Table-Mounted Manipulator System and Related Devices, Systems and Methods - Patent application

Abstract

A remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly includes a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator is translatable relative to the rail along the longitudinal dimension of the rail. The manipulator includes a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints. The length of the proximal arm is extendable.

Description

[Technical field]

[0001] (Reference to Related Application) This application claims priority to U.S. Provisional Application No. 63 / 336,840, entitled "TABLE-MOUNTED MANIPULATOR SYSTEM, AND RELATED DEVICES, SYSTEMS, AND METHODS," filed April 29, 2022, the entire contents of which are incorporated herein by reference.

[0002] (Technical field) Aspects of the present disclosure relate generally to a table mounted manipulator system. In particular, aspects of the present disclosure relate to a manipulator for a table mounted manipulator system, such as a medical system table for supporting a patient. Related devices, systems, and methods are also disclosed. [Background technology]

[0003] A computer-assisted manipulator system ("manipulator system"), sometimes referred to as a robot-assisted system or robotic system, includes one or more manipulators that can be operated with the aid of an electronic controller (e.g., a computer) to move and control the functions of one or more instruments coupled to the manipulators. Manipulators generally include mechanical links that are connected by joints. An instrument can typically be removably coupled (or alternatively is permanently coupled) to one of the links, typically a distal link of the multiple links.

[0004] In some computer-assisted manipulator systems, the manipulator is mounted to a manipulator support structure (e.g., a patient side cart) that is separate from the support structure that supports the patient or workpiece. In other manipulator systems, the manipulator is mounted directly to the support structure that supports the patient or workpiece (referred to herein as a "table assembly"), e.g., a surgical table. Manipulator systems in which the manipulator is mounted to a table assembly may be referred to herein as table-mounted manipulator systems.

[0005] Table-mounted manipulator systems present particular challenges. The space around the table assembly may need to be occupied with various equipment and / or personnel during the performance of various tasks that constitute a medical procedure. Moreover, the space constraints around the table may vary depending on the medical procedure being performed, and some tasks (such as transferring the patient to the table, draping the manipulator, etc.) benefit from or are facilitated by a large amount of open space around the table. In manipulator systems that include a mobile patient side cart, such open space around the table can be obtained by moving the patient side cart away from the table that is intended to support the patient. However, in table-mounted manipulator systems, moving the manipulator when space around the table is desired presents challenges because the manipulator is either fixed to the table during certain stages of the medical procedure or is at least impractical to remove from the table. Thus, avoiding interference between the manipulator and other entities in the space around the table in table-mounted manipulator systems may be a challenge.

[0006] In addition, some table assemblies can be switched between multiple spatial configurations, for example, by lowering or raising a section of a multi-section table, and accommodating such changes in the configuration of the table assembly when a manipulator is attached to the table assembly can be a challenge.

[0007] Another challenge with table-mounted manipulators is that because the manipulator is attached to the table, the positioning of the manipulator relative to the patient is limited, which can make it more difficult to reach certain parts of the patient or certain desired angles during a medical procedure. In particular, because of the limited reach of a manipulator coupled to a table, some systems can be relatively limited in terms of the location of the entry ports that the system can accommodate (an entry port is a natural orifice or incision through which an instrument enters the patient, e.g., via a cannula placed in the entry port). Summary of the Invention [Problem to be solved by the invention]

[0008] Thus, a need exists for an improved table mounted manipulator system, particularly one having an improved manipulator architecture. [Means for solving the problem]

[0009] Various embodiments of the present disclosure may solve one or more of the problems set forth above and / or demonstrate one or more of the desirable features set forth above. Other features and / or advantages may become apparent from the following description.

[0010] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints. The length of the proximal arm is extendable.

[0011] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints, and an intermediate link assembly including an intermediate arm coupled to the proximal arm. The length of the intermediate arm is extendable.

[0012] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints. The one or more proximal joints are configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm and about a second axis perpendicular to the first axis and parallel to the rail.

[0013] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly includes a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can be configured to extend across (over) and above the platform to a position adjacent a side of the platform opposite a side on which the rail can be disposed.

[0014] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal link assembly, an intermediate link assembly, a distal link assembly, a wrist, and an instrument holding portion. The proximal link assembly can include a proximal arm coupled to the rail by one or more proximal joints. The intermediate link assembly can include an intermediate arm coupled to the proximal arm. The distal link assembly can include a distal arm coupled to the intermediate arm. The wrist can include three rotational degrees of freedom of movement. The instrument holding portion can be configured to mount an instrument to the instrument holding portion and can be coupled to the distal arm by a wrist.

[0015] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal link assembly, an intermediate link assembly, a distal link assembly, a wrist, and an instrument holding portion. The proximal link assembly can include a proximal arm coupled to the rail by a first proximal joint and a second proximal joint. The first proximal joint can be configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm. The second proximal joint is configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail. The intermediate link assembly can include an intermediate arm coupled to the proximal arm. The distal link assembly can include a distal arm coupled to the intermediate arm. The wrist can include three rotational degrees of freedom of movement. The instrument holding portion can be configured to mount an instrument to the instrument holding portion and can be coupled to the distal arm by the wrist. The length of the proximal arm and the intermediate arm are extendable.

[0016] According to at least one embodiment of the present disclosure, a medical system can include a table assembly, a rail coupled to the table assembly, and a manipulator movably coupled to the rail. A method of operating the medical system can include positioning the manipulator such that the manipulator extends above a platform of the table assembly and extends across the table assembly from a first longitudinally extending side of the platform to a second longitudinally extending side of the platform opposite the first longitudinally extending side.

[0017] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include an arm, a wrist coupled to the arm, and an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion coupled to the arm by the wrist. The wrist can include three rotational degrees of freedom of movement. At least one of the degrees of freedom of movement of the wrist can be a redundant degree of freedom of movement.

[0018] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include an arm, a wrist coupled to the arm, and an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the arm by the wrist. In an attached state of the instrument to the instrument holding portion, a shaft of the instrument extends along a first axis. The wrist can include a first degree of freedom of movement providing rotation of the instrument holding portion about a second axis, and a second degree of freedom of movement providing rotation of the instrument holding portion about a third axis, the second axis and the third axis being offset from the first axis.

[0019] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform having a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a distal arm coupled to an intermediate member for rotation of the distal arm relative to the intermediate member, a wrist coupled to a distal portion of the distal arm, and an instrument holding portion, the instrument holding portion configured to mount an instrument to the instrument holding portion. The instrument holding portion can be coupled to the wrist for rotation of the instrument holding portion relative to the distal arm by a pitch axis and a yaw axis orthogonal to the pitch axis, the pitch axis and the yaw axis being axes of the wrist.

[0020] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform can include a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal arm coupled to the rail via one or more proximal joints, and an intermediate arm coupled to the proximal arm via an intermediate joint. The proximal arm can have an asymmetric shape such that a centerline of the proximal arm deviates from a straight line extending between a proximal end portion of the proximal arm and a distal end portion of the proximal arm when extending between the proximal end portion of the proximal arm and the distal end portion of the proximal arm.

[0021] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform can include a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal arm coupled to the rail, an intermediate arm coupled to the proximal arm, and a distal arm coupled to the proximal arm. The manipulator can be configured to be stored beneath the platform, and in a stored state of the manipulator, the distal arm and the intermediate arm can be parallel to one another and overlap along the lateral dimension, and the distal arm and the proximal arm overlap along the height dimension.

[0022] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform can include a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal arm coupled to the rail via a proximal joint housing, an intermediate arm coupled to the proximal arm, and a distal arm coupled to the proximal arm. The manipulator can be configured to be deployable in a first configuration in which the proximal arm is concave relative to the platform and the proximal joint housing extends outward from the rail, and in a second configuration in which the proximal arm is convex relative to the platform and the proximal joint housing extends inward from the rail.

[0023] According to at least one embodiment of the present disclosure, a remotely operable manipulator system can include a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail. The table assembly can include a platform configured to support a body, the platform can include a lateral dimension and a longitudinal dimension. The manipulator can be translatable relative to the rail along the longitudinal dimension of the rail. The manipulator can include a proximal arm coupled to the rail via one or more proximal joints, and an intermediate arm coupled to the proximal arm via an intermediate joint. The proximal arm can follow a non-linear path between the proximal joint and the intermediate joint. [Brief description of the drawings]

[0024] The present disclosure can be understood from the following detailed description taken alone or in conjunction with the accompanying drawings, which are included to provide a further understanding of the present disclosure, and are incorporated in and constitute a part of this specification. The drawings illustrate one or more embodiments of the present teachings and, together with the description, explain certain principles and operations.

[0025] [Figure 1] FIG. 1 is a schematic side view of an embodiment of a table-mounted manipulator system in a first state.

[0026] [Diagram 2] FIG. 13 is a perspective view of another embodiment of a table mounted manipulator system.

[0027] [Diagram 3] FIG. 3 is a perspective view of an embodiment of a first manipulator of the table mounted manipulator system of FIG.

[0028] [Figure 4] FIG. 3 is a perspective view of a second manipulator embodiment of the table mounted manipulator system of FIG.

[0029] [Diagram 5] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a first state.

[0030] [Figure 6A] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a second state.

[0031] [Figure 6B] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a third state.

[0032] [Figure 7] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a fourth position.

[0033] [Figure 8] FIG. 3 is another perspective view of a portion of the table mounted manipulator system of FIG. 2 with the manipulator in a fourth position.

[0034] [Figure 9A] FIG. 3 is a schematic perspective view of the table-mounted manipulator system of FIG. 2, with the manipulator in a fifth state.

[0035] [Figure 9B] FIG. 3 is a schematic perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a sixth state.

[0036] [Figure 10] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in a seventh position.

[0037] [Figure 11] FIG. 3 is a perspective view of the table-mounted manipulator system of FIG. 2 with the manipulator in an eighth position.

[0038] [Figure 12A] FIG. 2 is a schematic perspective view of an embodiment of a proximal link assembly in a first state.

[0039] [Figure 12B] FIG. 12B is a schematic perspective view of the proximal link assembly of FIG. 12A in a second state.

[0040] [Figure 13] FIG. 12B is an exploded perspective view of a portion of the proximal link assembly of FIG. 12A.

[0041] [Figure 14] FIG. 1 is a schematic perspective view of an embodiment of a manipulator wrist.

[0042] [Figure 15] FIG. 13 is a front view of another embodiment of a table-mounted manipulator system with the manipulator in a deployed state.

[0043] [Figure 16] FIG. 16 is a perspective view of one of the manipulators of the table mounted manipulator system of FIG. 15.

[0044] [Figure 17] FIG. 17 is a side view of an embodiment of a proximal link assembly of the manipulator of FIG.

[0045] [Figure 18] FIG. 18 is another side view of the proximal link assembly of FIG.

[0046] [Figure 19] FIG. 13 is a side view of another embodiment of a proximal link assembly.

[0047] [Figure 20] FIG. 16 is a side view of the table-mounted manipulator system of FIG. 15 with the manipulator in a stored position.

[0048] [Figure 21] FIG. 16 is a front view of the table-mounted manipulator system of FIG. 15 with the manipulator in a stored position.

[0049] [Figure 22] FIG. 16 is a top view of one of the manipulators of the table mounted manipulator system of FIG. 15 in a stored state.

[0050] [Figure 23] FIG. 16 is a perspective view of one of the manipulators of the table mounted manipulator system of FIG. 15 in a stored state.

[0051] [Figure 24] FIG. 16 is a side view of one of the manipulators of the table mounted manipulator system of FIG. 15 in a stored state.

[0052] [Diagram 25] FIG. 2 is a side view of another embodiment of a manipulator that can be used in the table mounted manipulator system of FIG. 1 with the manipulator in a stored state.

[0053] [Figure 26] FIG. 2 is a side view of another embodiment of a manipulator that can be used in the table mounted manipulator system of FIG. 1 with the manipulator in a stored state.

[0054] [Figure 27] FIG. 2 is a side view of another embodiment of a manipulator that can be used in the table mounted manipulator system of FIG. 1 with the manipulator in a stored state. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0055] As mentioned above, in a table mounted manipulator system there can be certain challenges that arise from mounting the manipulator to the table assembly, such as challenges related to constraints in positioning the manipulator.

[0056] To address the challenges with table-mounted manipulator systems, various embodiments disclosed herein contemplate a table-mounted manipulator system including a table assembly, rails coupled to the table assembly, and one or more manipulators coupled to the rails. The table assembly includes a platform for supporting a patient or other workpiece. The manipulators are translatable (parallel) relative to the table assembly along the rails. In some embodiments, the rails are optionally translatable relative to the table assembly. Translation of the manipulators along the rails (combined with rail translation in some embodiments) allows a relatively wide range of movement of the manipulators along the longitudinal dimension of the table assembly. The wide range of movement can advantageously allow the manipulators to reach a variety of locations along the patient and can facilitate moving the manipulators more fully out when desired.

[0057] Further, in embodiments disclosed herein, the manipulator includes a proximal link assembly, a distal link assembly, and an intermediate link assembly coupled in series by a joint. (In some embodiments, the intermediate link assembly is omitted and the proximal link assembly and the distal link assembly are coupled directly to each other, while in other embodiments, multiple intermediate link assemblies may be coupled in series between the proximal link assembly and the distal link assembly.) The proximal link assembly may include a proximal arm rotatably coupled to the rail via one or more proximal joints. For example, the proximal link assembly may include a first proximal joint coupled between the rail and a proximal end of the proximal arm, the first proximal joint providing rotation of the proximal arm relative to the rail about a first axis perpendicular to a longitudinal dimension of the platform in a neutral position of the table assembly.

[0058] In some embodiments, the proximal link assembly of a particular manipulator further includes a second proximal joint coupled between the rail and the first joint, which provides rotation of the first joint (and thus of the proximal arm coupled to the first joint) relative to the rail about a second axis perpendicular to the first axis and parallel to the longitudinal dimension of the rail. For example, when the table assembly is in a neutral position, the second axis can be horizontal. Rotation of the proximal arm about this second proximal joint tilts or lowers the proximal arm relative to the horizontal plane, thus raising or lowering the distal end of the proximal arm relative to the rail (and thus raising or lowering a more distal portion of the manipulator coupled to the distal end of the proximal arm). In addition, as the proximal arm tilts relative to the horizontal plane, movement of the proximal arm can correspondingly extend and raise the more distal portion of the manipulator farther beyond the table (rather than just vertical movement). The ability to tilt and / or lower the proximal arm can increase the overall range of motion of the manipulator, as described in more detail below, and can allow positions and poses of the manipulator to be achieved that might otherwise be difficult or not possible.

[0059] In some embodiments, the proximal arm is extendable and retractable. For example, the proximal arm can include two or more links (e.g., in some embodiments, coaxially nested links) that can be telescopically translated relative to one another to extend or retract the proximal arm. The extendibility of the proximal arm can allow for an increased range of motion (e.g., lengthening) of the manipulator, as described in more detail below, and can allow positions and poses of the manipulator to be achieved that may otherwise be difficult or not possible.

