

[0147] In FIG. 24A, the joint 304 includes a first joint 304-1 (e.g., a base joint or A0 joint) located at or near the base 306 of the robot arm 210. In some embodiments, the base joint 304-1 includes a prism joint that allows the robot arm 210 to translate along the bar 220 (e.g., along the y-axis). The joint 304 also includes a second joint 304-2. In some embodiments, the second joint 304-2 rotates relative to the base joint 304-1. The joint 304 also includes a third joint 304-3 connected to one end of the link 302-2. In some embodiments, the joint 304-3 includes multiple DoFs to facilitate both tilt and rotation of the link 302-2 tilt relative to the joint 304-3.

[0148] 24A also shows a fourth joint 304-4 connected to the other end of link 302-2. In some embodiments, joint 304-4 includes an elbow joint connecting link 302-2 and link 302-3. Joint 304 further includes a pair of joints 304-5 (e.g., a wrist roll joint) and 304-6 (e.g., a wrist pitch joint) located at a distal portion of robot arm 210.

[0149] The proximal end of the robotic arm 210 may be connected to a base 306, and the distal end of the robotic arm 210 may be connected to an advanced device manipulator (ADM) 308 (e.g., a tool driver, an instrument driver, or a robotic end effector, etc.). The ADM 308 may be configured to control the positioning and manipulation of medical instruments (e.g., tools, scopes, etc.).

[0150] The robotic arm 210 may also include a cannula sensor 310 for detecting the presence of a cannula or the proximity of a cannula to the robotic arm 210. In some embodiments, when the cannula sensor 310 detects the presence of a cannula (e.g., via one or more processors of the robotic medical system 200), the robotic arm 210 is placed in a docked state (e.g., a docked position). In some embodiments, when the robotic arm 210 is in the docked position, the robotic arm 210 may perform null space motion to maintain the position and / or orientation of the cannula, as discussed in more detail below. Conversely, when a cannula is not detected by the cannula sensor 310, the robotic arm 210 is placed in an undocked state (e.g., an undocked position).

[0151] In some embodiments, as illustrated in FIG. 24A , the robotic arm 210 includes an input or button 312 (e.g., a donut-shaped button, or other type of control, etc.) that can be used to put the robotic arm 210 into admittance mode (e.g., by pressing the button 312). The admittance mode is also referred to as an admittance scheme or admittance control. In the admittance mode, the robotic system 210 measures forces and / or torques (e.g., applied to the robotic arm 210) and outputs a corresponding velocity and / or position. In some embodiments, the robotic arm 210 can be manually manipulated by a user in the admittance mode (e.g., during a setup procedure, or between procedures, etc.). In some examples, by using admittance control, an operator does not need to overcome all of the inertia in the robotic medical system 200 to move the robotic arm 210. For example, under admittance control, when an operator applies a force to the arm, the robotic medical system 200 can assist the operator in moving the robotic arm 210 by measuring the force and driving one or more motors associated with the robotic arm 210, thereby resulting in a desired velocity and / or position of the robotic arm 210.

[0152] In some embodiments, the link 302 may be removably coupled to the medical tool 212 (e.g., to facilitate attachment and detachment of the medical tool 212 to the robotic arm 210). The joint 304 provides the robotic arm 210 with multiple degrees of freedom (DoF) that facilitates control of the medical tool 212 via the ADM 308. In one embodiment, such as shown in FIG. 22, including multiple robotic arms, each robotic arm can hold its own respective medical instrument and pivot the medical instrument about a remote center of motion.

[0153] FIG. 24B illustrates a front view of the robot arm 210. FIG. 24C illustrates a perspective view of the robot arm 210. In some embodiments, the robot arm 210 includes a second input or button 314 (e.g., a push button) different from the button 312 of FIG. 24A to put the robot arm 210 into impedance mode (e.g., by pressing the button 314 once or continuously). In this example, the button 314 is located between the joints 304-5 and 304-6. The impedance mode is also referred to as impedance scheme or impedance control. In the impedance mode, the robotic medical system 200 measures displacements (e.g., changes in position and velocity) and outputs forces and / or torques to facilitate manual movement of the robot arm. In some embodiments, the robot arm 210 can be manually operated by a user in the impedance mode (e.g., during a set-up procedure). In some embodiments, under impedance mode, operator movement of a portion of the robotic arm 210 can cause movement of one or more joints and / or links of the entire robotic arm 210.

[0154] In some embodiments, for admittance control, force sensors or load cells can measure the force an operator is applying to the robotic arm 210 and move the robotic arm 210 in a way that feels lighter. Under admittance control, motors in the controller can help accelerate the mass, thus hiding the perceived inertia of the robotic arm 210, so admittance control can feel lighter than impedance control. In contrast, with impedance control, according to some embodiments, the user is involved in most, if not all, of the mass acceleration.

[0155] In some situations, depending on the position of the robotic arm 210 relative to the operator, it may be inconvenient to reach for button 312 and / or button 314 to activate a manual operation mode (e.g., admittance mode and / or impedance mode). Thus, under these circumstances, it may be convenient for the operator to trigger the manual operation mode other than by a button.

[0156] In some embodiments, the robotic arm 210 includes a single button (e.g., button 312 or 314) that can be used to put the robotic arm 210 into admittance mode and / or impedance mode (e.g., by using different presses such as long press, short press, press and hold, etc.). In some embodiments, the robotic arm 210 can be put into impedance mode by a user pressing an arm linkage (e.g., link 302) and / or a joint (e.g., joint 304) and overcoming a force threshold. In some embodiments, the admittance mode and impedance mode are common in that they both allow a user to command movement by gripping the robotic arm 210 and interfacing directly with it.

[0157] In some embodiments, the robot arm 210 includes an input control for activating the arm following mode. For example, in some embodiments, the robot arm 210 may include designated touch points located on the links 302 or joints 304 (e.g., on the outer shell of the links 302 or on the buttons 316) of the robot arm. User interaction (e.g., a user touch, contact, etc.) with the designated touch points activates the arm following mode. In some embodiments, the robot arm 210 includes multiple touch points. User interaction with any of the touch points (e.g., one or more) activates the arm following mode.

[0158] During a medical procedure, it may be desirable to maintain the remote center of motion (RCM) of the ADM 308 of the robotic arm 210 and / or the tool 212 coupled thereto in a static attitude (e.g., position and / or orientation). The RCM may refer to a point in space where the motion of a cannula or other access port through which the medical tool 212 is inserted is constrained. In some embodiments, the medical tool 212 includes an end effector that is inserted through an incision or natural orifice in a patient while maintaining the RCM. In some embodiments, the medical tool 212 includes an end effector that is in a retracted state during a setup process of the robotic medical system.

[0159] In some circumstances, the robotic medical system 200 can be configured to move one or more links 302 of the robotic arm 210 in a "null space" to avoid collisions with nearby objects (e.g., other robotic arms) while the ADM 308 and / or RCM of the robotic arm 210 are maintained in their respective poses (e.g., positions and / or orientations). The null space can be considered as a set of joint states that the robotic arm 210 can move into that does not result in movement of the ADM 308 and / or RCM, thereby maintaining the position and / or orientation of the medical tool 212 (e.g., within the patient). In some embodiments, the robotic arm 210 can have multiple positions and / or configurations available for each pose of the ADM 308.

[0160] In order for the robotic arm 210 to move the instrument to a desired pose in space, in certain embodiments, the robotic arm 210 may have at least six DoFs, i.e., three DoFs for translation (e.g., X-position, Y-position, and Z-position) and three DoFs for rotation (e.g., yaw, pitch, and roll). In some embodiments, each joint 304 may provide the robotic arm 210 with a single DoF, and thus the robotic arm 210 may have at least six joints to achieve degrees of freedom of movement to position the ADM 308 at any pose in space. To further maintain the ADM 308 and / or remote center or movement of the robotic arm 210 at a desired pose, the robotic arm 210 may further have at least one additional "redundant joint." Thus, in certain embodiments, the system may include a robotic arm 210 with at least seven joints 304, providing the robotic arm 210 with at least seven DoFs. In some embodiments, the robotic arm 210 may include a subset of the joints 304 each having two or more degrees of freedom, thereby achieving additional DoF for null space motion, however, depending on the embodiment, the robotic arm 210 may have a greater or lesser number of DoF.