[0060] In some embodiments, the proximal arm has an asymmetric shape, meaning that while extending from the proximal end portion of the proximal arm to the distal end portion of the proximal arm, the proximal arm follows a non-linear path, i.e., a path that deviates from an imaginary straight line extending between (i.e., connecting) the two end portions. For example, in some embodiments, the proximal arm has a smoothly curved shape (e.g., an arcuate shape), while in other embodiments, the proximal arm has a segmented shape that includes multiple straight and / or curved segments joined together at an angle (e.g., in an L-shape).

[0061] In some instances, the asymmetric shape of the proximal arm results in a proximal arm having a concave side and a convex side, with the concave side defining an open space adjacent to it. This open space would be occupied by the proximal arm if it did not extend in a straight line between the proximal joint and the intermediate joint, but because the proximal arm is asymmetric, the open space is not occupied by the proximal arm. This open space allows the manipulator to be placed in a pose that would not otherwise be possible with a similarly sized straight proximal arm. For example, if the proximal arm is rotated upward and toward a table, a straight proximal arm would need to be stopped at a given point to avoid a collision between the arm and a patient, table, or other object, but one of the asymmetric proximal arms disclosed herein can continue to rotate some distance beyond that given point because the patient, table, or other object that would otherwise collide with the straight arm can instead fit within the open space along the concave side of the arm. This additional range of rotation of the proximal arm, for example, allows the manipulator to reach further beyond the table. As another example, when the manipulator is stowed, the open space provided along the concave side of the proximal arm can allow a more compact pose of the manipulator because one of the links of the manipulator can be positioned at least partially within the open space. For example, in some embodiments, in the stowed state, the distal arm and the proximal arm are both positioned on the same laterally extending side of the middle arm, with the distal arm positioned directly below the proximal arm and the distal arm parallel to the middle arm. This compact pose is made possible because the distal arm can extend into the open space formed along the concave side of the proximal arm.

[0062] In some embodiments with asymmetrically shaped proximal arms, the manipulator can be selectively deployed in two different configurations, including a first configuration in which the proximal arms are concave relative to the platform and a second configuration in which the proximal arms are convex relative to the platform. These different configurations of the manipulator can allow the manipulator to reach a greater variety of poses, since some poses that may be difficult or not possible in one configuration may be possible or easier in the other configuration, and vice versa. For example, in the first configuration of the manipulator (with a concave orientation of the proximal arms), the manipulator can reach farther beyond the platform than is possible in the second configuration. As another example, in the second configuration of the manipulator (with a convex orientation of the proximal arms), the manipulator can pitch the instrument holding portion further back relative to the distal link when utilizing an entry port that is lower on the patient.

[0063] In some embodiments disclosed herein, the intermediate link assembly includes an intermediate arm. In some embodiments, the intermediate arm is extendable and retractable. For example, the intermediate arm can include two or more links (e.g., in some embodiments, coaxially nested links), which are telescopically translatable relative to one another to extend or retract the intermediate arm. In some embodiments, the intermediate arm can be rotatably coupled to a distal end portion of the proximal arm via one or more intermediate rotation joints. For example, a first intermediate joint is coupled between the proximal arm and the intermediate arm, the first intermediate joint providing rotation of the intermediate arm relative to the proximal arm about a third axis perpendicular to the intermediate arm and the proximal arm. In some embodiments, the distal end of the intermediate arm is rotatable relative to the proximal arm about an axis parallel to the longitudinal dimension of the intermediate arm. For example, in some embodiments where the intermediate arm includes two or more translatable links, the links can also be rotatable relative to one another. The extensibility of the intermediate arm allows for an increased range of motion of the manipulator, as described in more detail below, allowing positions and poses of the manipulator to be achieved that might otherwise be difficult or not possible.

[0064] Various aspects of the embodiments of the table mounted manipulator system described above and further below increase the range of motion of the manipulator and may be included individually in some embodiments or in various combinations in other embodiments (including some embodiments in which all of these aspects are included together). Each of these aspects may individually contribute to increasing the range of motion of the manipulator, and in embodiments in which more than one of these aspects are combined, the effect may be even greater. For example, the ability to raise and lower the distal end portion of the proximal arm (via rotation of the proximal arm about the second proximal joint), extend and retract the proximal arm, and / or extend and retract the intermediate arm, individually or collectively (in embodiments in which more than one of the above aspects are combined), allows the manipulators to reach locations farther from the attachment point of the manipulator, while also being able to reach locations closer to the attachment point of the manipulator. For example, in some embodiments, the aspects described above and further below allow the manipulator to extend above the patient and across the platform such that the distal end portion of the manipulator is adjacent to the side of the platform opposite the side to which the manipulator is attached. This allows, for example, an instrument attached to the manipulator to use an entry port located on the side of the patient opposite the side of the platform to which the manipulator is attached. This ability of certain manipulators in the embodiments disclosed herein to cross the platform and reach to the opposite side can allow fewer manipulators to be provided along a given side of the table while maintaining the suitability of the system for procedures that may normally require more manipulators along a given side.For example, while a procedure using three entry ports located along one side of a patient would traditionally require three manipulators to be positioned on the side of the table assembly closest to the three entry ports, in some embodiments disclosed herein, a system having two manipulators on the side of the table closest to the entry ports and at least one manipulator on the opposite side of the table can perform the same procedure (e.g., with a manipulator on the opposite side of the table assembly extending above and across the platform to reach one of the entry ports). By reducing the number of manipulators located on a given side of the platform, the embodiments disclosed herein make it easier to move the manipulators away for certain tasks that require space along both longitudinal sides of the table (e.g., transferring a patient from a gurney to a table). This is because, for example, moving three manipulators to different locations when all three manipulators are mounted on the same rail is more difficult than moving four manipulators to different locations when two manipulators are mounted on one rail and two on another rail.

[0065] Moreover, the ability of a particular manipulator to reach locations on both longitudinal sides of the platform allows a single system with a given arrangement of manipulators to be used in a variety of procedures, including procedures with a variety of different inlet port arrangements. This is in contrast to using a specialized system for each type of inlet port arrangement. For example, an embodiment disclosed herein having two manipulators coupled to one side of the platform and two manipulators coupled to the other side of the platform can be used with both the above-mentioned port arrangement of three inlet ports arranged along one side of the patient, as well as other port arrangements such as four ports arranged in a line extending laterally along the midsection of the patient. In contrast, for a conventional system to be able to accommodate both of these types of port arrangements, the system may need to have at least three manipulators coupled to one side of the platform and at least two manipulators coupled to the other side. Thus, the systems disclosed herein can allow for greater variety in port arrangements and / or a reduction in the number of manipulators.

[0066] Moreover, in some embodiments, the distal link assembly includes a distal arm, an instrument holding portion, and a wrist for movably coupling the distal arm to the instrument holding portion. In some embodiments, the wrist provides three degrees of freedom of movement for the instrument holding portion relative to the distal arm. The degrees of freedom of movement provided by the wrist can enable the manipulator to position the instrument in a pose that would not otherwise be possible. For example, as described above, when reaching onto the patient on the other side of the platform, the instrument holding portion may need to be oriented at various angles relative to the distal arm to properly position the instrument to use the entry port. The wrist can provide degrees of freedom of movement that facilitate such orientation of the instrument holding portion. In some embodiments, some of the degrees of freedom of movement of the wrist mechanism are driven by an actuator located remotely from the wrist, such as in the distal arm, and an actuating element, such as a cable, extends from the actuator to the wrist to drive the movement of the wrist. This allows the wrist to be made relatively compact while still having an instrument holding portion and powered joints that are strong enough to support and move the instrument, and allows the weight of the actuator to be located more proximally along the manipulator, thus reducing the moment arm of the manipulator about the proximal joint.

[0067] I. Table Mounted Manipulator System FIG. 1 illustrates an embodiment of a table mounted manipulator system 100 ("system 100"). System 100 includes a table assembly 101, at least one rail assembly 120 coupled to the table assembly, and one or more manipulators 140 coupled to each rail assembly 120. Each manipulator 140 can support one or more instruments 150 that can be removably or permanently mounted thereon. As shown in FIG. 1, system 100 can also include a control system 1006, a user input and feedback system 1004, and / or an auxiliary system 1008. In some embodiments, system 100 is configured as a computer-assisted remotely operable medical system, in which case table assembly 101 can be configured to support a patient (not shown) and instrument 150 can be a medical instrument. System 100 in this configuration can be used to perform any of a variety of medical procedures, such as, for example, a surgical procedure, a diagnostic procedure, an imaging procedure, a therapeutic procedure, and the like. Moreover, system 100, when configured as a teleoperated medical system, does not necessarily have to be used on a live human patient. For example, non-human animals, cadavers, materials such as tissue used for training purposes, etc. can be supported on table assembly 101 and processed by system 100. In other embodiments, system 100 is configured as a computer-assisted teleoperated system for use in a non-medical context, in which case table assembly 101 can be configured to support an inanimate workpiece (something to be manufactured, repaired, tested, etc.) and tool 150 can be a non-medical tool, such as an industrial tool.

[0068] As shown in FIG. 1, the table assembly 101 includes a platform assembly 110 configured to support a patient or an inanimate workpiece, a support column 102 coupled to and supporting the platform assembly 110, and a base 105 coupled to the support column 102. The base can be configured to contact the ground or other surface on which the table assembly 101 rests to provide stability for the table assembly 101. In some embodiments, the base 105 is omitted. In some embodiments, the base 105 includes a movable structure, such as wheels, tracks, or other such structure (not shown), to enable movement of the table assembly 101 along the ground or other surface. In FIG. 1, the support column 102 is illustrated as a single vertical column section to simplify discussion, but the support column 102 can take any desired shape and include any number of sections. For example, the support column 102 can include a horizontal support structure (not shown), such as a beam, rail, or the like, to couple the platform assembly 110 to the vertical section of the support column 102. Moreover, in various embodiments, the support column 102 can be telescoping and configured to extend and contract in height.

[0069] The platform assembly 110 includes one or more platform sections 103 for supporting a patient or workpiece. The platform sections 103 each have a support surface configured to contact and support a patient or workpiece. In some embodiments, multiple platform sections 103 are used, and the platform sections 103 are arranged in series to support different portions of the patient or workpiece. For example, in the embodiment illustrated in FIG. 1, the platform assembly 110 includes a first end section 103_1, one or more middle sections 103_2, and a second end section 103_3, and the one or more middle sections 103_2 are arranged between the two end sections 103_1 and 103_3. In some embodiments, the first end section 103_1 can be configured to support the patient's head, the second end section 103_3 can be configured to support the patient's feet and / or legs, and the one or more middle sections 103_2 can be configured to support the patient's torso and / or other portions. For convenience, the side of the platform assembly 110 closer to the first end section 103_1 (e.g., the left side in the orientation shown in FIG. 1) will be referred to herein as the "head" (or "head side" or "head end") of the platform assembly 110, and the side of the platform assembly 110 closer to the second end section 103_3 (e.g., the right side in the orientation shown in FIG. 1) will be referred to herein as the "foot" (or "foot side" or "foot end") of the platform assembly 110, although this is merely an arbitrary convention chosen herein for convenience of description and is not intended to limit the configuration or use of the table assembly 101 (e.g., the patient's head can be positioned on the "foot" side of the platform assembly 110 if desired, and vice versa). The relative positions of two components or two portions of a single component can also be described using "head" and "foot" (e.g., the "head end" and "foot end" of rail 121), with "head" referring to the component or portion relatively closer to the head end of table assembly 110 and "foot" referring to the component or portion relatively closer to the foot end of table assembly 110.In other embodiments, different numbers and arrangements of platform sections 103 are used, including one, two, four, or more platform sections 103. In some embodiments, one or more of the platform sections 103 can be movable relative to the other platform sections 103 and / or relative to the support columns 102. For example, in some implementations, some or all of the platform sections 103 are coupled to adjacent platform sections 103 and / or support columns 102 by rotatable joints such that at least some of the platform sections 103 can tilt relative to each other and / or the support columns 102. The platform assembly 110 can also be movable as a whole relative to the support columns 102, as described in more detail below.

[0070] The platform assembly 110 has a longitudinal dimension 198 (e.g., parallel to the x-axis in FIG. 1), a lateral dimension orthogonal to the longitudinal dimension (e.g., parallel to the y-axis in FIG. 1), and a thickness or height dimension orthogonal to both the longitudinal dimension 198 and the lateral dimensions (e.g., parallel to the z-axis in FIG. 1). As used herein, the longitudinal dimension 198 refers to the maximum extent dimension of the platform assembly 110 when all of the platform sections 103 of the platform assembly are fully extended and oriented with their support surfaces generally aligned with one another in the same plane (or as close to this state as possible) so as to collectively form a substantially planar combined support surface with potentially small gaps between adjacent platform sections 103. In general, the longitudinal and lateral dimensions of the platform assembly 110 and the support surfaces of the platform sections 103 are oriented approximately parallel to the ground or other surface on which the table assembly 101 is supported when the platform assembly 110 is in a neutral configuration. However, those skilled in the art will appreciate that the platform assembly 110 as a whole and / or the individual platform sections 103 are not necessarily parallel to the ground, and that in various configurations in which the platform assembly 110 and / or the platform sections 103 may be movable, including in some cases in a neutral configuration, one or both of the longitudinal and / or lateral dimensions may be inclined relative to the ground. The platform assembly 110 and its various platform sections 103 have various sides or faces extending along the longitudinal dimension 198 or lateral dimension, which may be referred to herein as longitudinally extending sides (or faces) and laterally extending sides (or faces), respectively. Specifically, a longitudinally extending side (or face) is a side (or face) of the platform assembly 110, or a side (or face) of the platform section 103 that extends along the longitudinal dimension 198 of the platform assembly 110 (i.e., along the x-direction in FIG. 1).For example, one longitudinally extending side 109b of the platform assembly 1110 is shown in Figure 1. Similarly, a laterally extending side (or face) is a side (or face) of the platform assembly 110 or a side (or face) of a platform section 103 that extends along the lateral dimension of the platform assembly 110 (i.e., along the y-direction in Figure 1). For example, two laterally extending sides 109a of the platform assembly 110 are shown in Figure 1.

[0071] At least one of the platform sections 103 is directly coupled to and supported by the support columns 102. The remaining platform sections 103 can be directly coupled to the support columns 102 or they can be indirectly coupled to the support columns 102 via a chain of one or more intervening platform sections 103. For example, in some embodiments, the main platform section 103 (e.g., the middle section 103_2) is coupled to and directly supported by the support columns 102, and other portions of the platform section 103 (e.g., the end sections 103_1 and 103_3) are coupled to the main platform section 103 or to another platform section 103. As another example, in some embodiments, multiple platform sections 103 (in some embodiments, all of the platform sections 103) are directly coupled to the support columns 102 rather than to another platform section 103.

[0072] In some embodiments, some (and in some cases all) of the above-mentioned portions of the table assembly 101 can be movable relative to one another. For example, in some embodiments, the platform assembly 110 as a whole can be moved relative to the support column 102, e.g., by tilting about a horizontal axis, pivoting about a vertical axis, translating vertically along the support column 102, translating horizontally relative to the support column 102, etc. In some embodiments, such movement of the platform assembly 110 as a whole can be provided by one or more joints coupling the main platform section 103 (e.g., the intermediate section 103_2) to the support column 102. Additionally, as already mentioned above, the individual platform sections 103 can be movable relative to one another and also relative to the support column 102, which can be facilitated by joints coupling the platform section 103 to the support column 102 or to an adjacent platform section 103.

[0073] In some embodiments, the platform assembly 110 also includes one or more accessory rails 104. The accessory rails 104 can be configured to accept accessory devices removably mounted thereon, such as leg stirrups, liver retractors, arm boards, and bed extenders. In some embodiments, the accessory rails 104 conform to industry standard specifications familiar to those skilled in the art to allow compatibility with standard-compliant accessory devices. The accessory rails 104 can be mounted to one or more longitudinally extending sides of the platform section 103. One or more openings can be defined between the accessory rails 104 and the side of the platform section 103 to which the accessory rails 104 are mounted, and a portion of an accessory mounted to the accessory rails 104 can be inserted through the openings.

[0074] As mentioned above, the system 100 also includes one or more manipulators 140. Although FIG. 1 illustrates two manipulators 140, any number of manipulators 140 can be included (such as, for example, one, two, three, or more manipulators attached to each rail assembly 120, as described in further detail below). The manipulators 140 can include a kinematic structure of links coupled to each other by one or more joints. Specifically, the manipulators 140 each include a proximal link assembly including a proximal arm 141 movably coupled to the rail assembly 120 via one or more proximal joints 130, an intermediate link assembly including an intermediate arm 142 movably coupled to the proximal link assembly via one or more intermediate joints 145, and a distal link assembly including a distal arm 143 movably coupled to the intermediate link assembly by one or more distal joints 146. The distal link assembly can also include an instrument holding portion 169 coupled to the distal arm 143 and configured to support an instrument 150.

[0075] The manipulator 140 is movable through various degrees of freedom of movement provided by various joints, including proximal, intermediate and distal joints 130, 145 and 146, thus allowing the tool 150 mounted thereon to move relative to the work site. Some of the joints can provide rotation of the links relative to one another, other joints can provide translation of the links relative to one another, and other joints can provide both rotation and translation. In particular, in some embodiments, the proximal arm 141 is rotatably coupled to the rail 121 via a first proximal joint 130a, which provides rotation of the proximal arm 141 relative to the rail 121 about a first axis 136 that is perpendicular to the longitudinal dimension 197 of the rail 121 (e.g., perpendicular to the x-direction in FIG. 1). In the neutral state of the proximal arm 141, the first axis 136 is perpendicular to the lateral dimension of the rail 121 (e.g., perpendicular to the y direction in FIG. 1), and thus, in this state, the first axis 136 is oriented vertically (i.e., perpendicular to the aforementioned horizontal plane, or in other words, perpendicular to the z direction in FIG. 1). In addition, in the neutral state of the table assembly 101, where the platform 110 is parallel to the ground and the rail 121 (i.e., the x direction in the orientation in FIG. 1), the first axis 136 is also perpendicular to the longitudinal axis 198 of the platform 110, although this is not necessarily the case in other states (e.g., states where the platform 110 is tilted relative to the rail 121, which is possible in some embodiments).

[0076] In some embodiments, the proximal link assembly of a particular manipulator 140, in addition to allowing rotation about the first axis 136, is configured to allow rotation of the proximal link 141 about a second axis 137, the second axis 137 being orthogonal to the first axis 136. In some embodiments, rotation about the second axis 137 can be provided by a second proximal joint 130b included in the proximal link assembly. In particular, in some embodiments, the proximal link assembly of a particular manipulator 140 further includes a second proximal joint 130b, where the first and second proximal joints 130a and 130b together couple the proximal arm 141 to the rail 121, and the second proximal joint 130b provides for rotation of the proximal arm 141 relative to the rail 121 about a second axis 137 that is perpendicular to the first axis 136 and parallel to the longitudinal dimension 197 of the rail 121 (e.g., the x-direction in FIG. 1). In some embodiments, the second proximal joint 130b is coupled between the rail 121 and the first proximal joint 130a, while in other embodiments, the second proximal joint 130b is coupled between the first proximal joint 130a and the proximal joint 141 (not shown in FIG. 1) (see, for example, FIG. 16, which illustrates an embodiment in which the second proximal joint 530b is coupled between the first proximal joint 530a and the proximal arm 541). In yet other embodiments, rotation about the second axis 137 is provided by the first proximal joint 130a without the addition of a second proximal joint (e.g., the first proximal joint 130a is configured to provide rotation about multiple axes, such as a ball-and-socket joint). The longitudinal dimension 197, and therefore the second axis 137, is parallel to the ground in some embodiments. In the neutral state of the table assembly 101, the second axis 137 is also parallel to the longitudinal axis 198 of the platform 110, although this is not necessarily the case in other states (e.g., when the platform 110 is tilted relative to the rail 121, which is possible in some embodiments).Rotation of the proximal arm 141 about this second axis 137 (e.g., via the second proximal joint 130b) causes the proximal arm 141 to tilt or lower relative to the horizontal plane, thus raising or lowering the distal end of the proximal arm 141 relative to the rail 121. Additionally, as the proximal arm 141 tilts relative to the horizontal plane, movement of the proximal arm 141 can correspondingly extend and raise a more distal portion of the manipulator 140 farther beyond the table (rather than just moving vertically). In some embodiments, rotation about the second axis 137 (e.g., via the second proximal joint 130b) can enable the proximal arm 141 to move between orientations that range at least between a horizontal orientation and a vertically tilted orientation (e.g., at least a 90 degree rotation). In some embodiments, rotation about the second axis 137 (e.g., via the second proximal joint 130b) can also enable rotation of the proximal arm 141 to an orientation that is inclined relative to the horizontal orientation. In some embodiments, certain manipulators 140 include the ability to rotate about the second axis 137 (e.g., via the second proximal joint 130b), while other embodiments do not. For example, in some embodiments, a first manipulator 140, whose proximal arm 141 is positionable below a second manipulator 140 in a nested configuration (described further below), may include a second proximal joint 130b (e.g., because a downward positioning of the proximal arm 141 makes room for the proximal joint 130b), while the second proximal joint 130b may be omitted in the second manipulator 140 (e.g., because a more upward positioning of the proximal arm 141 of the second manipulator 140 does not leave enough room for the second joint). In other embodiments (not shown) coupled to the same rail 121, all of the manipulators 140 (or, in some embodiments, all of the manipulators 140 in the system 100) include the ability to rotate about the second axis 137 (e.g., via the second proximal joint 130b).In yet other embodiments (as shown), none of the manipulators 140 coupled to a given rail 121 (or, in some embodiments, none of the manipulators 140 in the entire system 100) have the ability to rotate about the second axis 137.

[0077] Additionally, in some embodiments, the proximal arm 141 is extendable and retractable. For example, the proximal arm 141 can include two or more links that can be telescopically translated relative to one another to extend or retract the proximal arm 141. In other words, the two or more links are coupled to one another by a prismatic joint or themselves form a prismatic joint. For example, in some embodiments, the proximal arm 141 includes an outer link having a bore (e.g., an axial bore extending along the longitudinal axis of the proximal arm 141) and an inner link nested within the outer link within the bore.

[0078] Additionally, in some embodiments, the proximal arm 141 has an asymmetric shape, meaning that the proximal arm 141 follows a non-linear path, i.e., a path that deviates from an imaginary straight line extending between (i.e., connecting) the two end portions, as it extends from a proximal end portion of the proximal arm 141 to a distal end portion of the proximal arm 141. More specifically, the proximal arm 141 can extend between a proximal joint 130 that is coupled to the proximal end portion of the proximal arm 141 and an intermediate joint 145 (described below) that couples the distal end portion of the proximal arm 141 to the intermediate arm 142, with a centerline of the proximal arm 141 extending between these joints 130 and 145 that deviates from a straight line between the axes of the respective joints 130 and 145. For example, in some embodiments, the proximal arm 141 has a smoothly curved shape (e.g., the centerline of the proximal arm follows a smoothly curved path), while in other embodiments, the proximal arm 141 has a segmented shape that includes multiple straight and / or curved segments that are joined to each other at an angle (e.g., an L-shape). Various embodiments of proximal arms having asymmetric shapes, which may be the configuration of the proximal arm 141, are described in more detail below with reference to Figures 15-24.

[0079] In some embodiments, the intermediate arm 142 can be rotatably coupled to a distal end portion of the proximal arm 141 via one or more intermediate rotation joints 145. For example, the intermediate joint 145 can provide for rotation of the intermediate arm 142 relative to the proximal arm 141 about a third axis (not shown) perpendicular to the intermediate arm 142 and the proximal arm 141. Additionally, in some embodiments, the intermediate joint 145 can provide for rotation of the distal end of the intermediate arm 142 relative to the proximal arm 141 about an axis parallel to the longitudinal dimension of the intermediate arm 142. In some embodiments, the intermediate arm 142 is also extendable and retractable. For example, the intermediate arm 142 can include two or more links that can telescopically translate relative to each other to extend or retract the intermediate arm 142 in a manner similar to that described above with respect to the proximal arm 141. In some embodiments, the links of the intermediate arm 142 are translatable relative to each other along the longitudinal dimension of the intermediate arm 142 and are also rotatable relative to each other about an axis parallel to the longitudinal dimension of the intermediate arm 142, thus providing the above-mentioned rotation of the distal end of the intermediate arm 142 relative to the proximal arm 141 about an axis parallel to the longitudinal dimension of the intermediate arm 142.

[0080] Moreover, in some embodiments, the distal arm 143 is movably coupled to the instrument holding portion 169 via a wrist 147, which includes a joint for moving the instrument holding portion 169 relative to the distal arm 143. The joint of the wrist 147 may be referred to herein as a wrist joint. In some embodiments, the wrist 147 provides multiple rotational degrees of freedom of movement. For example, in some embodiments, the wrist 147 has three rotational degrees of freedom of movement for the instrument holding portion 169 relative to the distal arm 143. For example, the wrist 147 may be rotatably coupled to the distal arm 143 to provide a roll degree of freedom of movement that includes rotation of the entire wrist 147 about an axis parallel to the distal arm 143, and the wrist 147 may further include two joints for providing yaw and pitch degrees of freedom of movement that include rotation about pitch and yaw axes perpendicular to each other. One of the pitch and yaw axes is also perpendicular to the roll axis (the other of the pitch and yaw axes can also be perpendicular to the roll axis in a neutral state of the wrist 147, but not necessarily in other states). In some embodiments, the joints providing some of the degrees of freedom of movement of the wrist 147 (e.g., yaw and pitch in some embodiments) are driven by actuators located remotely from the wrist 147, such as a more proximal portion of the manipulator 140 with actuator elements (such as cables, filaments, belts, bands, linkages) extending from the actuators 147 to the wrist 147 to drive the movement of the wrist. For example, in some embodiments, the wrist includes two wrist joints located at the wrist that provide rotation about the yaw and pitch axes, and these two wrist joints can be coupled to actuation elements (e.g., cables) that drive the rotation. In some embodiments, the actuators that drive the wrist 147 are positioned in the distal arm 143. Locating the actuators remotely from the wrist 147 allows the wrist 147 to be more compact.A compact wrist, such as wrist 147, can be positioned closer to other portions of manipulator 140, which can, in some circumstances, allow for greater flexibility in positioning and posing manipulator 140. Moreover, locating the actuator in a more proximal portion of manipulator 140, such as in distal arm 143, moves the weight of the actuator closer to the proximal end of the kinematic chain that makes up manipulator 140, thus reducing the moment arm generated by the weight of the actuator.

[0081] Some or all of the joints of system 100 described above (as well as other joints that may be present in the system) are powered joints, meaning that a powered drive element can control the movement of the joint through the supply of an actuation force. Such powered drive elements can include, for example, electric motors, pneumatic or hydraulic actuators, and other types of powered drive elements familiar to those skilled in the art. In some embodiments, the joints of wrist 147 are powered joints. Additionally, in some embodiments, some of the joints of system 100 can be manual (e.g., unpowered) joints that can be manually articulated, for example, by manually moving a link coupled thereto. Joints referred to herein as "unpowered" can lack a powered drive element to drive the articulation of the joint, but can include other powered aspects or devices, such as electronically (or hydraulically / pneumatically) controlled brakes, sensors (e.g., position, velocity, force, torque sensors), or other powered devices. Further, in some embodiments, some of the joints of the system 100 can be partially powered and partially manually articulated, e.g., powered elements such as motors can assist in the operation, e.g., by compensating for gravitational loads, but some manual power input can also be used to effect articulation. In addition, some joints (powered or unpowered) can be passively balanced (e.g., via masses or springs). Certain joints can be actively controllable during the performance of the procedure, e.g., under the control of the control system 1006, in response to inputs listed in the user input and feedback system 1004. Other joints, sometimes referred to as set-up joints, can be articulated during a set-up phase in preparation for the performance of the procedure, but generally can remain more or less stationary during the performance of the procedure.The set-up joints can be powered, manually articulatable, or partially powered. For example, in some embodiments, the proximal joint 130 and the prismatic joint that provide the extension of the proximal arm 141 are set-up joints.

[0082] As described above, the instrument holding portion 169 is configured to support the instrument 150, and in some embodiments, the instrument holding portion 169 includes a drive interface to removably couple an instrument and provide a drive input (e.g., mechanical force, electrical input, etc.) to drive the instrument coupled thereto. For example, the drive interface can include an output coupler (not shown) to engage (directly or indirectly through an intermediary) with an input coupler (not shown) of the instrument 150 to provide a drive force or other input to an attached instrument 150 to control various degrees of freedom movement and / or other functionality of the instrument 150, such as moving an end effector of the instrument, opening and closing jaws, driving translation and / or rotation of various components of the instrument, delivery of matter and / or energy from the instrument, and various other functions familiar to those of skill in the art. The output coupler can be driven by an actuator (e.g., an electric servo motor, a hydraulic actuator, a pneumatic actuator) familiar to those of skill in the art. To maintain a sterile separation between the instrument 150 and the manipulator 140, an instrument sterilization adapter can be disposed between the instrument 150 and the instrument manipulator mount interface. The instrument manipulator mount can also include other interfaces (not shown), such as an electrical interface for providing electrical signals to and / or receiving electrical signals from the instrument 150. The instrument 150 can include any tool or instrument, including, for example, industrial and medical instruments (e.g., surgical instruments, imaging instruments, diagnostic instruments, therapeutic instruments, etc.). In some embodiments, the system 100 can also include a flux delivery transmission capability, for example, to provide electricity, fluid, vacuum pressure, light, electromagnetic radiation, etc. to the end effector. In other embodiments, such flux delivery transmission can be provided to the instrument through another auxiliary system 1008, which is described further below and which one of ordinary skill in the art would be familiar with in the context of a computer-assisted telemedicine system.