[0161] 12, the bar 220 (e.g., an adjustable arm support) can provide several degrees of freedom including lift, lateral translation, tilt, etc. Thus, depending on the embodiment, the robotic medical system can have many more robotically controlled degrees of freedom beyond those in the robotic arm 210 to provide zero space movement and collision avoidance. In each of these embodiments, the end effector (and any tools or instruments coupled thereto) of one or more robotic arms, as well as remote centers along the axes of the tools, can advantageously maintain their orientation and / or position within the patient.

[0162] A robotic arm 210 with at least one redundant DoF has at least one more DoF than the minimum number of DoFs to perform a given task. For example, the robotic arm 210 may have at least seven DoFs, and according to some embodiments, one of the joints 304 of the robotic arm 210 may be considered a redundant joint. The one or more redundant joints may enable the robotic arm 210 to move in null space to maintain the attitude of the ADM 308 and the position of the RCM, and to avoid collisions with other robotic arms or objects.

[0163] In some embodiments, the robotic medical system 200 can be configured to perform collision avoidance, for example, to avoid collisions between adjacent robotic arms 210, by utilizing movement of one or more redundant joints in the null space. For example, when a robotic arm 210 collides or approaches (e.g., within a defined distance of) another robotic arm 210, one or more processors of the robotic medical system 200 can be configured to detect the collision or impending collision (e.g., via kinematics). Thus, the robotic medical system 200 can control one or both of the robotic arms 210 to adjust their respective joints in the null space to avoid the collision or impending collision. In embodiments including at least a pair of robotic arms, the base of one of the robotic arms and its end effector can remain in its pose while the link or joint between them moves in the null space to avoid collision with the adjacent robotic arm.

[0164] C. Example Surgical Setup FIG. 25 shows a perspective view of a robotic medical system 200 including four robotic arms 210-1, 210-2, 210-3, and 210-4, according to some embodiments. Each of the robotic arms 210-1, 210-2, 210-3, and 210-4 is coupled to a respective surgical tool 602 (e.g., 602-1 to 602-4, which may correspond to an instrument 212) via a respective ADM 308 (e.g., tool driver), such as ADM 308-1 to 308-4. The surgical tools 602 may be inserted into a patient through respective ports 608 disposed on the patient. As used herein, a port (e.g., port location, entry port, entry point, port area, port area, or port location, etc.) refers to a location on a patient's body through which a medical instrument / instrument (e.g., held by a robotic arm) may be inserted and motion constrained. In some embodiments, the port corresponds to an incision point (or incision area) made through a patient's skin to facilitate a medical operation or procedure. In some embodiments, the port corresponds to a natural opening, such as a patient's mouth (e.g., for a bronchoscopy procedure). In some embodiments, the port corresponds to a medical device with an opening that is placed at the incision point or natural opening to allow access to a surgical space through the opening. An illustration of the patient has been omitted from FIG. 25 to enhance visibility of the robotic arm 210 and surgical tool 602.

[0165] In FIG. 25, the robotic arm 210-2 is coupled to a camera 606. In this example, the camera 606 is coupled to the robotic arm 210-2 via a medical instrument 602-2 (e.g., an endoscope) (e.g., at a distal end of the medical instrument 602-2). In some embodiments, the camera 606 is part of the medical instrument 602-2. In some embodiments, the camera 606 can be a standalone device (e.g., not part of a surgical instrument) coupled to the robotic arm (e.g., the camera 606 is distinct and separate from the medical instrument). In some embodiments, the camera 606 defines an axis 604 (e.g., an optical axis) that specifies the orientation of the camera 606. The camera 606 (or scope) provides an image of the surgical site to facilitate control of surgical tools to perform a robotic medical procedure. For example, a robotically controllable endoscope of a robotic system can include a camera disposed at its distal tip. A user can view an image from the camera of the endoscope in a viewer to facilitate control of the endoscope and / or other components of the robotic medical system. As another example, the robotic system may include one or more cameras that are inserted laparoscopically or endoscopically into the patient, where a user can view images from the inserted camera to facilitate control of one or more additional robotically-controlled medical instruments, such as one or more additional medical instruments inserted laparoscopically.

[0166] In some embodiments, the robotic medical system 200 includes a coordinate system (e.g., a robot coordinate system, coordinate frame, system frame, etc., which may be a Cartesian or non-Cartesian coordinate system) and the respective positions of the patient support platform 202, the robotic arm 210, the adjustable arm support 220, and / or the instrument 212 are expressed as coordinates (e.g., x-, y-, and z-coordinates) on the coordinate system. For example, the robotic medical system 200 (e.g., one or more processors 380 of the robotic medical system 200) may be configured to identify the positions and orientations of the patient support platform 202, the robotic arm 210, the adjustable arm support 220, and / or the instrument 212 based on the coordinates in the coordinate system.

[0167] 26A and 26B illustrate a camera field of view in three-dimensional space according to some embodiments. In some embodiments, the robotic medical system 200 determines the field of view based on the focal length of the camera 606 (e.g., the field of view may correspond to a space within a particular distance from the center of the field of view of the camera 606). In some embodiments, the robotic medical system 200 determines the field of view using data acquired by one or more sensors 388 of the robotic medical system 200, such as position (and orientation) data corresponding to the tip of an endoscope (e.g., a medical instrument) to which the camera 606 is coupled, or position data corresponding to the camera 606 (e.g., a safe area may be determined to be located a particular distance from the camera 606). In some embodiments, the robotic medical system 200 stores (e.g., in a memory) information specifying the field of view of the camera 606 and utilizes the stored information to determine the field of view of the camera 606 based on the position and orientation of the camera 606. For example, the robotic medical system 200 may store information specifying a predetermined height (e.g., centimeters) and predetermined base, slope, and / or edge angles of a three-dimensional volume corresponding to the field of view that has the shape of a truncated square pyramid. In another example, the robotic medical system 200 may store information identifying a predetermined radius or diameter and a predetermined distance (e.g., centimeters) for a spherical volume corresponding to the field of view that is located a predetermined distance from the camera 606 and has a predetermined radius or diameter. In some embodiments, the robotic medical system 200 determines the field of view according to the image(s) acquired using the camera 606.

[0168] In FIGS. 26A and 26B, the camera field of view 702 (e.g., as seen by a camera coupled to another robotic arm) is represented by a three-dimensional space (e.g., a pyramid). One skilled in the art will appreciate that the three-dimensional space of the camera field of view can be represented by other shapes, such as a cone, a cylinder, a sphere, a tetrahedron, etc. In the example of FIG. 26A, the robotic arm 210-8 is coupled to a surgical tool 704 (e.g., a medical instrument) via an ADM 308-8. The surgical tool 704 intersects (e.g., overlaps, is within, etc.) the three-dimensional space of the camera field of view 702. In contrast, FIG. 26B shows a robotic arm 210-9 holding a surgical tool 708 (e.g., via an ADM 308-9) that does not intersect the three-dimensional space of the camera field of view 702 (e.g., due to the position and / or orientation of the tool 708).

[0169] D. Exemplary User Interface 27A-27J illustrate exemplary user interfaces displayed on a display device according to some embodiments.

[0170] Figure 27A shows a user interface 802 displayed on a display device 800, according to some embodiments. In some embodiments, as shown in Figure 27A, the user interface 802 includes an image or representation of a camera's field of view (e.g., a view of a surgical site, such as treatment site 600) or a scope. Figure 27A also shows that the user interface 802 includes an image or representation of medical instruments 500 and 550 located within the field of view of the camera or scope.

[0171] FIG. 27B illustrates that the user interface 802 is updated in response to the medical instrument 550 moving out of the field of view. As a result, the user interface 802 in FIG. 27B does not include an image or representation of the medical instrument 550. In addition, FIG. 27B illustrates that the user interface 802 is updated (e.g., in response to the medical instrument 550 moving out of the field of view) to include an indicator 810-1 (e.g., along a periphery or portion of the user interface 802) to indicate the position (or orientation) of the medical instrument 550 relative to the field of view. For example, in FIG. 27B, the indicator 810-1 is located along the left edge of the user interface 802, indicating that the medical instrument 550 is positioned to the left of the field of view. In some embodiments, as shown in FIG. 27B, the indicator 810-1 includes information identifying the medical instrument 550 (e.g., a number associated with a robotic arm coupled to the medical instrument 550, such as the number "3" indicating a third robotic arm). Although indicator 810-1 is illustrated as being near or adjacent to the boundary of the rectangle, in some embodiments indicator 810-1 may be positioned further inward, away from the boundary of the rectangle.