[0083] Additional details regarding manipulators are described below with reference to FIGS. 3, 4 and 16, which illustrate various embodiments of manipulators 240 and 540 that can be used as manipulator 140. Additionally, in some embodiments, aspects of the manipulator 140 may be implemented using manipulators described in U.S. Provisional Patent Application No. 63 / 336,773, entitled “RAIL ASSEMBLY FOR TABLE MOUNTED MANIPULATOR SYSTEM, AND RELATED DEVICES, SYSTEMS AND METHODS,” with Ryan Abbott as inventor, and U.S. Provisional Patent Application No. 63 / 336,778, entitled “NESTING PROXIMAL LINKS FOR TABLE MOUNTED MANIPULATOR SYSTEM, AND RELATED DEVICES, SYSTEMS AND METHODS,” with Bram Lambrecht as first inventor, both filed on April 29, 2022, or in U.S. Provisional Patent Application No. 63 / 336,778, entitled “Multi-Port Surgical Robotic System Architecture,” with Schena et al., the entire contents of each of which are incorporated herein by reference. No. 9,358,074 issued to Schena et al. (filed May 31, 2013), U.S. Pat. No. 9,295,524 issued to Schena et al. (filed May 31, 2013), entitled “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator,” and U.S. Pat. No. 8,852,208 issued to Gomez et al. (filed August 12, 2010), entitled “Sugical System Instrument Mounting.”Various other embodiments of the manipulator can include those configured as part of medical systems that are part of various da Vinci® Surgical Systems, such as the da Vinci®, da Vinci Xi®, and da Vinci SP systems, commercialized by Intuitive Surgical, Inc. of Sunnyvale, California.

[0084] The number, location, and type of links and joints of the manipulator and its various degrees of freedom of movement are not limited to those described above. In some embodiments, the manipulator includes additional links, joints, and / or degrees of freedom beyond those described above. In other embodiments, the manipulator can omit certain links, joints, and / or degrees of freedom described above. Embodiments contemplated herein include embodiments that include various combinations of one or more of the links, joints, and degrees of freedom of movement described above.

[0085] As shown in FIG. 1 , the manipulator 140 is coupled to the table assembly 101 via at least one rail assembly 120. In some embodiments, multiple similar rail assemblies 120 are provided, e.g., one rail assembly for each longitudinally extending side of the platform assembly 110. For example, in some embodiments, a first rail assembly 120 can be provided on a first longitudinally extending side of the platform assembly 110 and a second rail assembly 120 can be provided on a second longitudinally extending side of the platform assembly 110. In such embodiments having multiple rail assemblies 120, the manipulators 140 can be coupled to the rail assemblies 120 in any number or combination, and since the rail assemblies 120 can be disposed along different sides of the platform assembly 110, the manipulators 140 can also be disposed along different sides of the platform assembly 110. The following description describes one rail assembly 120 for ease of description, but other rail assemblies 120 (if present) may be similarly configured. The rail assembly 120 includes a rail 121 and a number of carriages 126 (also referred to as "first carriages 126") coupled to the rail 121 and the manipulators 140 to enable movement of the manipulators 140 along the rail 121. More specifically, the first carriage 126 may be coupled to (or may be part of) a proximal link assembly of a corresponding manipulator 140. Each carriage 126 is movable along a longitudinal dimension 197 of the rail 121 and couples a respective corresponding one of the manipulators 140 to the rail 121 such that the manipulators 140 can translate relative to the rail 121 along the longitudinal dimension 197 of the rail 121. In some embodiments, a longitudinal dimension 197 of the rail 121 is parallel to a longitudinal dimension 198 of the platform assembly 110 (eg, parallel to the x-axis) in the neutral configuration of the platform assembly 110, as shown in FIG.

[0086] The movable rail 121 includes a first set of engagement features 122 configured to engage with complementary engagement features of the first carriage 126. For example, the first set of engagement features 122 of the rail 121 can include a track including a flange extending along the longitudinal dimension 197, and the complementary engagement features of the first carriage 126 are configured to engage with and ride along the flange of the first set of engagement features 122. The first set of engagement features 122 can also include a track including a groove into which the complementary engagement features are received. Any other type of complementary engagement features that allow for relative translation when engaged can be used as the complementary engagement features, and one of ordinary skill in the art will be familiar with the various complementary engagement features used in rail and carriage systems. In some embodiments, the first set of engagement features 122 and / or the complementary engagement features can include bearing devices configured to reduce friction to facilitate easier translation, such as wheels, balls, sliding bearing surfaces coated or otherwise provided with a low friction material, and other friction reducing mechanisms. Although one first carriage 126 is shown per manipulator 140 in FIG. 1, multiple first carriages 126 can be provided to operably couple to and support a given manipulator 140.

[0087] In some embodiments, in addition to the manipulator 140 being movable along the rail 121, the rail 121 can also be movable relative to the table assembly 101. In such embodiments, the rail assembly 120 also includes one or more carriages 127 (also referred to as "second carriages 127") coupled to the rail 121 and the table assembly 101 to enable movement of the rail 121. More specifically, the carriages 127 couple the rail 121 to the table assembly 101 such that the rail 121 can translate relative to the table assembly 101 along the direction of the longitudinal dimension 197 of the rail 121. Notably, in these embodiments, the rail 121 includes a second set of engagement features 123 (e.g., tracks or other engagement features) that engage with complementary engagement features of the second carriage 127 to couple the rail 121 to the second carriage 127 while enabling translation between the rail 121 and the second carriage 127.

[0088] In some embodiments, translation between the rail 121 and the table assembly 101 is provided by relative motion between the second carriage 127 and the rail 121. For example, in some embodiments, the second carriage 127 is fixed relative to the table assembly 101 (e.g., is part of the table assembly 101), and the rail 121 and the second carriage 127 are movably coupled to one another, such that the rail 121 translates relative to the second carriage 127 along the direction of the longitudinal dimension 197 of the rail 121. For ease of description, one second carriage 127 is shown in FIG. 1, however, any number can be used, including none in some embodiments.

[0089] In some embodiments, translation of the rail 121 and table assembly 101 is provided by relative motion between the second carriage 127 and the table assembly 101. For example, in some embodiments, the second carriage 127 is fixed relative to (e.g., a portion of) the rail 121 and movably coupled to the table assembly 101 such that translation of the second carriage 127 relative to the table assembly 101 along the longitudinal dimension 197 also causes the rail 121 to translate relative to the table assembly 101.

[0090] In some embodiments, translation between the rail 121 and the table assembly 101 is provided by a combination of relative motion between the second carriage 127 and the rail 121 and relative motion of the second carriage 127 and the table assembly 101 .

[0091] In some embodiments in which the second carriage 127 is movably coupled to the table assembly 101, the rail assembly 120 further includes a second rail 124, which can be coupled between the second carriage 127 and the table assembly 101. In other embodiments, the second carriage 127 can be directly coupled to the table assembly 101.

[0092] The moveability of the rail 121 relative to the table assembly 101 allows for a greater range of motion of the manipulator 140 and / or a shortening of the rail 121 as compared to a configuration in which the rail 121 is fixed relative to the table assembly 101. This allows the rail assembly 120 and / or the manipulator 140 to be more easily moved out of the way of the platform assembly 110 to avoid interference with the platform assembly 110 and / or its individual platform sections 103 as they are moved through various configurations. However, in some embodiments, the rail 121 is fixed relative to the table assembly 101 and the manipulator 140 is positioned relative to the platform assembly 110 solely through movement of the manipulator 140 along the rail 121.

[0093] In some embodiments, the rail assembly 120 is coupled to one of the platform sections 103. In other embodiments, the rail assembly 120 is coupled to the support column 102. Which structure the rail assembly 120 is coupled to can make a difference in embodiments where the platform assembly 110 is movable relative to the support column 102 as a whole, for example by tilting relative to the support column 102. In embodiments where the rail assembly 120 is coupled to one of the platform sections 103 (e.g., the intermediate section 103_2), as the platform assembly 110 moves relative to the support column 102, the rail assembly 120, and therefore the manipulator 140 coupled to the rail assembly 120, moves with the platform assembly 110. This allows the manipulator 140 to automatically maintain a set pose and position relative to the platform assembly 110, and thus, the patient supported on the platform assembly, regardless of the configuration of the platform assembly 110, without requiring repositioning of the manipulator 140. Moreover, in some circumstances, collisions between the platform assembly 110 and the rail assembly 120 due to movement of the platform assembly 110 can be avoided when they move together. In embodiments where the rail assembly 120 is coupled to a support column, as the platform assembly 110 moves relative to the support column 102, the rail assembly 120, and therefore the manipulator 140 coupled to the rail assembly 120, stays on the support column 102 and does not move with the platform assembly 110. This can allow for greater movement of the rail assembly 120 and manipulator 140 relative to the platform assembly 110. This can also increase the strength and / or relative stiffness of the structure between the manipulator 140 and the support column 102 by reducing the length of the structure between them and reducing the number of connections between them.

[0094] In some embodiments, a motor or other actuating device (not shown) is provided to drive the relative translation between the rail 121 and the first carriage 126. Similarly, in embodiments in which a second carriage 127 is present, a motor or other actuating device (not shown) can be provided to drive the relative translation between the rail 121 and the second carriage 127 and / or between the second carriage 127 and the table assembly 101. In some embodiments, the motor / actuator is housed within the rail 121. In some embodiments, the motor / actuator is housed within the first and / or second carriages 126 and 127. In some embodiments, the motor / actuator is housed within the table assembly 101.

[0095] In some embodiments, movement of the manipulator 140 relative to the platform assembly 110 enabled by the rail assembly 120 allows a distal link assembly of the manipulator 140 to be moved to a nested configuration near one end portion of the platform assembly 110, which allows the intermediate and distal link assemblies of the manipulator 140 to be moved from around an end of the platform assembly 110 to a position adjacent a laterally extending side 109a of the platform assembly 110. In particular, in some embodiments, the nested configuration includes a configuration in which the proximal arms 141 of two adjacent manipulators 140 coupled to the same rail 121 are oriented at an angle of 180 degrees or more with respect to that rail 121 (measured in the same direction as the angles φ_1 and φ_2 shown in FIG. 10, described in more detail below). In other words, the nested configuration includes a configuration in which each of the proximal arms 141 is oriented parallel to or beyond the longitudinal dimension 197 of the rail 121 and / or the longitudinal dimension 199 of the platform 110. Moreover, in the nested configuration, the proximal arms 141 of the two manipulators 140 are positioned adjacent to each other near an end portion of the platform assembly 110 (e.g., near the foot end in some embodiments), and the proximal arms 141 overlap each other in the vertical direction (e.g., in the z-axis direction). This allows the manipulators to step out of the way for tasks that require clearance along the longitudinally extending side 109b of the platform assembly 110. In the embodiment of FIG. 1, the manipulators 140 are configured to be moved beyond the foot end of the platform assembly 110 in the nested configuration. In other embodiments, the manipulator 140 can be moved beyond the head end of the platform assembly 110, and in yet other embodiments, the manipulator 140 can be moved beyond both the head and foot ends. Additionally, the nesting configuration can allow the manipulator 140 to be stored in a compact manner beneath the second end section 103_3.

[0096] In some embodiments, the rail assembly 120 can be similar to the rail assemblies described in U.S. Provisional Patent Application No. 63 / 336,773, entitled "RAIL ASSEMBLY FOR TABLE MOUNTED MANIPULATOR SYSTEM, AND RELATED DEVICES, SYSTEMS AND METHODS," and U.S. Provisional Patent Application No. 63 / 336,778, entitled "NESTING PROXIMAL LINKS FOR TABLE MOUNTED MANIPULATOR SYSTEM, AND RELATED DEVICES, SYSTEMS AND METHODS," both of which are incorporated by reference above.

[0097] A user input and feedback system 1004, a control system 1006, and an auxiliary system 1008 are further described. Some or all of these components can be provided remotely from the table assembly 101. The user input and feedback system 1004 is operatively coupled to the control system 1006 and includes one or more input devices for receiving input control commands to control the operation of the manipulator 140, the instruments 150, the rail assembly 120, and / or the table assembly 101. Such input devices can include, for example, but are not limited to, telepresence input devices, triggers, grip input devices, buttons, switches, pedals, joysticks, trackballs, data gloves, trigger guns, gaze detection devices, voice recognition devices, body movement or presence sensors, touch screen technology, or any other type of device for registering user input. In some cases, the input devices can have the same degrees of freedom as the associated devices they control, and when the input devices are actuated, the instruments are controlled to follow or mimic the movement of the input devices through drive inputs from the manipulator assembly, which can provide the user with the sensation of directly controlling the instruments. The telepresence input device can provide the operator with telepresence, meaning the perception that the input device is integral with the instrument. The user input and feedback system 1004 can include feedback devices, such as a display device (not shown) that displays an image (e.g., an image of the workspace as captured by one of the instruments 1010), a haptic feedback device, an audio feedback device, other forms of graphical user interface feedback, etc.

[0098] The control system 1006 can control the operation of the system 100. In particular, the control system 1006 can send control signals (e.g., electrical signals) to the table assembly 101, the rail assembly 120, the manipulator 140, and / or the instrument 150 to control the movement and / or other operation of the various components. In some embodiments, the control system 1006 can also control the operation of some or all of the user input and feedback system 1004, the auxiliary system 1008, or other components of the system 100. The control system 1006 can include an electronic controller that controls and / or assists a user in controlling the operation of the manipulator assembly 1001. The electronic controller includes processing circuitry configured with logic for performing various operations. The logic of the processing circuitry can include dedicated hardware for performing various operations, software (machine-readable and / or processor-executable instructions) for performing various operations, or any combination thereof. In examples where the logic includes software, the processing circuitry can include a processor for executing the software instructions and a memory device for storing the software. A processor may include one or more processing devices capable of executing machine-readable instructions, such as, for example, a processor, processor core, central processing unit (CPU), controller, microcontroller, system-on-chip (SoC), digital signal processor (DSP), graphics processing unit (GPU), etc. When the processing circuitry includes special-purpose hardware in addition to or instead of a processor, the special-purpose hardware may include any electronic device configured to perform a specific operation, such as an application specific integrated circuit (ASIC), field programmable gate array (FPGA), complex programmable logic device (CPLD), discrete logic circuit, hardware accelerator, hardware encoder, etc. The processing circuitry may also include any combination of special-purpose hardware and processor plus software.

[0099] Different degrees of user control versus autonomous control can be utilized in the system 100, and embodiments disclosed herein can include systems that are fully user controlled, fully autonomously controlled, and systems with any combination of user and autonomous control. For user-controlled operations, the control system 1006 generates control signals in response to receiving corresponding user input commands via the user input and feedback system 1004. For autonomously controlled operations, the control system 1006 can execute pre-programmed logic (e.g., software programs) and determine and send control commands based on the programming (e.g., in response to detected conditions or stimuli specified in the programming). In some systems, some operations can be user controlled and in other systems can be autonomously controlled. Moreover, some operations can be partially user controlled and partially autonomously controlled. For example, a user input command can initiate the execution of a sequence of events, and then the control system 1006 can execute various operations associated with that sequence without requiring further user input.

[0100] 2-11, another embodiment of a table mounted manipulator system 200 ("system 200") is described below. System 200 can be used as system 100, and some components of system 200 can be used as components of system 100 described above. In particular, system 200 includes manipulators 240 (e.g., manipulators 240_1, 240_2) that can be used as manipulators 140 of system 100, as described in more detail below. Thus, the description of the components of system 100 described above is applicable to the relevant components of system 200, and duplicate descriptions of these components are omitted below. Related components of systems 100 and 200 are given reference numbers having the same rightmost two digits, e.g., 140 and 240. System 200 is one embodiment of system 100, but system 100 is not limited to system 200.

[0101] As shown in FIG. 2, system 200 includes a table assembly 201, two rail assemblies 220 coupled to the table assembly, and a number of manipulators 240 coupled to the rail assemblies 220. Each manipulator 240 is configured to support one or more instruments (not shown) that can be removably or permanently mounted thereon. System 200 may also include a control system (not shown), a user input and feedback system (not shown), and / or ancillary systems (not shown) similar to those described above with respect to system 100. In some embodiments, system 200 is configured as a computer-assisted teleoperated medical system. In other embodiments, system 200 is configured as a teleoperated system for use in non-medical contexts.

[0102] 2, the table assembly 201 includes a platform assembly 210 configured to support a patient or inanimate workpiece, a support column 202 coupled to and supporting the platform assembly 210, and a base 205 coupled to the support column 202. The base 205 can be configured to contact the ground or other surface on which the table assembly 201 rests, and in some embodiments, the base 205 includes wheels 206 that enable movement of the system 200 along the ground or other surface. In some embodiments, the support column 202 includes a telescoping support column that can raise or lower the platform assembly 210.

[0103] The platform assembly 210 includes a plurality of platform sections 203 configured to support a patient or workpiece. In particular, in the embodiment shown in FIGS. 2-11, the platform assembly 210 includes a first end section 203_1 ("head section 203_1"), intermediate sections 203_2 and 203_3, and a second end section 203_4 ("foot section 203_4") arranged in series and movably coupled to one another via joints 207. In some embodiments, the first end section 203_1 can be configured to support the patient's head, the second end section 203_4 can be configured to support the patient's feet and / or legs, and the intermediate sections 203_2 and 203_3 can be configured to support the patient's torso and / or other parts. The joints 207 allow adjacent platform sections 203 to pivot relative to one another about an axis of rotation parallel to a lateral dimension 299 of the platform assembly 210 (e.g., parallel to the y-axis in the figures). In some embodiments, one or more of the platform sections 203 can be removable when it is not needed, for example, based on the size of the patient or based on the procedure to be performed. In some embodiments, additional platform sections 203 can be added to the platform assembly 210. In some embodiments, an auxiliary device can be coupled to one or more of the platform sections 203 in addition to or instead of one or more of the platform sections 203. For example, in some embodiments, a leg stirrup can be coupled to the middle section 203_3 instead of the second end section 203_4. While Figures 7, 10, and 11 show the platform sections 210 in a neutral configuration in which all of the platform sections 203 are parallel to each other and to the ground or other support surface on which the table assembly 201 rests, Figures 2 and 5 show the platform sections 210 in an articulated configuration in which a portion of the platform section 203 is oriented at a non-zero angle relative to adjacent platform sections 203 and / or relative to the ground or other support surface.In some embodiments, some of the joints 207 may also allow other movements between adjacent platform sections 203, such as relative rotation about a vertical axis parallel to the lateral and height dimensions perpendicular to the longitudinal dimensions 299 and 298 (i.e., the z-axis in the figures) or relative translation along the longitudinal dimension 298. In some embodiments, the platform sections 203 include a relatively rigid support portion 203b and a softer cushion portion 203a attached to the support portion 203b, with a surface of the cushion portion 203a (i.e., the upper surface in the orientation shown in FIG. 2) forming a support surface that contacts the patient or workpiece. In some embodiments, multiple platform sections 203 may share some components. For example, as shown in FIG. 2, the intermediate platform sections 203_2 and 203_3 may share the same cushion portion 203a that extends across both platform sections 203_2 and 203_3. As shown in FIG. 2, the cushion portion 203a shared by the platform sections 203_2 and 203_3 can bend when the platform sections 203_2 and 203_3 are articulated to one another.

[0104] In addition to moving individual platform sections 203 relative to adjacent platform sections 203, the platform assembly 210 as a whole is movable relative to the support column 202. In some embodiments, the intermediate section 203_3 is coupled to the support column 202 by one or more joints (not shown) to provide movement between the intermediate section 203_3 and the column 202. The other platform sections 203_1, 203_2, and 203_4 are coupled (directly or indirectly) to the intermediate section 203_3, such that as the intermediate section 203_3 moves relative to the support column 202, the platform assembly 210 as a whole moves relative to the support column 202. In some embodiments, movement of the intermediate section 203_3 (and thus the entire platform assembly 210) relative to the support column 202 includes pivoting (tilting) about a horizontal axis parallel to the lateral dimension 299 (e.g., pitch degree of freedom of movement), as shown in FIG. In some embodiments, other degrees of freedom of movement are provided between the central section 203_3 and the support column 202, including pivoting (tilting) about a horizontal axis parallel to the longitudinal dimension 298 (e.g., roll degree of freedom of movement), rotation about a vertical axis (e.g., yaw degree of freedom of movement), and / or translation along the longitudinal and / or lateral dimensions 299 or 298. As shown in Figures 7, 10, and 11, in the neutral configuration of the platform assembly 210, the platform assembly 210 is parallel to the ground or other supporting surface.

[0105] 2, the platform assembly 210 also includes a number of accessory rails 204 attached to the sides of the support portions 203b of the platform sections 203. The accessory rails 204 can be configured to receive accessory devices, such as leg stirrups, liver retractors, arm boards, and bed extenders, removably mounted thereon. The accessory rails 204 are attached to the longitudinally extending sides of one or more of the platform sections 203.

[0106] As mentioned above, the system 200 includes a plurality of manipulators 240. In the embodiment shown in Figures 2-11, there are four manipulators 240, two manipulators 240 on each longitudinally extending side 209b of the platform assembly 210 (i.e., two manipulators 240 are attached to a first longitudinally extending side 209b of the platform assembly 210 and two manipulators 240 are attached to a second longitudinally extending side 209b of the platform assembly 210). In other embodiments, more or fewer manipulators 240 can be used, such as one, two, three, or more manipulators per longitudinally extending side 209b. In FIG. 11, the manipulator 240 is shown stored under the end section 203_4 while remaining coupled to the rail 221, while in FIGS. 2-10, some or all of the manipulator 240 are shown in various deployed states (not all of the manipulator 240 are visible in each of the figures). A deployed state includes a state in which one or more of the manipulators 240 are not stored, which in some embodiments means that at least one or more of the manipulators 240 are at least partially unfolded / uncompacted and removed from a stored position, e.g., removed from under the platform assembly 110, while remaining coupled to the rail 221. The manipulator 240 can be positioned in various deployed states. In some deployed states, the manipulator 240 has a distal link assembly that is deployed and positioned within a sterile field (see, e.g., FIG. 2). A sterile field is an area in which any exposed surfaces of objects within that area are maintained sterile (e.g., substantially free of contaminants such as biological agents, dust, oil, etc.) and non-sterile surfaces are covered by a sterile barrier. The sterile field typically includes the area above a certain height, such as above the rail 221, platform 210, or other selected reference point, while portions below that height are not considered to be within the sterile field.In some deployment states, the distal link assembly 263 is elevated to a height sufficient to allow the distal link assembly 263 and any instruments supported thereon to remain within the sterile field during deployment. Thus, in some embodiments, in the deployment state, the distal link assembly 263 is at or above the height of the proximal arm 241, rail 221, platform 210, and / or some other predetermined level. In other deployment states, the manipulator 240 can be deployed but does not have the distal link assembly positioned completely within the sterile field (see, e.g., FIG. 10). Deployment states can include various configurations and positions of the manipulator 240, including, but not limited to, those shown in FIGS. 2-10.

[0107] The manipulator 240 includes a number of links movably coupled to each other via joints, as described above with respect to the manipulator 140. In particular, Figures 3 and 4 show two embodiments of manipulators 240_1 and 240_2, respectively. The manipulators 240_1 and 240_2 are generally similar to each other, except that the manipulator 240_1 includes two proximal joints 230 and associated joint housings 264 and 265, and the proximal arm 241 of the manipulator 240_1 is positioned at a lower height than the proximal arm 241 of the manipulator 240_2, as described in more detail below. In some embodiments, one manipulator 240 of each rail 221 is configured like the manipulator 240_1 shown in Figure 3, while the other manipulator 240 of each rail is configured like the manipulator 240_2 shown in Figure 4. In other embodiments, multiple manipulators 240 coupled to the same rail 221 have two proximal joints 230 similar to manipulator 240_1, and in particular, in some embodiments, all of the manipulators 240 have two proximal joints 230 similar to manipulator 240_1. In still other embodiments, none of the manipulators 240 coupled to a given rail 221 (including, in some embodiments, none of the manipulators 240 in the entire system 200) have two proximal joints 230. For example, in some of these embodiments, all of the manipulators 240 are configured similarly to manipulator 240_2. The following description of the various parts of the manipulator 240 below is applicable to both types of manipulators 240_1 and 240_2, unless specifically described as applying to one type or the other.

[0108] 3 and 4, each manipulator 240 includes a proximal link assembly 261 including a proximal arm 241 coupled to the rail assembly 220 via one or more proximal joints 230 and a carriage 226, an intermediate link assembly 262 including an intermediate arm 242 coupled to a distal end portion of the proximal link assembly 261 via one or more intermediate joints 245, and a distal link assembly 263 including a distal arm 243 coupled to the intermediate link assembly 262 via one or more distal joints 246. The distal link assembly 263 also includes an instrument holding portion 269 coupled to the distal arm 243 and configured to support an instrument 250.

[0109] As described above, the proximal link assembly 261 includes the proximal arm 241. As shown in FIGS. 3 and 4, the proximal arm 241 includes a first link 241a and a second link 241b. The first and second links 241a and 241b are movable relative to one another along a direction 248 parallel to the longitudinal dimension of the proximal arm 241. In the illustrated embodiment, the first link 241a and the second link 241b are in a telescoping configuration to provide a translational degree of freedom of movement with the second link 241b received within a bore in the first link 241a, although in other embodiments, the opposite configuration is used with the first link 241a received within a bore in the second link 241b. In yet other embodiments, the first and second links 241a and 241b are arranged in a configuration in which the links 241a and 241b are translatable relative to one another but cannot be received one within the other, such as a side-by-side configuration in which the links 241a and 241b are positioned adjacent to one another or a one-above-the-other configuration in which the links 241a and 241b are aligned with one another in series (e.g., end-to-end).

[0110] As shown in Figures 3 and 4, a proximal end portion of the proximal arm 241 of each manipulator 240 is coupled to a carriage 226 (also referred to as "first carriage 226") via a first proximal joint 230a. The carriage 226 is in turn coupled to the rail 221, as shown in Figure 2. The first proximal joint 230a allows rotation of the proximal arm 241 relative to the carriage 226 (and thus relative to the rail 221) about a first axis 236 that is perpendicular to the longitudinal dimension 297 of the rail 221, as shown in Figures 2-4. The first axis 236 is perpendicular to both the longitudinal dimension 297 and the lateral dimension 299 of the platform 210, or in other words is oriented vertically in the neutral position of the table assembly 201 and in the neutral state of the proximal arm 241.

[0111] As mentioned above, one difference between the manipulator 240_1 of Fig. 3 and the manipulator 240_2 of Fig. 4 is that the manipulator 240_1 further includes a second proximal joint 230b interposed between the first proximal joint 230a and the carriage 226, whereas in the manipulator 240_2, the first proximal joint 230a is directly coupled to the carriage 226 without the second proximal joint 230b. The second proximal joint 230b provides for rotation of the proximal arm 241 relative to the rail 221 about a second axis 237 that is perpendicular to the first axis 236 and parallel to the longitudinal dimension 297 of the rail 221 (i.e., when the table assembly 101 is in a neutral position, the second axis 237 is horizontal). More specifically, the first proximal joint housing 264 is rotatably coupled to the second proximal joint housing 265 via the second proximal joint 230b to allow the second proximal joint housing 265 to rotate relative to the first proximal joint housing 264 about the second axis 237. The first proximal joint housing 264 is coupled to the carriage 226, and the second proximal joint housing 265 is rotatably coupled to the proximal arm 241 via the first proximal joint 230a. In the embodiment shown in Figures 2-11, the first and second proximal joint housings 264 and 265 each form an L-shaped 90 degree bend. In other embodiments, a different joint arrangement can be used for the proximal joint 230, such as in the embodiment of Figures 12A-12B described in more detail below, where a 45 degree rotational joint is used as the second proximal joint. As another example, in some embodiments, one or more manipulators 240 include one or more proximal joints 230 that enable rotation of the proximal arm 241 about axes 236 and 237, similar to manipulator 240_1, but unlike manipulator 240_1, the proximal joints 230 in these manipulators 240 are configured such that the second axis 237 is not significantly offset from the central longitudinal axis of the proximal arm 241 (e.g., the second axis 237 and the central longitudinal axis of the proximal arm 241 intersect and are in the same plane).Moreover, in still other embodiments, none of the manipulators 240 coupled to the same rail 221 (or, in some embodiments, none of the manipulators 240 in the entire system 200) have the ability to rotate about axis 237, e.g., multiple manipulators 240_2 are present while manipulator 240_1 is not provided.

[0112] Rotation of the proximal arm 241 about the second axis 237 (e.g., via the second proximal joint 230b) causes the proximal arm 241 to tilt or lower relative to a horizontal plane (e.g., a plane parallel to the longitudinal or lateral dimensions 298 and 299 of the platform 210 in embodiments in which the rail assembly 220 is coupled to the platform 210, or a plane parallel to the ground in embodiments in which the rail assembly 220 is coupled to the support column 202), thereby raising or lowering the distal end of the proximal arm 241 relative to the rail 221. For example, FIG. 9A shows the proximal arm 241 in a neutral position parallel to a horizontal plane defined by longitudinal and lateral dimensions 298 and 299, and FIG. 9B shows the proximal arm 241 in a tilted position where the proximal arm 241 is rotated about the second axis 237 (e.g., via the second proximal joint 230b) and tilted at a positive angle θ relative to the horizontal plane. As the proximal arm 241 tilts relative to the horizontal plane, the movement of the proximal arm 241 can extend and lift a more distal portion of the manipulator farther beyond the table (rather than just vertical movement). The ability to rotate about the second axis 237 (e.g., via the second proximal joint 230b) allows the proximal arm 241 to be moved between orientations in a range at least between the horizontal and vertical tilt orientations (e.g., at least 90 degree rotation or any angle between them). For example, Figures 6 and 7 show the proximal arm 241 of one manipulator 240 (marked 240_1 in Figures 6 and 7) tilted in a fully vertical orientation (i.e., parallel to the height dimension of the platform 210, or the z-axis in the figures). In some embodiments, the ability to rotate about the second axis 237 (e.g., via the second proximal joint 230b) can also enable rotation of the proximal arm 241 to a lowered orientation relative to a horizontal orientation.