[0172] In some embodiments, when the medical instrument 550 returns within the field of view, the user interface 802 is updated to include an image or representation of the medical instrument 550. In some embodiments, the user interface 802 no longer includes the indicator 810-1 in response to the medical instrument 550 returning within the field of view (e.g., the indicator 810-1 is no longer displayed in response to the medical instrument 550 returning within the field of view). Thus, in some embodiments, the indicator 810-1 (or any other indicator for any medical instrument) is only displayed when the corresponding medical instrument is located outside the field of view.

[0173] In some embodiments, indicator 810-1 (or any other indicator for any medical instrument) is displayed regardless of whether the corresponding medical instrument is located within or outside the field of view. For example, FIG. 27C shows that user interface 802 includes indicator 810-1 associated with medical instrument 550 and indicator 810-2 associated with medical instrument 500, even though user interface 802 includes images or representations of medical instruments 500 and 550.

[0174] 27D shows that indicator 810-1 is updated to indicate the distance between the medical instrument 550 and the field of view. For example, in some embodiments, in response to the medical instrument 550 moving out of the field of view, indicator 810-1 is reduced in size (e.g., indicator 810-1 becomes shorter and / or narrower) to indicate an increased distance between the medical instrument 550 and the field of view.

[0175] Similarly, the user interface 802 shown in Figure 27B may be updated as shown in Figure 27D when the medical instrument 550 is outside of the field of view to decrease the size of indicator 810-1 to indicate that the distance between the medical instrument 550 and the field of view has increased. Thus, indicator 810-1 may represent a dynamic indicator that may increase or decrease in size as the surgical procedure progresses.

[0176] 27E shows that user interface 802 includes images or representations of medical instruments 550 and 550 located within the field of view. User interface 802 further includes indicators 810-3 through 810-6 that correspond to medical instruments located outside the field of view. For example, indicator 810-4 indicates the position (or orientation) of medical instrument 560 relative to the field of view.

[0177] 27F illustrates that the user interface 802 is updated in response to (e.g., lateral) movement of the medical instrument 560 relative to the field of view. For example, indicator 810-4 moves within the user interface 802 (e.g., along the periphery of the user interface 802) to indicate an updated position (or orientation) of the medical instrument 560 relative to the field of view.

[0178] FIG. 27G illustrates that the user interface 802 is updated in response to movement of the medical instrument 560 relative to the field of view to change the distance between the medical instrument 560 and the field of view. Specifically, the shape of the indicator 810-4 may be updated to indicate the distance between the medical instrument 560 (located outside the field of view) and the field of view. For example, in FIG. 27G, the size of the indicator 810-4 is increased (e.g., the indicator 810-4 becomes longer and / or wider) to indicate that the distance between the medical instrument 560 and the field of view has decreased. Alternatively, the size of the indicator 810-4 may be decreased (e.g., the indicator 810-4 becomes shorter and / or narrower) to indicate that the distance between the medical instrument 560 and the field of view has increased. Additionally or alternatively, text associated with the indicator 810-4 may be displayed to indicate the distance between the medical instrument 560 and the field of view (e.g., text such as "close," "medium," or "far" may be displayed based on a comparison of the distance between the medical instrument 560 and the field of view to one or more distance thresholds). In some embodiments, the color of the indicator 810-4 may change to indicate the distance between the medical instrument 560 and the field of view (e.g., a first color, such as green, indicating that the distance between the medical instrument 560 and the field of view is less than a distance threshold, and a second color, such as yellow, indicating that the distance between the medical instrument 560 and the field of view is greater than the distance threshold).

[0179] 27H illustrates a user interface 802 that includes an image or representation of the field of view along with an image or representation of a medical instrument located outside the field of view. In the user interface 802 illustrated in FIG. 27H, the image or representation of the field of view is surrounded by a margin 806 in which representations 812-1 and 812-2 of medical instruments 570 and 580 located outside the field of view are shown. In some embodiments, the images or representations of the medical instruments located outside the field of view identify the type and / or orientation of the medical instrument. For example, the images or representations of the medical instruments may include separate images or representations for each type of medical instrument (e.g., representation 812-1 may identify a first type of medical instrument, such as a clamp, and representation 812-2 may identify a second type of medical instrument different from the first type, such as a suturing device).

[0180] FIG. 27I illustrates a user interface 802 that includes a user interface element that highlights a portion (e.g., a focal point) of the user interface 802. For example, the user interface 802 of FIG. 27I includes a user interface element 820 that highlights a central region of the user interface 802. In FIG. 27I, the user interface element 820 has a circular shape, but the user interface element 820 may have a shape that is oval, rectangular (with or without rounded corners), square, triangular, pentagonal, hexagonal, or any other shape. In some embodiments, the user interface element 820 highlights a portion of the user interface 802 by showing a boundary (e.g., a circular boundary) of the portion of the user interface 802. In some embodiments, the user interface element 820 highlights a portion of the user interface 802 by changing the appearance (e.g., by changing the brightness, color contrast, or hue) of the portion of the user interface 802 or the remainder of the user interface 802 other than the portion of the user interface 802.

[0181] The user interface 802 of FIG. 27I also includes an indicator 814 that indicates the position (or orientation) of the medical instrument 560 relative to the field of view. In some embodiments, the indicator 814 is positioned adjacent a periphery of the user interface element 820. In some embodiments, the indicator 814 may move along the periphery of the user interface element 820 in response to a movement of the medical instrument 560 that changes the orientation of the medical instrument 560 from the field of view. In some embodiments, the indicator 814 may be updated (e.g., the size, color, or shape of the indicator 814 may change) to indicate a change in the distance between the medical instrument 560 and the portion of the field of view that corresponds to the highlighted portion of the user interface 802.

[0182] FIG. 27J also shows a user interface 802 including an image or representation of the field of view along with indicators 815-1 and 815-2. In some embodiments, indicators 815-1 and 815-2 include images or representations 814-1 and 814-2 of medical instruments 560 and 570 located outside the field of view. In some embodiments, indicators 815-1 and 815-2 include additional user interface elements to indicate a direction toward and / or a distance to the corresponding medical instrument. For example, in FIG. 27J, indicator 815-1 includes a user interface element 816-1 that indicates a distance between the field of view and medical instrument 560. User interface element 816-1 may be shown adjacent to a representation 814-1 of medical instrument 560. In some embodiments, user interface element 816-1 includes a line (e.g., a straight line or a curved line such as an arc) whose length indicates a distance between the field of view and medical instrument 560. In some embodiments, the orientation of user interface element 816-1 also indicates the orientation of medical instrument 560 relative to the field of view. In FIG. 27J, indicator 815-1 also includes user interface element 817-1 that indicates the orientation of medical instrument 560 relative to the field of view. User interface element 817-1 may be shown adjacent to representation 814 of medical instrument 560. In some embodiments, user interface element 817-1 has a shape suitable for indicating a direction (e.g., user interface element 817-1 may have a shape of an arrow, a triangle, etc.). In some embodiments, indicator 815-1 includes user interface element 816-1 without user interface element 817-1. In some embodiments, indicator 815-1 includes user interface element 817-1 without user interface element 816-1. In some embodiments, indicator 815-1 includes both user interface element 816-1 and user interface element 817-1, as shown in FIG. 27J.Similarly, indicator 815-2 shown in FIG. 27J also includes both a user interface element 816-2 indicating the distance between the field of view and medical instrument 570, and a user interface element 817-2, shown adjacent to representation 814 of medical instrument 570, indicating the orientation of medical instrument 570 relative to the field of view. The use of a separate user interface element (e.g., user interface element 816-1) to indicate the distance between the field of view and the corresponding medical instrument may facilitate a user to easily ascertain the distance between the field of view and the corresponding medical instrument. The use of a separate user interface element (e.g., user interface element 817-1) to indicate the direction from the field of view to the corresponding medical instrument allows an image or representation of the corresponding medical instrument (e.g., representation 814) to be positioned at a location within user interface 802 independent of the direction from the field of view to the corresponding medical instrument, thus allowing the indicator to be positioned in a direction away from the central region of the field of view.