[0113] Another difference between manipulators 240_1 and 240_2 is that the proximal arm 241 of manipulator 240_1 is positioned at a different height relative to rail 221 than the proximal arm 241 of manipulator 240_2, as best seen in FIGS. 10 and 11. Specifically, the proximal arm 241 of manipulator 240_1 is positioned further away from rail 221 (i.e., closer to the ground or other supporting surface) in the vertical (z-axis) direction than the proximal arm 241 of manipulator 240_2. More specifically, the height difference between these proximal arms 241 is large enough that the lower proximal arm 241 of manipulator 240_1 can move below the higher proximal arm 241 of manipulator 240_2 without colliding, as shown in FIGS. 10 and 11. This height difference is determined by the height dimensions of the first and second proximal joint housings 264 and 265. The height difference allows the manipulators 240 to be arranged in a nested configuration, as in Figures 10 and 11. Specifically, the nested configuration includes a configuration in which the proximal arms 241 of two adjacent manipulators 240_1 and 240_2 coupled to the same rail 221 are oriented at angles φ_1 and φ_2 of 180 degrees or more relative to that rail 221, as shown in Figure 10 (the angles referred to here are measured in the direction shown in Figure 7). In other words, the nested configuration includes a configuration in which each of the proximal arms 241 is oriented parallel to or beyond the longitudinal dimension 297 of the rail 221 and / or the longitudinal dimension 298 of the platform 210, as shown in Figures 10 and 11. Moreover, in the nested configuration, the proximal arms 241 overlap each other in the vertical direction (e.g., z-axis direction). In some circumstances, the telescoping configuration allows a more distal portion of the manipulator 240 in the deployed state to be pivoted around the edge of the platform 210 so that the manipulator 240 can be moved away from the longitudinally extending side 209b of the platform assembly 210 to a location along the laterally extending side 209a of the platform, as shown in FIG.The nested configuration, in which the manipulator 240 is deployed and positioned along the laterally extending side 209a, may be beneficial for various tasks that require or benefit from free space along the longitudinally extending side 109b, such as moving a patient from a patient transport mobile bed to the platform assembly 210. The nested configuration also allows the manipulator 240 to be stored in a compact manner under the second end section 203_4, as shown in FIG. 11. It should be understood that in some embodiments, offsets between the heights of adjacent proximal arms 241, such as those described above, may be provided using different numbers, shapes, and / or arrangements of proximal joints and joint housings than those shown in FIGS. 2-4. 2-4, the proximal arms 241 of manipulator 240_1 are vertically offset at least in part due to the inclusion of second proximal joint 230b, whereas in other embodiments, manipulators 240 lacking such a second proximal joint (or lacking the ability to rotate about second axis 237) may nevertheless have their proximal arms 241 vertically offset, for example, by providing a proximal joint housing that extends vertically downward from carriage 226. Moreover, in some embodiments, no vertical offset is provided between the proximal arms 241 of adjacent manipulators 240.

[0114] 2-4, the intermediate link assembly 262 includes an intermediate arm 242. As shown in FIGS. 3 and 4, the intermediate arm 242 includes a first link 242a and a second link 242b. The first and second links 242a and 242b are movable relative to one another along a direction 249 parallel to a longitudinal dimension of the intermediate arm 242. In other words, the first and second links 242a and 242b are coupled to one another by a prismatic joint. In the illustrated embodiment, the first link 242a and the second link 242b are in a telescoping configuration to provide a translational degree of freedom of movement, and the second link 241b is received within a bore in the first link 242a, although in other embodiments the opposite configuration is used, with the first link 242a being received within a bore in the second link 242b, and in still other embodiments the first and second links 242a and 242b are positioned side by side instead of one being received within the other.

[0115] As shown in FIGS. 3 and 4, a proximal end portion of the intermediate arm 242 of each manipulator 240 is rotatably coupled to a second link 241b of the proximal arm 241 via a first intermediate joint 245a. More specifically, the proximal end portion of the intermediate arm 242 is rotatably coupled to an intermediate joint housing 266 via the first intermediate joint 245a, which is coupled to or is part of a distal end portion of the proximal arm 241. The first intermediate joint 245a enables rotation of the intermediate arm 242 relative to the proximal arm 241 about a third axis 238 perpendicular to the longitudinal dimension of the proximal arm 241 and the longitudinal dimension of the intermediate arm 242. In addition, a second intermediate joint 245b is provided to enable rotation of a distal portion of the intermediate arm 242 relative to the proximal portion of the intermediate arm 242 about a fourth axis 239 parallel to the longitudinal dimension of the intermediate arm 242. For example, in the embodiment shown in Figures 3 and 4, the second intermediate joint 245b rotatably couples the first link 242a to the second link 242b such that the second link 242b can rotate relative to the first link 242a about the fourth axis 239 while also allowing translation between the first links 242a and 242b. In other words, in the embodiment of Figures 3 and 4, the second intermediate joint 245b functions as both a prismatic joint between the first and second links 242a and 242b described above and a revolute joint between the first and second links 242a and 242b. In other embodiments, the second intermediate joint 245b can function only as a revolute joint and / or can be located at a different location within the intermediate link assembly 262 instead of being located between the first and second links 242a and 242b. For example, in some embodiments (not shown), the first link 242a is split into two portions: a proximal portion rotatably coupled to the proximal arm 241 via a first intermediate joint 245a and a distal portion rotatably coupled to the proximal portion via a second intermediate joint 245b.The distal portion of the first link 242a can then be movably coupled to the second link 242b via a prismatic joint as described above. Thus, in such an embodiment, the prismatic joint between the first link 242a and the second link 242b is located distal to the second intermediate joint 245b. In yet another embodiment, the second link 242b is split into two portions that are rotatably coupled to each other by the second intermediate joint 245b, in which case the prismatic joint between the first and second links 242a and 242b is located proximal to the second intermediate joint 245b.

[0116] The distal link assembly 263 includes a distal arm 243, a wrist 247, and an instrument holding portion 269 coupled to the distal arm 243 via the wrist 247. As shown in FIGS. 3 and 4, a proximal end portion of the distal arm 243 of each manipulator 240 is rotatably coupled to a second link 242b of the middle arm 242 via a first distal joint 246a. More specifically, a distal end of the second link 242b is coupled to or includes a first distal joint housing 267, which is rotatably coupled to a second distal joint housing 268 coupled to or part of the distal arm 243. The first distal joint 246a allows for rotation of the distal arm relative to the middle arm 242 about a fifth axis 252 perpendicular to the longitudinal dimension of the middle arm 242 and the longitudinal dimension of the distal arm 243. Additionally, the second distal joint 246b rotatably couples the wrist 247 (via the arm 243) to the second distal joint housing 268 such that the wrist 247 can rotate relative to the second distal joint housing 268 about a sixth axis 251 that is parallel to the longitudinal dimension of the distal arm 243. Rotation about this sixth axis 251 via the second distal joint 246b constitutes a degree of freedom of movement of the wrist 247 that can be referred to as roll. Thus, the sixth axis 251 can also be referred to as a roll axis. In some embodiments, the distal arm 243 moves with the wrist 247 as the wrist rotates about the sixth axis 251 (i.e., the distal arm 243 rotates relative to the second distal joint housing 268), and in other embodiments, the distal arm 243 remains stationary relative to the second distal joint housing 268 as the wrist rotates about the sixth axis 251 (i.e., the wrist 247 rotates relative to the distal arm 243).

[0117] In addition to the roll degree of freedom of movement described above, the wrist 247 allows for rotation of the instrument holding portion 269 relative to the arm 243 about two additional axes, namely, seventh and eighth axes 253 and 254. The seventh and eighth axes 253 and 254 are perpendicular to each other. The seventh and eighth axes 253 and 254 are also perpendicular to the sixth axis 251, and thus perpendicular to the longitudinal dimension of the distal arm 243 in the neutral state of the wrist 247, but not necessarily in other states of the wrist 247. Specifically, in some embodiments, the seventh axis 253 remains perpendicular to the sixth axis 251 in all states of the wrist, while the eighth axis 254 is not. In other embodiments, this relationship is reversed, with the eighth axis 254 remaining perpendicular to the sixth axis 251, while the seventh axis 253 is not. Rotation about the seventh and eighth axes 253 and 254 can be referred to as pitch and yaw degrees of freedom of motion, respectively, and thus the seventh and eighth axes 253 and 254 can be referred to as pitch and yaw axes, respectively. Specifically, wrist 247 includes two wrist joints that provide rotation about the seventh and eighth axes. Figure 14, described in more detail below, shows an embodiment of a wrist mechanism that can be used as wrist 247.

[0118] Although some of the degrees of freedom of motion of the manipulator 240 described above are redundant in the sense that they are not strictly necessary to manipulate the instrument, the inclusion of these redundant degrees of freedom of motion can improve the operation of the manipulator 240 in certain situations, for example, by aiding in reaching and collision avoidance. For example, the rotation (yaw) of the wrist 247 about the eighth axis 254, the extension of the proximal arm 241 along the direction 248, and the extension of the middle arm 242 along the direction 249 may be redundant degrees of freedom of motion. In some embodiments, one, some, or all of these degrees of freedom of motion are omitted. In some embodiments, some or all of these redundant degrees of freedom of motion can be used as set-up joints whose positions are fixed to obtain a desired deployed pose of the manipulator 240, but which then remain stationary during a procedure (or are moved infrequently during a procedure when a change in pose is desired).

[0119] As shown in FIGS. 3 and 4 , the instrument holding portion 269 includes an instrument holder base member 255 coupled to the wrist 247 and extending parallel to the eighth axis 254, an instrument holder 244 movably coupled to the instrument holder base member 255, and an accessory mount portion 256 coupled to one end portion of the instrument holder base member 255. The instrument holder 244 is translatable along the length of the instrument holder base member 255 along a direction parallel to the eighth axis 254. The instrument holder 244 includes an interface that couples to an instrument 250 mounted thereon. For example, the interface can include an output coupler (not shown) that engages (directly or indirectly through an intermediate) with an input coupler (not shown) of the instrument 250 to provide a drive force or other input to the mounted instrument 250 to control the various degrees of freedom of movement and / or other functionality of the instrument 250. The accessory mount 256 is configured to receive an accessory mounted thereon, such as a cannula. A cannula attached to accessory mount portion 256 can be positioned to receive an instrument shaft of an instrument 250 attached to instrument holder 244. The instrument shaft and passageway through the cannula can define an insertion axis along which the instrument may translate in response to translation of the instrument holder 244 along the instrument holder base member 255. A remote center of motion can be located within, at, or on the insertion axis near the cannula.

[0120] The configuration of manipulator 240 described above provides a wide range of manipulator movement, allowing manipulator 240 to be positioned and posed in a variety of poses, which can enable an instrument held by manipulator 240 to reach locations (e.g., entry ports) that may not otherwise be possible. In particular, the above-described aspects relating to at least the ability of proximal arm 241 to rotate about second proximal joint 230b, the ability of proximal arm 241 to extend, the ability of middle arm 242 to extend, and / or the degrees of freedom of movement provided by wrist 247, individually or in any combination, can facilitate positioning and posing of manipulator 240. For example, Figures 5-6B show all four manipulators 240 positioned and arranged to position the shafts of instruments 250 (not shown in Figure 5) supported thereon to access four entry ports 280 located near a central portion of the platform 210 (e.g., along the patient's abdomen) in a line extending parallel to the lateral dimension 299 of the platform (virtual locations of the entry ports 280 are shown in Figures 5-6B, but the actual locations may vary from case to case as desired). As shown in Figure 5, in order for the shafts of the instruments 250 to reach the entry ports 280, the instrument-holding portions 269 of each of the manipulators 240 need to be positioned in a variety of different poses relative to their respective distal arms 243, and such positioning and posing of the instrument-holding portions 269 may be facilitated by the freedom of movement provided by the wrists 247 described above. Without the wrists 247, such positioning and posing of the instrument-holding portions 269 may be difficult or not possible in some circumstances.For example, the distal arms 243 and instrument holding portions 269 of manipulators 240_1 and 240_3 may block manipulators 240_2 and 240_4, preventing the manipulators 240 from being positioned in series, but the freedom of movement provided by wrist 247 may allow the instrument holding portions 269 of manipulators 240_2 and 240_4 to be oriented as shown in FIG. 5 so that the shafts of the instruments 250 of all manipulators 240 can reach the line of inlet ports 280 even though the instrument holding portions 269 are not arranged in series. While the above description focuses on an example where only one manipulator 240 from each rail 221 can reach beyond the platform 210 to the opposite side, in some embodiments, multiple manipulators (including, in some embodiments, all manipulators) coupled to the same rail may be configured to reach beyond the platform 210 to the opposite side. For example, in some embodiments, four manipulators configured similarly to manipulator 240_1 are provided, with two manipulators coupled to each longitudinal side of the platform via two rail assemblies, and all four of these manipulators can reach onto the platform and patient to reach entry ports on opposite sides of the patient and position instruments mounted thereon.

[0121] Additionally, the wrist 247 may also allow for an increased range of motion of the distal end of the instrument 250 within the patient. For example, Figures 6A and 6B show the manipulator 240_2 moving between two states while the instrument shaft of the instrument 250 is inside the patient. In Figure 6A, the instrument holding portion 269 of the manipulator 240_2 is positioned somewhat upright to allow the distal end of the shaft of the instrument 250 to reach a location inside the patient near the entry port 280. In Figure 6B, the instrument holding portion 269 of the manipulator 240_2 is moved to a relatively lowered orientation from the position of Figure 6A to allow the distal end of the shaft of the instrument 250 to reach a location inside the patient away from the entry port 280. Such movement of the instrument holding portion 269 between these two states is facilitated by the freedom of movement of the wrist 247. Moreover, in some embodiments, once set to a desired pose, the proximal arm 241 and the intermediate arm 242 (and in some embodiments the distal arm 243 as well) do not move at all (or in some embodiments move very little) during the performance of subsequent tasks of the overall procedure, so that, after setting the initial pose, subsequent position changes of the instrument 250 occur exclusively (or in some embodiments primarily) through movement of the wrist 247. This can allow personnel or equipment to be positioned near the more proximal and intermediate portions of the manipulator 240 during a procedure without concern that the manipulator 240 will subsequently move and collide with the personnel or equipment, because it is known in advance that only the instrument holding portion 269 of the manipulator 240 will move around during the procedure.

[0122] As another example of how the configuration of the manipulators 240 described above provides a wide range of motion for the manipulators 240 and allows the manipulators to be posed in various poses, Figs. 7 and 8 show one of the manipulators 240_1 reaching over and beyond the platform 210 and the patient supported on the platform 210 such that the instrument holding portion 269 is in a position opposite the side to which the manipulator 240_1 is attached. This allows the instrument 250 supported by the manipulator 240_1 to reach the entry port 280 on the opposite side of the patient. Thus, the system 200 can perform a procedure with three entry ports 280 located on one side of the patient, as shown in Fig. 8, even with only two manipulators 240 positioned along the same side as the entry port 280. The reach of the manipulator 240_1 on the platform 210 is partially facilitated by the second proximal joint 230b. Specifically, by rotating the proximal arm 241 about the second axis 237 via the second proximal joint 230b, the proximal arm 241 tilts relative to the horizontal plane, as shown in Figure 9B, which raises the distal end of the proximal arm 241. This raising of the distal end of the proximal arm 241 can position the intermediate arm 242 coupled thereto at a height above the patient, such that the intermediate arm 242 can extend at least partially laterally from the proximal arm 241 across the platform 210 and the patient, as shown in Figure 8. Moreover, the ability of the proximal arm 241 to extend (increase in length) can be used in the tilted state described above to raise the distal end of the proximal arm 241 even higher than would be possible from tilting only the proximal arm 241, as shown in FIG. 8, which can further help position the intermediate arm 242 at a sufficient height to allow the intermediate arm 242 to extend at least partially above and laterally across the patient (this can be particularly useful when additional vertical clearance is needed, such as with larger patients).With the intermediate arm 242 positioned above the patient and extending partially across the patient, the distal arm 243 can be oriented to extend the remaining path from the intermediate arm 242 across the patient to position the instrument holding portion 269 along the opposite side of the platform 210, as shown in Figure 8. Moreover, the ability of the intermediate arm 242 to extend (increase in length) can be used in this configuration to increase the distance that the intermediate arm 242 and distal arm 243 can reach laterally, which can further aid in positioning the instrument holding portion 269 along the opposite side of the platform 210 (which can be particularly useful when additional lateral reach is needed).

[0123] As shown in FIG. 2, the manipulators 240 are coupled to the table assembly 201 via rail assemblies 220. One rail assembly 220 is provided for each of the two longitudinally extending sides of the platform assembly 210. The following description describes a single rail assembly 220 for ease of description, and other rail assemblies 220 can be similarly configured. As shown in FIG. 2, the rail assembly 220 includes a movable rail 221 ("rail 221"), a first carriage 226 coupled to the rail 221 and the manipulators 240 (at least one first carriage 226 per manipulator 240), and one or more second carriages 227 coupled to the rail 221 and the table assembly 201. Each first carriage 226 couples a respective one of the manipulators 240 to the rail 221 such that the manipulators 240 can move relative to the rail 221 along a longitudinal dimension 297 of the rail 221. In addition, each second carriage 227 couples the rail assembly 220 to the platform assembly 210 (e.g., the central section 203_3) such that the rail 221 can translate relative to the platform assembly 210 and the support column 202 along a longitudinal dimension 297 of the rail 221. Specifically, in the embodiment shown in FIGS. 2-11, one or more second carriages 227 couple the rail 221 to the central section 203_3, and thus, in this embodiment, the longitudinal dimension 297 of the rail 221 is parallel to the longitudinal dimension 298 of the platform assembly 210 regardless of how the platform assembly 210 is moved or oriented relative to the support column 202. In other embodiments, the rail assembly 220 can be coupled to another platform section 203. In yet other embodiments, the rail assembly 220 can be directly coupled to the support column 202; thus, in these embodiments, the orientation of the longitudinal dimension 297 of the rail 221 relative to the longitudinal dimension 298 of the platform assembly 110 can differ depending on the orientation of the platform assembly 210 relative to the support column 202.

[0124] 2, the movable rail 221 includes first and second sets of engagement features 222 and 223 configured to engage with complementary engagement features of the first and second carriages 226 and 227, respectively, to movably couple the rail 221 to the first and second carriages 226 and 227. The first set of engagement features 222 is configured to engage with complementary engagement features of the first carriage 226, while the second set of engagement features 223 is configured to engage with complementary engagement features of the second carriage 227. The first and second sets of engagement features 222 and 223 each include two tracks including flanges and / or grooves extending along the longitudinal dimension 297, and the complementary engagement features of the first and second carriages 226 and 227 are configured to engage and ride along the flanges and / or in the grooves of the first and second sets of engagement features 222 and 223, respectively. The tracks 222 of the first set of engagement formations are spaced apart from one another in a lateral dimension to provide increased stability and strengthen the coupling with the first carriage 226. The second set of engagement formations 223 are similarly configured. In some embodiments, the complementary engagement formations of the first and second carriages 226 and 227 can include bearing devices (not shown) configured to reduce friction to promote easier translation, such as wheels, balls, plain bearing surfaces, etc.

[0125] In some embodiments, the rail assembly 220 further includes a translation mechanism configured to drive the translation of the first carriage 226 relative to the rail and to drive the movement of the rail 221 relative to the second carriage 227. The translation mechanism can include an actuator, such as an electric motor or other actuation device (e.g., a hydraulic, pneumatic, or other device for providing motive force).

[0126] The ability to translate the manipulator 240 and rail 221 relative to the table assembly 201 allows the manipulator 240 to be moved to various positions. Specifically, in one state, the rail 221 and manipulator 240 can be moved toward one end of the table assembly 201 (e.g., toward the foot end) to facilitate placing the manipulator 240 in the nested configuration described above and shown in FIG.

[0127] 12A-13, an embodiment of a proximal link assembly 361 is described below. The proximal link assembly 361 can be used as a proximal portion of one or more of the manipulators 140 of the system 100 described above. Moreover, the proximal link assembly 361 can be used in place of the proximal link assembly 261 in the system 200 described above. Thus, the descriptions of similar components above are applicable to the associated components of the proximal link assembly 361, and redundant descriptions of these components are omitted below. The associated components are given reference numbers having the same rightmost two digits, e.g., 141 and 341.

[0128] 12A, the proximal link assembly 361 includes a proximal arm 341, a first 45 degree joint 371, a first proximal joint 330a that rotatably couples the proximal arm 341 to the first 45 degree joint 371, a second 45 degree joint 372, and a second proximal joint 330b that rotatably couples the first 45 degree joint 371 to the second 45 degree joint 372. The second 45 degree joint 372 may be coupled to or may include a carriage 326 that may be used to couple the proximal link assembly 361 to a rail, such as the rail 121 or 221 described above. The first proximal joint 330a allows the proximal arm 341 to rotate relative to the first 45 degree joint 371 about an axis 373 that is perpendicular to the longitudinal dimension of the proximal arm 341.

[0129] The first and second 45 degree joint parts 371 and 372 each include an engagement portion 374 and 375 that is angled at 45 degrees relative to a horizontal plane 379. The horizontal plane 379 is parallel to the longitudinal and lateral dimensions of the rail to which the proximal link assembly 361 is coupled (or can be coupled). The engagement portions 374 and 375 are parallel to each other when the first and second 45 degree joint parts 371 and 372 are coupled to each other, as shown in FIGS. 12A-13, so that the engagement surface between the engagement portions 374 and 375 is oriented at a 45 degree angle relative to the horizontal plane 379, as shown in FIG. 12B. The first 45 degree joint part 371 further includes an arm coupling portion 376 that is coupled to the proximal arm 341 and coupled to the engagement portion 374. As shown in FIGS. 12A-13. The arm coupling portion 376 extends from the engagement portion 374 in a first direction 377 that is perpendicular to the arm coupling portion 376 and parallel to the axis 373, and the proximal arm 341 extends from the arm coupling portion 376 in a second direction 378 that is perpendicular to the first direction 377. The second 45 degree joint portion 372 further includes a rail coupling portion 381 that is coupled to (or includes) the carriage 326 and coupled to the engagement portion 375.

[0130] The second proximal joint 330b includes a rotatable coupling between the first 45 degree joint portion 371 and the second 45 degree joint portion 372 that allows for relative rotation between the first 45 degree joint portion 371 and the second 45 degree joint portion 372 about an axis 382. For example, as shown in FIG. 13, in some embodiments, the second proximal joint 330b includes a rotational bearing mechanism 383 that rotatably couples the first and second 45 degree joint portions 371 and 372 to one another. In some embodiments, the rotational bearing mechanism 383 has an outer bearing portion 384 coupled to the first 45 degree joint portion 371 and an inner bearing portion 385 coupled to the second 45 degree joint portion 372, where the inner bearing portion 384 and the outer bearing portion 385 are rotatable relative to one another. For example, in some embodiments, ball bearings are held in raceways between the inner bearing portion 384 and the outer bearing portion 385 to facilitate low friction rotation. Those skilled in the art will appreciate that other types of bearing mechanisms may be used as the rotary bearing mechanism 383, including plain bearings (with or without lubricants, coatings, or other friction-reducing additives).

[0131] Because the angle between engagement portions 374 and 375 is 45 degrees, rotation of the first 45 degree joint portion 371 relative to the second 45 degree joint portion 372 about axis 382 causes the arm coupling portion 376 to change orientation relative to the second 45 degree joint portion 372, and therefore relative to the rail. Specifically, in a first state shown in Figure 12B, the arm coupling portion 376 extends vertically from the engagement portion 374 (i.e., the first direction 377 is vertical in this state), and in a second state shown in Figure 12A, the arm coupling portion 376 extends horizontally from the engagement portion 374 (i.e., the first direction 377 is horizontal in this state). The state of Figure 12A is reached from the state of Figure 12B by rotating the first 45 degree joint 372 180 degrees about axis 382, ​​and by rotating the proximal arm 341 about the first proximal joint 330a by 180 degrees. Rotation about the second proximal joint 330b thus moves the proximal arm 341 through a range of motion between and including the vertical tilt orientation (Figure 12A) and the horizontal orientation (Figure 12B).

[0132] The second proximal joint 330b described above, including the first and second 45 degree joints 371, 372, can be relatively compact compared to other joints and can be stiffer than other joints because the axis 382 is not aligned with other axes of the manipulator, so compliance about the axis 382 does not affect the other axes. On the other hand, other joints such as the second proximal joint 230b described above can allow more options for the orientation of the proximal arm (e.g., in some embodiments, any orientation between horizontal and vertical), whereas in some circumstances the second proximal joint 330b can allow a separate set of fixed orientations (e.g., in some embodiments, fully vertical and fully horizontal).

[0133] The 45 degree angle of the joints 371 and 372 described above is merely exemplary, and other angles can be used in other embodiments. The angle used determines the range of motion of the proximal arm 341. For example, if it is not necessary to reach a full 90° tilt for the proximal arm 341 in the final position, the joints 371 and 372 can be angled at less than 45°. For example, in some embodiments, a 70° tilt of the proximal arm 341 is sufficient to provide the desired reach across the table, and therefore the joints 371 and 372 are angled at 35°. In other embodiments, any other desired combination of angles of the joints 371 and 372 can be used to obtain various angles of tilt of the proximal arm 341.

[0134] 14, an embodiment of list 447 will be described. List 447 can be used as list 147 or 247 described above, and duplicate descriptions of similar aspects of list 447 will be omitted below.

[0135] Wrist 447 includes three rotational degrees of freedom of movement about axes 451, 453, and 454. More specifically, the degrees of freedom of movement provide for rotation of an instrument holding portion 469 coupled to wrist 447 about axes 451, 453, and 454. These axes 451, 453, and 454 are mutually orthogonal, meaning that in a neutral state of the wrist, such as the state shown in FIG. 14, the axes are all perpendicular to each other (however, they are not necessarily all perpendicular in other states). In some embodiments, axis 451 is orthogonal (perpendicular) to axis 454 in all states, and axis 454 is orthogonal (perpendicular) to axis 453 in all states, but axes 453 and 451 can be non-perpendicular to each other in certain states other than the neutral state. The degrees of freedom of movement of the wrist can be referred to as roll (i.e., rotation about axis 451), pitch (i.e., rotation about axis 454), and yaw (i.e., rotation about axis 453). In some embodiments, one or more of the degrees of freedom of movement of wrist 447 are redundant degrees of freedom of movement (redundant degrees of freedom of movement are as described above). For example, in some embodiments, the pitch and / or yaw degrees of freedom of movement of wrist 447 are redundant.

[0136] The wrist includes a first link 486a, a second link 486b, a first wrist joint 492, and a second wrist joint 493. The first link 486a is rotatably coupled to a distal end portion of the distal arm 443 (which may be used as the distal arm 143 or 243) of the manipulator via the first wrist joint 492 such that the first link 486a can rotate about an axis 454 that is perpendicular to the longitudinal dimension 487 of the distal arm 443 and perpendicular to an axis 451 (described further below). Thus, the first wrist joint 492 provides a pitch degree of freedom of movement for the wrist 447 described above. The second link 486b is rotatably coupled to the first link 486a via the second wrist joint 493 such that the second link 486b can rotate about an axis 453 that is perpendicular to the axis 454. Thus, the second wrist joint 493 provides the yaw degree of freedom of movement of the wrist 447 described above. (Axis 453 is also perpendicular to the longitudinal dimension 487 of the distal arm 443 in the neutral state of the wrist 447, as shown in FIG. 14 .) A roll degree of freedom of movement of the wrist 447 can be provided by a third joint positioned proximal to the wrist. For example, in some embodiments, the distal arm 443 includes distal and proximal portions that are rotatably coupled to one another by a revolute joint such that the distal portion of the distal arm 443 can rotate relative to the proximal portion about axis 451 that is aligned with the longitudinal dimension 487. Because the wrist 447 is coupled to the distal portion of the distal arm 443, the wrist 447 rotates with the distal portion of the distal arm 443 about axis 451, thus providing a roll degree of movement. In other embodiments, the first link 486a of the wrist 447 is coupled to the distal arm 443 via a rotary joint (not shown) that provides rotation between the first link 486a and the distal arm 443, thus providing a rolling degree of freedom of movement.In yet another embodiment, the distal arm 443 is rotatably coupled to another link assembly (e.g., the intermediate link assembly 262) by a joint (not shown) that provides rotation of the entire distal arm 443 (and thus of the wrist 447 coupled to the distal arm) about axis 451, thereby providing a roll degree of freedom of movement.

[0137] In some embodiments, the first and second revolute joints 492 and 493 are actuable by an actuator (e.g., a motor) located externally from the wrist, such as in a more proximal portion of the manipulator (e.g., in the distal arm 443). The first and second revolute joints 492 and 493 can be coupled to the actuator by an actuation element (not shown), such as a cable, filament, belt, band, linkage, etc., that extends distally from the more proximal portion of the manipulator into the wrist 447. Housing the actuator remotely from the wrist 447 allows the wrist 447 to have a relatively small diameter, also reducing the moment arm of the manipulator.

[0138] As shown in FIG. 14, the instrument holding portion 469 coupled to the wrist 447 (which can be used as the instrument holding portion 269) includes an instrument holder base member 455, and an accessory mount portion 456 coupled to the second link 486b and extending in a different direction from the second link 486b. An insertion axis 490 is configured to pass through an accessory (e.g., a cannula) attached to the accessory mount portion 456, and the insertion axis 490 is the axis along which the shaft of the instrument extends when attached to an instrument mount (not shown) coupled to the instrument holder base member 455. As shown in FIG. 14, the insertion axis 490 is offset a predetermined distance from the wrist 447, specifically, from the axis 453. In some embodiments, the axes 490 and 453 are disposed in the same plane as each other (first plane). Furthermore, the axes 453 and 451 are disposed in the same plane as each other (second plane). In some states, the first and second planes are parallel, while in other states, the first and second planes are angled with respect to each other (depending on the rotation about axis 453). In addition, axes 454 and 451 are disposed in the same plane (third plane) as each other. Moreover, rotation axes 451, 453, and 454 do not intersect with the remote center of motion of the system. In addition, in the embodiment shown in FIG. 14, the longitudinal dimension of instrument holder base member 255 is slightly offset from axis 453. In other embodiments (not shown), the longitudinal dimension of instrument holder base member 255 can be aligned with axis 453.

[0139] 15-24, another embodiment of a table-mounted manipulator system 500 ("system 500") is described below. System 500 can be used as system 100 (i.e., can be one exemplary configuration of system 100), and some components of system 500 can be used as components of system 100 described above (i.e., can be exemplary configurations of components of system 100). Specifically, system 500 includes manipulator 540 (e.g., manipulators 540_1, 540_2, 540_3) that can be used as manipulator 140 of system 100. Thus, the description of the components of system 100 described above is applicable to the related components of system 500, and redundant descriptions of these components are omitted below. Related components of systems 100 and 500 are given reference numbers having the same rightmost two digits, e.g., 140 and 540. System 500 is one embodiment of system 100, but system 100 is not limited to system 500.