[0183] Although some aspects of the indicator may have been described with respect to a particular embodiment of an indicator (e.g., indicator 810-4), such aspects may be applicable to any other indicator described with respect to Figures 27A-27J.

[0184] Although Figures 27E-27J show one or more medical instruments (e.g., medical instruments 560, 570, and 580) located outside the field of view relative to user interface 802 shown on display device 800, one skilled in the art will understand that the position (or orientation) of the one or more medical instruments shown relative to user interface 802 in Figures 27E-27J represents the position (or orientation) of the one or more medical instruments relative to the field of view at the surgical site.

[0185] 28A-28D illustrate exemplary user interfaces displayed on a display device, according to some embodiments.

[0186] FIG. 28A illustrates a bird's-eye view of a robotic medical system shown in user interface 802, according to some embodiments. The bird's-eye view shown in FIG. 28A includes robotic arms 832-1, 832-2, and 832-3. The bird's-eye view shown in FIG. 28A also includes ADMs (e.g., 834-1, 834-2, and 834-3) coupled to each robotic arm 832. In some embodiments, each ADM indicates the location of the medical instrument coupled to it. In some embodiments, the bird's-eye view also includes information identifying each robotic arm (e.g., robotic arm number in indicators 836-1, 836-2, and 836-3). In some embodiments, the bird's-eye view includes an image or representation of a camera or scope 838 to indicate the location and / or orientation of the camera or scope 838. The bird's-eye view can facilitate determining potential collisions between the robotic arms, the ADMs, and / or associated tools. In some embodiments, the bird's-eye view may include a visual representation 830 of the camera or scope's field of view, as shown in Figure 28 A. In some embodiments, the bird's-eye view highlights which tools are currently under the surgeon's control (or "active").

[0187] FIG. 28B illustrates a graphical representation of a bird's-eye view according to some embodiments. In some embodiments, the user interface 802 includes a visual representation 830 of the field of view and one or more indicators for the corresponding medical instruments. For example, in FIG. 28B, the user interface 802 includes indicators 836-1 and 836-2 inside the visual representation 830 for medical instruments located within the field of view (e.g., medical instruments held by ADMs 834-1 and 834-2) and indicator 836-3 outside the visual representation 830 for medical instruments located outside the field of view (e.g., medical instruments held by ADMs 834-3). The indicators 836-3 are positioned to indicate the location of the corresponding medical instruments relative to the field of view (e.g., the medical instruments held by ADMs 834-3 are positioned in an upper right direction from the field of view). In some embodiments, the bird's-eye view highlights which tools are currently under the surgeon's control (or are "active").

[0188] In FIG. 28B, indicators 836-1, 836-2, and 836-3 include information identifying the associated robotic arm (e.g., robotic arm number). FIG. 28C is similar to FIG. 28B with the following differences: In FIG. 28C, instead of indicators 836-1, 836-2, and 836-3, user interface 802 includes indicators 840-1, 840-2, and 840-3 that graphically identify the associated medical instrument type. For example, indicator 840-1 may identify a grasper, indicator 840-2 may identify a scissors, and indicator 840-3 may identify a grasper. In some embodiments, the bird's-eye view highlights which tool is currently under the surgeon's control (or "active").

[0189] In some embodiments, the user interface 802 may include an indicator that identifies both the type of associated medical instrument and the type of associated robotic arm (e.g., a combination of a graphical representation of the type of associated medical instrument and the robotic arm number).

[0190] 28D shows that the user interface 802 includes a simultaneous display of (i) an image or representation of the field of view, and (ii) graphical representations 844 of medical instruments located within and outside the field of view. In FIG. 28D, the graphical representations 844 include (a) a visual representation 830 of the field of view, and (b) graphical representations of each of the medical instruments 500, 550, and 560. In some embodiments, the graphical representations of the medical instruments 500, 550, and 560 identify the direction, orientation, and / or type of the medical instruments 500, 550, and 560.

[0191] In some embodiments, instead of graphical representation 844, any of the graphical representations shown in Figures 28A, 28B, and 28C may be displayed simultaneously with an image or representation of the field of view (e.g., the graphical representations shown in Figures 28A, 28B, or 28C may be shown as insets in place of graphical representation 844 shown in Figure 28D). In some embodiments, graphical representation 844 or any of the graphical representations shown in Figures 28A, 28B, and 28C may be displayed side-by-side with an image or representation of the field of view.

[0192] In some embodiments, the user interface 802 also includes indicators 842-1, 842-2, and 842-3. In some embodiments, each of the indicators 842-1, 842-2, and 843-3 is shown adjacent to a left corner (e.g., the upper left corner or the lower left corner) or a right corner (e.g., the upper right corner or the lower right corner) depending on the location of the corresponding tool relative to the center of the field of view (e.g., indicator 842-1 is shown in the upper left corner because the corresponding medical instrument 550 is positioned to the left of the center of the field of view, and indicators 842-2 and 842-3 are shown in the upper right corner because the corresponding medical instruments 500 and 560 are positioned to the right of the center of the field of view). In some embodiments, one or more indicators of medical instruments located within the field of view are visually distinguishable (e.g., based on color, size, highlighting, etc.) from one or more indicators of medical instruments located outside the field of view (e.g., indicators 842-1 and 842-2 of medical instruments 550 and 500 located within the field of view are highlighted, while indicator 842-3 of medical instrument 560 located outside the field of view is not highlighted). In some embodiments, the size, shape, and / or color of the indicators are updated to indicate the distance between the corresponding medical instrument and the field of view (e.g., the size of indicator 842-3 is reduced to indicate the distance between medical instrument 560 and the field of view).

[0193] In some embodiments, a user (e.g., a surgeon) may switch the display of an indicator on or off. For example, a user may provide a request to display an indicator or to stop displaying an indicator via one or more input devices (e.g., one or more user interface elements such as a button displayed on a display device, foot pedal 244, etc.). In some configurations, a user may provide a request to display an indicator or to stop displaying an indicator via a voice command. In some embodiments, a user may switch from a first type of indicator to a second type of indicator different from the first type (e.g., from the indicator shown in FIG. 27G to the indicator shown in FIG. 27H) via one or more input devices (or via a voice command).

[0194] As discussed above, Figures 27A-27J and 28A-28D show exemplary user interfaces. Those skilled in the art will appreciate that one or more processors (e.g., central processing units, graphics processing units, accelerated processing units, application specific integrated circuits, etc.) may be configured to generate electrical signals (e.g., video signals) such that one or more display devices can display the user interfaces illustrated in Figures 27A-27J and 28A-28D.

[0195] E. Exemplary Process for Displaying an Off-Screen Indicator 29A-29C illustrate a flowchart diagram of a method 900 implemented by one or more processors (e.g., processor 380) of a surgical robotic system (e.g., a robotic medical system 200 as illustrated in FIGS. 21 and 22, or a robotic surgery platform, etc.), according to some embodiments. The surgical robotic system includes a memory that stores instructions executed by the one or more processors.

[0196] The surgical robotic system includes a first robotic arm (e.g., a robotic manipulator) (e.g., robotic arm 210-1 of FIG. 22) coupled to a first surgical tool (e.g., medical instrument 212 of FIGS. 21 and 24A, surgical tool 602 of FIG. 25, and surgical tools 704 and 708 of FIGS. 26A and 26B).

[0197] The surgical robotic system includes a second robotic arm (e.g., a robotic manipulator) (e.g., robotic arm 210-2 of FIG. 22) coupled to a second surgical tool (e.g., medical instrument 212 of FIGS. 21 and 24A, surgical tool 602 of FIG. 25, and surgical tools 704 and 708 of FIGS. 26A and 26B).

[0198] The surgical robotic system includes a third robotic arm (eg, a robotic manipulator) (eg, robotic arm 210-1 in FIG. 22) coupled to a scope (eg, a camera 606).

[0199] The robotic system also includes a viewer (eg, display 232 located on tower 230 or display 242 included with physician console 240) for displaying a view of the surgical site derived from the scope.

[0200] The robotic system further includes one or more processors (eg, processor 380) and a memory (eg, memory 382) that stores instructions executed by the one or more processors.

[0201] The surgical robotic system (902) provides an electrical signal (e.g., a video signal, such as an analog video signal or a digital video signal) for presenting a first visual indicator on a viewer (e.g., user interface 802 shown in FIG. 27B having indicator 810-1) in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view. The first visual indicator indicates the position (or orientation) of the first surgical tool (e.g., indicator 810-1 indicates the orientation of medical instrument 550 relative to the field of view).

[0202] In some embodiments, the surgical robotic system (904) provides an electrical signal to present a first visual indicator at a first location on the viewer to indicate a position (or orientation) of the first surgical tool, and after providing the electrical signal to present the first visual indicator at the first location on the viewer (906), in accordance with a determination that the position (or orientation) of the first surgical tool has changed, provides an electrical signal to present the first visual indicator at a second location on the viewer that corresponds to the changed position (or orientation) of the first surgical tool. For example, as shown in Figures 27E and 27F, the surgical robotic system changes the position of indicator 810-4 to indicate the changed orientation of the medical instrument 560 relative to the field of view.

[0203] In some embodiments, the first visual indicator also indicates (908) a distance from the field of view to the first surgical tool (e.g., a size, color, and / or shape of the first visual indicator and / or associated text may indicate the distance from the field of view to the first surgical tool). In some embodiments, the distance from the field of view to the first surgical tool corresponds to a distance between the first surgical tool and a point on a boundary of the field of view (e.g., a position on the boundary of the field of view closest to the first surgical tool). For example, the distance from the field of view to the first surgical tool corresponds to a foreshortened distance between the first surgical tool and any point on the boundary of the field of view. In some embodiments, the distance from the field of view to the first surgical tool corresponds to a distance between the first surgical tool and a center of the field of view.

[0204] In some embodiments, the surgical robotic system updates the first visual indicator in real time to indicate the position (or orientation) of the first surgical tool and / or the distance between the first surgical tool and the field of view while the first surgical tool is moving relative to the field of view.

[0205] In some embodiments, the (910) first visual indicator includes a graphic element having a size indicating the distance from the field of view to the first surgical tool (eg, Figures 27F and 27G).

[0206] In some embodiments, after the surgical robotic system provides the electrical signal for presenting the first visual indicator on the viewer (912), in accordance with a determination that the distance from the field of view to the first surgical tool has changed, the surgical robotic system provides an electrical signal for presenting an updated first visual indicator on the viewer indicating the changed distance from the field of view to the first surgical tool (912) (e.g., the size, color, and / or shape of the first visual indicator and / or associated text may be updated to indicate the changed distance between the first surgical tool and the field of view). For example, as shown in Figures 27F and 27G, the surgical robotic system changes the size of indicator 810-4 to indicate the changed distance between medical instrument 560 and the field of view.

[0207] In some embodiments, (914) the first visual indicator includes information identifying the robot arm associated with the graphic element (e.g., as shown in FIG. 27B, indicator 810-1 may include a number associated with the robot arm).

[0208] In some embodiments, the (916) first visual indicator identifies a type of the first surgical tool. For example, in some embodiments, the (918) first visual indicator includes a graphical representation of the first surgical tool (e.g., representation 812-1 in FIG. 27H, indicator 814 in FIG. 27I, etc.).

[0209] In some embodiments, (920) a first visual indicator is displayed simultaneously with the display of a field of view of the surgical site on the viewer (eg, Figures 27B-27J and 28D).

[0210] In some embodiments, (922) the first visual indicator is displayed around the periphery of the representation of the view of the surgical site (e.g., in FIG. 27H, indicator 810-1 is displayed around the periphery of the representation of the view of the surgical site 804). In some embodiments, the first visual indicator is displayed around and separate from the representation of the view of the surgical site (e.g., FIG. 27H). In some embodiments, the first visual indicator is displayed around and in contact with the representation of the view of the surgical site (e.g., FIG. 27G).

[0211] In some embodiments, (924) a first visual indicator is displayed over a representation of the field of view of the surgical site (eg, FIG. 28D).

[0212] In some embodiments, (926) the surgical robot system provides electrical signals to highlight a predetermined area of ​​a representation of the view of the surgical site (e.g., as shown in FIG. 27I, user interface 802 includes user interface element 820 that highlights a central area of ​​user interface 802). A first visual indicator is displayed along a periphery of the predetermined area (e.g., indicator 814 located along the periphery of user interface element 820 or an area of ​​user interface 802 defined by user interface element 820).

[0213] In some embodiments, the surgical robotic system (928) provides an electrical signal for presenting the first visual indicator on the viewer in response to receiving a request for display of the first visual indicator and in accordance with a determination that the second surgical tool is in the field of view and the first surgical tool is not in the field of view. For example, the surgical robotic system may display the first visual indicator only in response to receiving a request for display of the first visual indicator (e.g., user input on one or more input devices). In some embodiments, the surgical robotic system provides an electrical signal for presenting the first visual indicator on the viewer in response to receiving a request for display of the first visual indicator (and in some embodiments, regardless of a determination that the second surgical tool is in the field of view and the first surgical tool is not in the field of view).

[0214] In some embodiments, the surgical robotic system (930) stops providing the electrical signal for presenting the first visual indicator on the viewer in response to determining that the request for displaying the first visual indicator has ceased. For example, the surgical robotic system may stop displaying the first visual indicator in response to determining that the request for displaying the first visual indicator has ceased. For example, the request for displaying the first visual indicator may include pressing a button or pedal, and the surgical robotic system may display the first visual indicator while the button or pedal is pressed, and stop displaying the first visual indicator pursuant to determining that the button or pedal has been released.

[0215] In some embodiments, the surgical robotic system provides an electrical signal for presenting the first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view while the robotic system is in the indicator display mode, and stops providing the electrical signal for presenting the first visual indicator on the viewer while the robotic system is not in the indicator display mode. For example, the display of the indicator can be turned on or off. When the display of the indicator is turned on (e.g., when the surgical robotic system is in the indicator display mode), the surgical robotic system displays the indicator (e.g., as shown in FIG. 27B). When the display of the indicator is turned off (e.g., when the surgical robotic system is not in the indicator display mode), the surgical robotic system does not display the indicator (regardless of whether one or more tools are located outside the field of view). In some embodiments, the surgical robotic system stops determining whether one or more tools are located outside the field of view while the surgical robotic system is not in the indicator display mode.

[0216] In some embodiments, the surgical robotic system switches into or out of the indicator display mode in response to a user input. For example, the surgical robotic system switches into (or activates) the indicator display mode in response to a request to display indicators via one or more input devices (e.g., one or more user interface elements such as buttons displayed on a display device, foot pedal 244, voice command, etc.). Similarly, the surgical robotic system switches out of (or deactivates) the indicator display mode in response to a request to stop displaying indicators via one or more input devices (e.g., one or more user interface elements such as buttons displayed on a display device, foot pedal 244, voice command, etc.).

[0217] In some embodiments, after providing the electrical signals for presenting the first visual indicator on the viewer, the surgical robotic system (932) ceases providing the electrical signals for presenting the first visual indicator on the viewer pursuant to a determination that the first surgical tool is in the field of view (e.g., the surgical robotic system provides electrical signals for presenting a user interface that does not include the first visual indicator). For example, as described with respect to Figures 27A and 27B, in some embodiments, in response to the surgical tool 550 returning to the field of view, indicator 810-1 is no longer displayed.

[0218] In some embodiments, (934) the surgical robot system provides a rendered image including a first visual indicator (e.g., FIG. 28B is a rendered image including indicator 836-3 indicating the position (or orientation) of a tool associated with ADM 834-3).

[0219] In some embodiments, (936) the rendered image also includes a second visual indicator indicating the position (or orientation) of a second surgical tool (e.g., in FIG. 28B, the rendered image includes indicator 836-1 indicating the position of the tool associated with ADM 834-1).

[0220] In some embodiments, (938) the first visual indicator includes information identifying a first robotic arm associated with the first surgical tool and the second visual indicator includes information identifying a second robotic arm associated with the second surgical tool (e.g., in FIG. 28B , indicators 836-3 and 836-1 include associated robotic arm numbers).

[0221] In some embodiments, (940) the first visual indicator includes a graphical representation of a first surgical tool and the second visual indicator includes a graphical representation of a second surgical tool (e.g., in FIG. 28C , indicators 840-3 and 840-1 include graphical representations of associated medical tools).

[0222] In some embodiments, the surgical robotic system replaces (942) the display of the field of view with a rendered image. For example, the surgical robotic system may display the field of view (e.g., as part of the user interface 802 shown in any of FIGS. 27A-27J) and then replace the display of the field of view with the rendered image in response to receiving a request from a user (e.g., user input on one or more input devices) to display the rendered image.

[0223] In some embodiments, (944) the surgical robot system partially overlays the rendered image onto the field of view display (e.g., as shown in FIG. 28D, the rendered image is overlaid on less than the entire field of view display).

[0224] In some embodiments, the (946) viewer is part of the surgeon console (eg, the display 242 of the doctor console 240).

[0225] In some embodiments, the surgeon console includes an input device (e.g., a button, a switch, a touch-sensitive surface, a gimbal, a pedal, etc.). (948) The surgical robotic system receives an input (e.g., pressing a button or pedal) on the input device and, in response to receiving the input on the input device, provides electrical signals to present a bird's-eye view of the first robotic arm, the second robotic arm, and the third robotic arm (e.g., the user interface shown in FIG. 28A).

[0226] In some embodiments, the input device includes a foot pedal (eg, foot pedal 244 shown in FIG. 23).

[0227] In some embodiments, the first and second robotic arms are positioned on either side of the surgical table (eg, robotic arms 210-1 and 210-4 in FIG. 22).

[0228] In some embodiments, a first robotic arm is supported (e.g., movably coupled) on a first adjustable arm support and a second robotic arm is supported (e.g., movably coupled) on a second adjustable arm support (e.g., in FIG. 22 , robotic arm 210-1 is supported by adjustable arm support 220-1 and robotic arm 210-4 is supported by adjustable arm support 220-2).

[0229] In some embodiments, the first robotic arm and the second robotic arm are located on the same side of the surgical table (eg, robotic arms 210-1 and 210-2 in FIG. 22).

[0230] In some embodiments, the first robotic arm and the second robotic arm are supported on an adjustable arm support (e.g., in FIG. 22, robotic arms 210-1 and 210-2 are supported on a common adjustable arm support 220-1).

[0231] In some embodiments, the surgical robotic system provides an electrical signal to present the first visual indicator on the viewer regardless of a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view.

[0232] In some embodiments, the surgical robot system provides an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the first surgical tool is not within the field of view (in some embodiments, regardless of a determination that the second surgical tool is within the field of view).

[0233] 3. Mounting system and terminology FIG. 30 is a schematic diagram illustrating electronic components of a medical robotic system (e.g., a surgical robotic system), according to some embodiments.

[0234] A robotic medical system (e.g., a surgical robotic system) includes one or more processors 380 in communication with a computer-readable storage medium 382 (e.g., computer memory devices such as random access memory, read-only memory, static random access memory, and non-volatile memory, as well as other storage devices such as hard drives, optical disks, magnetic tape recordings, or any combination thereof) that stores instructions for performing any of the methods described herein (e.g., the operations described with respect to FIGS. 25, 26A, 26B, and 29A-29C). The one or more processors 380 also communicate (via a system bus or any suitable electrical circuitry) with an input / output controller 384. The input / output controller 384 receives sensor data from one or more sensors 388-1, 388-2, etc., and relays the sensor data to the one or more processors 380. The input / output controller 384 also receives instructions and / or data from the one or more processors 380 and relays the instructions and / or data to one or more actuators, such as the first motors 387-1 and 387-2. In some embodiments, the input / output controller 384 is coupled to one or more actuator controllers 386 and provides instructions and / or data to at least a subset of the one or more actuator controllers 386, which in turn provide control signals to selected actuators. In some embodiments, the one or more actuator controllers 386 are integrated with the input / output controller 384, which provides control signals directly to one or more actuators 387 (without a separate actuator controller). Although FIG. 30 shows that there is one actuator controller 386 (e.g., one actuator controller for the entire medical robotic system), in some embodiments, additional actuator controllers may be used (e.g., one actuator controller for each actuator, etc.).In some embodiments, the one or more processors 380 are in communication with one or more displays 381 for displaying information as described herein.

[0235] It should be noted that, as used herein, the terms "couple," "coupled," "coupled," or other variations of the word coupled, may indicate either an indirect connection or a direct connection. For example, when a first component is "coupled" to a second component, the first component may be either indirectly connected to the second component through another component, or directly connected to the second component.

[0236] The functionality for determining whether a tool is within or outside the surgical field of view provided by a camera or scope and rendering one or more indicators representing the position or orientation of one or more medical instruments as described herein may be stored as a processor-readable medium or one or more instructions on a computer-readable medium. The term "computer-readable medium" refers to any available medium that can be accessed by a computer or processor. By way of example and not limitation, such media may include random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, compact disk read-only memory (CD-ROM), or other optical disk storage, magnetic disk storage, or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that a computer-readable medium may be tangible and non-transitory. As used herein, the term "code" may refer to software, instructions, code, or data that is executable by a computing device or processor.

[0237] The methods disclosed herein include one or more steps or actions for achieving the described method. The method steps and / or actions may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is required for the proper operation of the described method, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims.

[0238] As used herein, the term "plurality" refers to two or more. For example, a plurality of components refers to two or more components. The term "determining" covers a wide variety of acts, and thus "determining" can include calculating, computing, processing, deriving, investigating, looking up (e.g., consulting a table, database, or another data structure), ascertaining, and the like. Also, "determining" can include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), and the like. Also, "determining" can include resolving, selecting, electing, establishing, and the like.

[0239] The phrase "based on" does not mean "based only on," unless expressly specified otherwise. In other words, the phrase "based on" refers to both "based only on" and "based at least on."

[0240] As used herein, the term "exemplary" means "serving as an example, instance, or illustration" and does not necessarily imply any preference or superiority of the example over any other configurations or implementations.

[0241] The preceding description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments without departing from the scope of the present invention. For example, those skilled in the art will recognize that many corresponding alternatives, equivalent structural details, such as similar manners of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for producing specific actuation motions, and equivalent mechanisms for delivering electrical energy, may be employed. Thus, the present invention is not intended to be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

[0242] 4. Examples of Subject Technology The following clauses describe several embodiments or implementations.

[0243] Clause 1. A robotic system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; a third robotic arm coupled to the scope; and a viewer for displaying a view of the surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

[0244] Article 2. The stored instructions are providing an electrical signal to present a first visual indicator at a first position on the viewer to indicate a position of a first surgical tool; The robotic system of clause 1, further comprising instructions for: providing an electrical signal for presenting a first visual indicator at a first position on the viewer; and, in accordance with a determination that a position of the first surgical tool has changed, providing an electrical signal for presenting the first visual indicator at a second position on the viewer corresponding to the changed position of the first surgical tool.

[0245] Clause 3. The robotic system of clause 1 or clause 2, wherein the first visual indicator further indicates a distance from the field of view to the first surgical tool.

[0246] Clause 4. The robotic system of clause 3, wherein the stored instructions further include instructions for, after providing an electrical signal for presenting the first visual indicator on the viewer, providing an updated first visual indicator on the viewer indicating a changed distance from the field of view to the first surgical tool in accordance with a determination that a distance from the field of view to the first surgical tool has changed.

[0247] Clause 5. The robotic system of clause 3 or clause 4, wherein the stored instructions further include instructions for, after providing the electrical signal for presenting the first visual indicator on the viewer, ceasing providing the electrical signal for presenting the first visual indicator on the viewer in accordance with a determination that the first surgical tool is within the field of view.

[0248] Clause 6. A robotic system described in any of clauses 3 to 5, wherein the first visual indicator includes a graphical element having a size indicating the distance from the field of view to the first surgical tool.

[0249] Clause 7. The robot system of clause 6, wherein the first visual indicator includes information identifying a robot arm associated with the graphic element.

[0250] Clause 8. A robotic system described in any of clauses 1 to 7, wherein the first visual indicator identifies a type of the first surgical tool.

[0251] Clause 9. The robotic system of clause 8, wherein the first visual indicator includes a graphical representation of a first surgical tool.

[0252] Clause 10. A robotic system as described in any of clauses 1 to 9, wherein the first visual indicator is displayed simultaneously with the display of the field of view of the surgical site on the viewer.

[0253] Clause 11. The robotic system of clause 10, wherein a first visual indicator is displayed around the representation of the field of view of the surgical site.

[0254] Clause 12. The robotic system of clause 10 or clause 11, wherein the first visual indicator is displayed on a display of a field of view of the surgical site.

[0255] Clause 13. The robotic system of clause 12, wherein the stored instructions further include instructions for providing an electrical signal to highlight a predetermined area of ​​the representation of the field of view of the surgical site, and the first visual indicator is displayed along a periphery of the predetermined area.

[0256] Clause 14. A robot system described in any of clauses 1 to 13, wherein the stored instructions further include instructions for providing a rendered image including the first visual indicator.

[0257] Clause 15. The robotic system of clause 14, wherein the rendered image further includes a second visual indicator indicating a position of the second surgical tool.

[0258] Clause 16. The robotic system of clause 15, wherein the first visual indicator includes information identifying a first robotic arm associated with a first surgical tool and the second visual indicator includes information identifying a second robotic arm associated with a second surgical tool.

[0259] Clause 17. The robotic system of clause 15 or clause 16, wherein the first visual indicator includes a graphical representation of a first surgical tool and the second visual indicator includes a graphical representation of a second surgical tool.

[0260] Clause 18. A robot system described in any of clauses 14 to 17, wherein the stored instructions include instructions for replacing the display of the field of view with a rendered image.

[0261] Clause 19. A robot system as described in any of clauses 14 to 18, wherein the stored instructions include instructions for partially overlaying a rendered image on a display of the field of view.

[0262] Clause 20. A robotic system described in any of clauses 1 to 19, wherein the stored instructions include instructions for providing an electrical signal for presenting the first visual indicator on the viewer in response to receiving a request for displaying the first visual indicator and in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view.

[0263] Clause 21. The robotic system of clause 20, wherein the stored instructions include instructions for ceasing providing an electrical signal for presenting the first visual indicator on the viewer in response to determining that a request for display of the first visual indicator has ceased.

[0264] Article 22. The stored instructions are: providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination while the robotic system is in the indicator display mode that the second surgical tool is within the field of view and the first surgical tool is not within the field of view; and ceasing to provide an electrical signal for presenting the first visual indicator on the viewer while the robotic system is not in the indicator display mode.

[0265] Clause 23. The robotic system of clause 22, wherein the stored instructions include instructions for switching to or from an indicator display mode in response to user input.

[0266] Clause 24. A robot system described in any one of clauses 1 to 23, wherein the first robot arm and the second robot arm are arranged on both the left and right sides of the operating table.

[0267] Clause 25. A robot system described in any of clauses 1 to 24, wherein a first robotic arm is supported on a first adjustable arm support and a second robotic arm is supported on a second adjustable arm support.

[0268] Clause 26. A robotic system described in any one of clauses 1 to 25, wherein the first robotic arm and the second robotic arm are positioned on the same side of the operating table.

[0269] Clause 27. A robot system described in any of clauses 1 to 26, wherein the first robot arm and the second robot arm are supported on adjustable arm supports.

[0270] Clause 28. A robotic system described in any one of clauses 1 to 27, wherein the viewer is part of the surgeon console.

[0271] Article 29. a surgeon console including an input device; The stored instructions are Receiving input on an input device; 29. The robotic system of clause 28, including instructions for: in response to receiving an input on the input device, providing electrical signals to present a bird's-eye view of the first robotic arm, the second robotic arm, and the third robotic arm.

[0272] Clause 30. The robotic system of clause 29, wherein the input device includes a foot pedal.

[0273] Clause 31. An electronic device in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and an electronic device including instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

[0274] Clause 32. A computer-readable storage medium storing instructions for execution by one or more processors in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, the stored instructions comprising: and an electronic device including instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

[0275] Clause 33. A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of the surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal for presenting a first visual indicator on a viewer in response to receiving a request for display of a first visual indicator, the first visual indicator indicating a position of a first surgical tool.

[0276] Clause 34. A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of the surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: A robotic system including instructions for providing an electrical signal to present a first visual indicator on a viewer, the first visual indicator indicating a position of a first surgical tool.

[0277] Clause 35. A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of the surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal for presenting a first visual indicator on a viewer in response to receiving a request for display of a first visual indicator, the first visual indicator indicating a position of a first surgical tool.

[0278] Clause 36. A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of the surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: A robotic system including instructions for providing an electrical signal to present a first visual indicator on a viewer, the first visual indicator indicating a position of a first surgical tool.

[0279] [Embodiment] (1) A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; a third robotic arm coupled to the scope; and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool. (2) the stored instructions are: providing an electrical signal to present the first visual indicator at a first position on the viewer to indicate the position of the first surgical tool; The robotic system of embodiment 1, further comprising instructions for: subsequent to providing the electrical signal for presenting the first visual indicator at the first position on the viewer, and, in accordance with a determination that the position of the first surgical tool has changed, providing an electrical signal for presenting the first visual indicator at a second position on the viewer corresponding to the changed position of the first surgical tool. (3) The robotic system of embodiment 1, wherein the first visual indicator further indicates a distance from the field of view to the first surgical tool. (4) The robot system of embodiment 3, wherein the stored instructions further include instructions for providing an electrical signal for presenting the first visual indicator on the viewer, in accordance with a determination that the distance from the field of view to the first surgical tool has changed after providing the electrical signal for presenting the first visual indicator on the viewer, the electrical signal for presenting an updated first visual indicator on the viewer indicating the changed distance from the field of view to the first surgical tool. (5) The robotic system of embodiment 3, wherein the stored instructions further include instructions for, after providing the electrical signal for presenting the first visual indicator on the viewer, ceasing providing the electrical signal for presenting the first visual indicator on the viewer in accordance with a determination that the first surgical tool is within the field of view.

[0280] (6) The robotic system of embodiment 3, wherein the first visual indicator includes a graphical element having a size indicative of the distance from the field of view to the first surgical tool. (7) The robot system of embodiment 6, wherein the first visual indicator includes information identifying a robot arm associated with the graphic element. (8) The robotic system of embodiment 1, wherein the first visual indicator identifies a type of the first surgical tool. (9) The robotic system of embodiment 8, wherein the first visual indicator includes a graphical representation of the first surgical tool. (10) The robotic system of embodiment 1, wherein the first visual indicator is displayed simultaneously with the display of the field of view of the surgical site on the viewer.

[0281] (11) The robotic system of embodiment 10, wherein the first visual indicator is displayed around the representation of the field of view of the surgical site. (12) The robotic system of embodiment 10, wherein the first visual indicator is displayed on the representation of the field of view of the surgical site. (13) The robotic system of embodiment 12, wherein the stored instructions further include instructions for providing an electrical signal to highlight a predetermined area of ​​the representation of the field of view of the surgical site, and the first visual indicator is displayed along a periphery of the predetermined area. (14) The robot system of embodiment 1, wherein the stored instructions further comprise instructions for providing a rendered image including the first visual indicator. (15) The robot system of embodiment 14, wherein the rendered image further includes a second visual indicator indicating a position of the second surgical tool.

[0282] (16) The robotic system of embodiment 15, wherein the first visual indicator includes information identifying the first robotic arm associated with the first surgical tool, and the second visual indicator includes information identifying the second robotic arm associated with the second surgical tool. (17) The robotic system of embodiment 15, wherein the first visual indicator includes a graphical representation of the first surgical tool and the second visual indicator includes a graphical representation of the second surgical tool. (18) The robot system of claim 14, wherein the stored instructions include instructions for replacing the representation of the field of view with the rendered image. (19) The robot system of claim 14, wherein the stored instructions include instructions for partially overlaying the rendered image on the representation of the field of view. (20) The robotic system of embodiment 1, wherein the stored instructions include instructions for providing the electrical signal to present the first visual indicator on the viewer in response to receiving a request for displaying the first visual indicator and in accordance with the determination that a second surgical tool is within the field of view and the first surgical tool is not within the field of view.

[0283] (21) The robotic system of embodiment 20, wherein the stored instructions include instructions for stopping providing the electrical signal for presenting the first visual indicator on the viewer in response to determining that the request for display of the first visual indicator has ceased. (22) The stored instructions include: providing the electrical signal to present the first visual indicator on the viewer in accordance with the determination that a second surgical tool is within the field of view and the first surgical tool is not within the field of view while the robotic system is in an indicator display mode; 2. The robot system of claim 1, further comprising instructions for: ceasing to provide the electrical signal for presenting the first visual indicator on the viewer while the robot system is not in the indicator display mode. (23) The robot system of claim 22, wherein the stored instructions include instructions for switching to or from the indicator display mode in response to user input. (24) The robot system of embodiment 1, wherein the first robot arm and the second robot arm are arranged on either side of a surgical table. (25) The robot system of embodiment 1, wherein the first robotic arm is supported on a first adjustable arm support and the second robotic arm is supported on a second adjustable arm support.

[0284] (26) The robotic system of embodiment 1, wherein the first robotic arm and the second robotic arm are located on the same side of a surgical table. (27) The robot system of embodiment 1, wherein the first robotic arm and the second robotic arm are supported on adjustable arm supports. (28) The robotic system of embodiment 1, wherein the viewer is part of a surgeon console. (29) The surgeon console includes an input device; The stored instructions include: receiving an input on the input device; 29. The robotic system of claim 28, further comprising instructions for: providing electrical signals to present a bird's-eye view of the first robotic arm, the second robotic arm, and the third robotic arm in response to receiving the input on the input device. (30) The robot system of embodiment 29, wherein the input device includes a foot pedal.

[0285] (31) An electronic device in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, comprising: one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and an electronic device comprising instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool. (32) A computer-readable storage medium storing instructions for execution by one or more processors in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, the stored instructions comprising: A computer-readable storage medium comprising instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool. (33) A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator, the first visual indicator indicating a position of the first surgical tool. (34) A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: The robotic system includes instructions for providing an electrical signal to present a first visual indicator on the viewer, the first visual indicator indicating a position of the first surgical tool. (35) A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator, the first visual indicator indicating a position of the first surgical tool.

[0286] (36) A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: The robotic system includes instructions for providing an electrical signal to present a first visual indicator on the viewer, the first visual indicator indicating a position of the first surgical tool.

Claims

1. 1. A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; a third robotic arm coupled to the scope; and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: The robotic system includes instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

2. The stored instructions include: providing an electrical signal to present the first visual indicator at a first position on the viewer to indicate the position of the first surgical tool; 10. The robotic system of claim 1, further comprising instructions for: subsequent to providing the electrical signal to present the first visual indicator at the first location on the viewer, in accordance with a determination that the position of the first surgical tool has changed, providing an electrical signal to present the first visual indicator at a second location on the viewer corresponding to the changed position of the first surgical tool.

3. The robotic system of claim 1 , wherein the first visual indicator further indicates a distance from the field of view to the first surgical tool.

4. 4. The robotic system of claim 3, wherein the stored instructions further comprise instructions for, after providing the electrical signal for presenting the first visual indicator on the viewer, in accordance with a determination that the distance from the field of view to the first surgical tool has changed, providing an electrical signal for presenting an updated first visual indicator on the viewer indicating the changed distance from the field of view to the first surgical tool.

5. 4. The robotic system of claim 3, wherein the stored instructions further comprise instructions for, after providing the electrical signals for presenting the first visual indicator on the viewer, ceasing providing the electrical signals for presenting the first visual indicator on the viewer in accordance with a determination that the first surgical tool is within the field of view.

6. The robotic system of claim 3 , wherein the first visual indicator comprises a graphical element having a size indicative of the distance from the field of view to the first surgical tool.

7. The robotic system of claim 6 , wherein the first visual indicator includes information identifying a robotic arm associated with the graphic element.

8. The robotic system of claim 1 , wherein the first visual indicator identifies a type of the first surgical tool.

9. The robotic system of claim 8 , wherein the first visual indicator comprises a graphical representation of the first surgical tool.

10. The robotic system of claim 1 , wherein the first visual indicator is displayed simultaneously with the display of the view of the surgical site on the viewer.

11. The robotic system of claim 10 , wherein the first visual indicator is displayed around the representation of the field of view of the surgical site.

12. The robotic system of claim 10 , wherein the first visual indicator is displayed on the representation of the view of the surgical site.

13. 13. The robotic system of claim 12, wherein the stored instructions further comprise instructions for providing an electrical signal to highlight a predetermined area of ​​the representation of the field of view of the surgical site, the first visual indicator being displayed along a periphery of the predetermined area.

14. The robotic system of claim 1 , wherein the stored instructions further comprise instructions for providing a rendered image including the first visual indicator.

15. The robotic system of claim 14 , wherein the rendered image further comprises a second visual indicator indicating a position of the second surgical tool.

16. 16. The robotic system of claim 15, wherein the first visual indicator includes information identifying the first robotic arm associated with the first surgical tool and the second visual indicator includes information identifying the second robotic arm associated with the second surgical tool.

17. The robotic system of claim 15 , wherein the first visual indicator includes a graphical representation of the first surgical tool and the second visual indicator includes a graphical representation of the second surgical tool.

18. The robotic system of claim 14 , wherein the stored instructions include instructions for replacing the representation of the field of view with the rendered image.

19. The robotic system of claim 14 , wherein the stored instructions include instructions for partially overlaying the rendered image onto the representation of the field of view.

20. 2. The robotic system of claim 1, wherein the stored instructions include instructions for providing the electrical signal to present the first visual indicator on the viewer in response to receiving a request for display of the first visual indicator and in accordance with the determination that a second surgical tool is within the field of view and the first surgical tool is not within the field of view.

21. 21. The robotic system of claim 20, wherein the stored instructions include instructions for ceasing providing the electrical signal for presenting the first visual indicator on the viewer in response to determining that the request for display of the first visual indicator has ceased.

22. The stored instructions include: providing the electrical signal to present the first visual indicator on the viewer in accordance with the determination that a second surgical tool is within the field of view and the first surgical tool is not within the field of view while the robotic system is in an indicator display mode; and ceasing to provide the electrical signal for presenting the first visual indicator on the viewer while the robotic system is not in the indicator display mode.

23. 23. The robotic system of claim 22, wherein the stored instructions include instructions for switching to or from the indicator display mode in response to a user input.

24. The robot system according to claim 1 , wherein the first robot arm and the second robot arm are disposed on both left and right sides of a surgical table.

25. 2. The robotic system of claim 1, wherein the first robotic arm is supported on a first adjustable arm support and the second robotic arm is supported on a second adjustable arm support.

26. The robotic system of claim 1 , wherein the first robotic arm and the second robotic arm are located on the same side of a surgical table.

27. The robotic system of claim 1 , wherein the first robotic arm and the second robotic arm are supported on adjustable arm supports.

28. The robotic system of claim 1 , wherein the viewer is part of a surgeon console.

29. the surgeon console including an input device; The stored instructions include: receiving an input on the input device; 30. The robotic system of claim 28, further comprising instructions for: in response to receiving the input on the input device, providing electrical signals to present a bird's-eye view of the first robotic arm, the second robotic arm, and the third robotic arm.

30. 30. The robotic system of claim 29, wherein the input device comprises a foot pedal.

31. 1. An electronic device in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

32. 1. A computer readable storage medium storing instructions for execution by one or more processors in communication with a robotic system having a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, the stored instructions comprising: A computer-readable storage medium comprising instructions for providing an electrical signal to present a first visual indicator on the viewer in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, the first visual indicator indicating a position of the first surgical tool.

33. 1. A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator, the first visual indicator indicating a position of the first surgical tool.

34. 1. A robot system comprising: a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: A robotic system comprising instructions for providing an electrical signal to present a first visual indicator on the viewer, the first visual indicator indicating a position of the first surgical tool.

35. 1. A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: and instructions for providing an electrical signal to present a first visual indicator on the viewer in response to receiving a request for display of the first visual indicator, the first visual indicator indicating a position of the first surgical tool.

36. 1. A robot system comprising: a first robotic arm coupled to a first surgical tool; Scope and a viewer for displaying a view of a surgical site derived from the scope; one or more processors; and a memory for storing instructions for execution by the one or more processors, the stored instructions comprising: A robotic system comprising instructions for providing an electrical signal to present a first visual indicator on the viewer, the first visual indicator indicating a position of the first surgical tool.

Images