[0140] As shown in FIG. 15, the system 500 includes a table assembly 501, two rail assemblies 520 coupled to the table assembly 501, and a number of manipulators 540 coupled to the rail assemblies 520. Each manipulator 540 is configured to support one or more instruments (not shown) that can be removably or permanently mounted thereon. The system 500 can also include a control system (not shown), a user input and feedback system (not shown), and / or ancillary systems (not shown) similar to those described above in connection with the system 100. In some embodiments, the system 500 is configured as a computer-assisted teleoperated medical system. In other embodiments, the system 500 is configured as a teleoperated system for use in non-medical contexts.

[0141] 1 , the table assembly 501 includes a platform assembly 510 configured to support a patient or inanimate workpiece, a support column 502 coupled to and supporting the platform assembly 510, and a base 505 coupled to the support column 502. The base 505 can be configured to contact the ground or other surface on which the table assembly 501 rests, and in some embodiments, the base 505 includes wheels 506 that enable movement of the system 500 along the ground or other surface. In some embodiments, the support column 502 includes a telescoping support column that can raise or lower the platform assembly 510.

[0142] The platform assembly 510 includes multiple platform sections configured to support a patient or workpiece, which may be fixed or movable relative to one another and / or the support column 502. In addition to moving the individual platform sections, the platform assembly 510 as a whole may be movable relative to the support column 502 through one or more degrees of freedom, which may include both translational and rotational degrees of freedom. For example, in some embodiments, the platform assembly 510 is configured similarly to the platform assembly 210 described above.

[0143] As shown in FIG. 15 and FIG. 20, the manipulators 540 are coupled to the table assembly 501 via rail assemblies 520. One rail assembly 520 is provided for each of the two longitudinally extending sides of the platform assembly 510. As shown in FIG. 15 and FIG. 20, the rail assembly 520 includes a movable rail 521 ("rail 521"), a first carriage 526 that couples the manipulators 540 to the rail 521, and one or more second carriages 527 that couple the rail 521 to the table assembly 501. Each first carriage 526 couples a respective one of the manipulators 540 to the rail 521 such that the manipulators 540 can move relative to the rail 521 along a longitudinal dimension 597 of the rail 521. In some examples, the first carriage 526 can be part of the corresponding manipulator 540. For example, in some embodiments, the first carriage 526 is coupled to (or is part of) an upper surface of a first proximal joint housing 564 (described below) of the manipulator 540 and includes a track or other engagement arrangement configured to engage a complementary engagement arrangement of the rail 521 to movably couple the manipulator 540 to the rail 521. In addition, each second carriage 527 couples the rail assembly 520 to the table assembly 501 (e.g., either the platform assembly 510 or the support column 502) such that the rail 521 can translate relative to the table assembly 501 along a longitudinal dimension of the rail 521. For example, in some embodiments, the second carriage 527 is coupled to (or is part of) the table assembly 501 and includes a track or other engagement arrangement configured to engage a complementary engagement arrangement of the rail 521 to movably couple the rail 521 to the table assembly 501.

[0144] In some embodiments, the rail assembly 520 further includes a translation mechanism (not shown) configured to drive translation of the first carriage 526 relative to the rail and to drive translation of the rail 521 relative to the second carriage 527. The translation mechanism can include an actuator, such as an electric motor or other actuation device (e.g., hydraulic, pneumatic, or other device for providing motive force).

[0145] As mentioned above, the system 500 includes a plurality of manipulators 540. In some embodiments, four manipulators 540 are provided, with two manipulators coupled to each rail assembly 520 (of these four manipulators 540, only manipulators 540_1, 540_2, and 540_3 are visible in the figures). In other embodiments, more or fewer manipulators 540 can be used, such as one, two, three, five, or more manipulators. Additionally, more or fewer manipulators 540 can be coupled to the rail assemblies 520, and the rail assemblies 520 do not necessarily have to have the same number of manipulators 540 as each other.

[0146] In FIG. 15, the manipulators 540 are shown in an unfolded state or configuration, whereas in FIGS. 21-24, the manipulators 540 are shown in a stored state under the platform assembly 510 while remaining coupled to the rail assembly 520 (not all of the manipulators 540 are visible in each of the figures). The unfolded state includes a state in which one or more of the manipulators 540 are not stored, which in some embodiments means that at least one or more of the manipulators 540 are at least partially unfolded / uncompacted and removed from a stored location, e.g., removed from under the platform assembly 510, while remaining coupled to the rail assembly 520. The manipulators 540 can be positioned in various unfolded states, which can include various configurations and positions of the manipulators 540, including but not limited to those shown in FIG. 15.

[0147] The manipulators 540 include a number of links movably coupled to one another via joints, as described above with respect to the manipulators 140 and 240. In particular, FIG. 16 illustrates one of the manipulators 540 in isolation. As shown in FIGS. 15 and 16, each manipulator 540 includes a proximal link assembly 561 including a proximal arm 541 coupled to the rail assembly 520 via one or more proximal joints 530 and a carriage 526, an intermediate link assembly 562 including an intermediate arm 542 coupled to a distal end portion of the proximal link assembly 561 via one or more intermediate joints 545, and a distal link assembly 563 including a distal arm 543 coupled to the intermediate link assembly 562 via one or more distal joints 546. The distal link assembly 563 also includes an instrument holding portion 569 coupled to the distal arm 543 and configured to support an instrument 550.

[0148] As described above, the proximal link assembly 561 includes a proximal arm 541 and a proximal joint 530. A proximal end portion of the proximal arm 541 of each manipulator 540 is coupled to the rail assembly 520 via the proximal joint 530. Specifically, the proximal link assembly 561 includes a first proximal joint housing 564, a second proximal joint housing 565, and a third proximal joint housing 594 (coupled to or part of the proximal arm 541), where the rail assembly 520 is coupled (via the first carriage 526) to the first proximal joint housing 564, which is rotatably coupled to the second proximal joint housing 565, which is rotatably coupled to the third proximal joint housing 594 (and thus to the proximal arm 541).

[0149] The rotatable coupling between the first proximal joint housing 564 and the second proximal joint housing 565 forms a first proximal joint 530a. The first proximal joint 530a allows rotation of the proximal arm 541 relative to the rail 521 about a first axis 536 (via rotation between the first proximal joint housing 564 and the second proximal joint housing 565). The first axis 536 is perpendicular to the longitudinal and lateral dimensions of the rail 521 (i.e., the first axis 536 extends parallel to the z-axis in FIGS. 15 and 20), or in other words, perpendicular to both the longitudinal and lateral dimensions of the platform 510 (in a neutral position of the table assembly 501).

[0150] The rotatable coupling between the second proximal joint housing 565 and the third proximal joint housing 594 forms a second proximal joint 530b. The second proximal joint 530b provides for rotation of the proximal arm 541 relative to the rail 521 about a second axis 537 that is perpendicular to the first axis 536 and parallel to the longitudinal dimension of the rail 521 (i.e., the second axis 537 extends parallel to the x-axis in FIGS. 15 and 20 ). Rotation of the proximal arm 541 about the second axis 537 (e.g., via the second proximal joint 530b) causes the proximal arm 541 to tilt or lower relative to a horizontal plane (e.g., a plane parallel to a longitudinal or lateral dimension of the platform 510 in embodiments in which the rail assembly 520 is coupled to the platform 510, or a plane parallel to the ground in embodiments in which the rail assembly 520 is coupled to the support column 502), thereby raising or lowering the distal end of the proximal arm 541 relative to the rail 521. As the proximal arm 541 tilts relative to the horizontal plane, movement of the proximal arm 541 can correspondingly extend and raise a more distal portion of the manipulator farther beyond the table (rather than just vertical movement).

[0151] 15 and 16, a distal end portion of the proximal arm 541 includes (or is coupled to) a first intermediate joint housing 595, and a proximal end portion of the intermediate arm 542 includes (or is coupled to) a second intermediate joint housing 599, where the first and second intermediate joint housings 595 and 599 are rotatably coupled to one another. The rotatable coupling between the first intermediate joint housing 595 and the second intermediate joint housing 599 forms a first intermediate joint 545a. The first intermediate joint 545a allows the intermediate arm 542 to rotate relative to the proximal arm 541 about a third axis 538 that is parallel to the second axis 537.

[0152] Additionally, in some examples, the intermediate arm 542 includes a first link 542a and a second link 542b that are movable and / or rotatable relative to one another. More specifically, in some examples, the first and second links 542a and 542b are translatable relative to one another along a direction 549 parallel to the longitudinal dimension of the intermediate arm 542 and / or rotatable relative to one another about a fourth axis 539 parallel to the longitudinal dimension of the intermediate arm 542. The translatable and / or rotatable coupling between the first link 542a and the second link 542b forms a second intermediate joint 545b. In some embodiments, the second intermediate joint 545b provides only rotation, in other embodiments, the second intermediate joint 545b provides only translation, and in still other embodiments, the second intermediate joint 545b provides both rotation and translation.

[0153] The distal link assembly 563 includes a distal arm 543, a wrist 547, and an instrument holding portion 569 coupled to the distal arm 543 via the wrist 547. As shown in FIGS. 15 and 16 , a proximal end portion of the distal arm 543 of each manipulator 540 is rotatably coupled to a second link 542b of the intermediate arm 542 via a first distal joint 546a. More specifically, a distal end of the second link 542b is coupled to or includes a first distal joint housing 567, which is rotatably coupled to a second distal joint housing 568 that is coupled to or is part of the distal arm 543. The first distal joint 546a allows rotation of the distal arm relative to the intermediate arm 542 about a fifth axis 552 that is perpendicular to the longitudinal dimension of the intermediate arm 542 and the longitudinal dimension of the distal arm 543. In addition, the second distal joint 546b rotatably couples the wrist 547 (via the arm 543) to the second distal joint housing 568 such that the wrist 547 can rotate relative to the second distal joint housing 568 about a sixth axis 551 that is parallel to the longitudinal dimension of the distal arm 543. Rotation about this sixth axis 551 via the second distal joint 546b constitutes a degree of freedom of movement of the wrist 547 that can be referred to as roll. Thus, the sixth axis 551 can also be referred to as a roll axis. In some embodiments, a distal end portion of the distal arm 543 moves with the wrist 547 relative to a proximal end portion of the distal arm 543 as the wrist rotates about the sixth axis 551 .

[0154] In addition to the roll degree of freedom of movement described above, the wrist 547 allows for rotation of the instrument holding portion 569 relative to the arm 543 about two additional axes, namely, the seventh and eighth axes 553 and 554. The seventh and eighth axes 553 and 554 are perpendicular to each other. The seventh and eighth axes 553 and 554 are perpendicular to the sixth axis 551, and thus also perpendicular to the longitudinal dimension of the distal arm 543 in the neutral state of the wrist 547, but not necessarily in other states of the wrist 547. Specifically, in some embodiments, the seventh axis 553 remains perpendicular to the sixth axis 551 in all states of the wrist, whereas the eighth axis 554 does not remain perpendicular. In other embodiments, this relationship is reversed, and the eighth axis 554 remains perpendicular to the sixth axis 551, while the seventh axis 553 does not remain perpendicular. Rotation about the seventh and eighth axes 553 and 554 can be referred to as the pitch and yaw degrees of freedom of motion, respectively, and thus the seventh and eighth axes 553 and 554 can be referred to as the pitch and yaw axes, respectively. Specifically, wrist 547 includes two wrist joints that provide rotation about the seventh and eighth axes.

[0155] Although some of the degrees of freedom of motion of the manipulator 540 described above are redundant in the sense that they are not strictly necessary to manipulate the instrument, the inclusion of these redundant degrees of freedom of motion can improve the operation of the manipulator 540 in some situations, for example, by aiding in reaching and collision avoidance. For example, the rotation (yaw) of the wrist 547 about the eighth axis 554, the extension of the proximal arm 541 along the direction 548, and the extension of the middle arm 542 along the direction 549 may be redundant degrees of freedom of motion. In some embodiments, one, some, or all of these degrees of freedom of motion are omitted. In some embodiments, some or all of these redundant degrees of freedom of motion can be used as set-up joints whose positions are fixed to obtain a desired deployment pose of the manipulator 540, but which then remain stationary during the procedure (or are moved infrequently during the procedure when a change in pose is desired).

[0156] 16, the instrument holding portion 569 includes an instrument holder base member 555 coupled to the wrist 547 and extending parallel to an eighth axis 554, an instrument holder 544 movably coupled to the instrument holder base member 555, and an accessory mount portion 556 coupled to one end portion of the instrument holder base member 555. The instrument holder 544 is translatable along a length of the instrument holder base member 555 along a direction parallel to the eighth axis 554. The instrument holder 544 includes an interface that couples to an instrument 550 attached to the instrument holder. For example, the interface may include an output coupler (not shown) that engages (directly or indirectly via an intermediary) with an input coupler (not shown) of the instrument 550 to provide a drive force or other input to the attached instrument 550 to control movement and / or other functionality of the instrument 550 in various degrees of freedom. Accessory mount portion 556 is configured to receive an accessory mounted to accessory mount portion 556, such as a cannula (a cannula mounted to access mount portion 556 is shown by way of example in FIG. 16 ). The cannula mounted to accessory mount portion 556 can be positioned to receive an instrument shaft of an instrument 550 mounted to instrument holder 544. The instrument shaft and passageway through the cannula can define an insertion axis along which the instrument may translate in response to translation of instrument holder 544 along instrument holder base member 555. A remote center of motion can be located on the insertion axis within, at, or near the cannula.

[0157] As shown in Figures 15-17, the proximal arm 541 of the manipulator 540 has an asymmetric shape. The asymmetric shape means that, in extending from a proximal end portion of the proximal arm 541 (e.g., the third proximal joint housing 594) to a distal end portion of the proximal arm 541 (e.g., the first intermediate joint housing 595), the proximal arm 541 follows a path that deviates from an imaginary straight line that extends between (i.e., connects) the two end portions. More specifically, as shown in Figure 17, the center line 589 of the proximal arm 541 extends between the second axis of rotation 537 of the second proximal joint 530b and the third axis of rotation 538 of the first intermediate joint 545a, while deviating from a straight line 591 between these two axes of rotation 537 and 538. In other words, the respective rotation axes 537 and 538 (which are parallel to one another) are offset from one another along both a first direction d1 and a second direction d2, as shown by the offsets s1 and s2 in FIG. 17. The first direction d1, which corresponds to the offset s1, is parallel to a line 596 that is tangent to the centerline 589 of the proximal arm 541 at the second rotation axis 537. This line 596 corresponds to the initial direction of extension of the proximal arm 541 as it initially extends from the second rotation axis 537. The second direction d2, which corresponds to the offset s2, is perpendicular to the first direction d1.

[0158] As shown in FIG. 17, the asymmetric shape of the proximal arm 541 results in the proximal arm 541 having a concave side 541a and a convex side 541b. As used herein, concave and convex are determined relative to the platform assembly 510 with the proximal arm 541 oriented approximately vertically (i.e., line 596 is parallel to the z-axis). As a result, as shown in FIG. 18, there is an open space 559 along the concave side 541a of the proximal arm 541 that would be occupied by the proximal arm if it extended in a straight line between axes 537 and 538. As shown in FIG. 18, this open space 559 corresponds to the area between line 588 and the outer surface of the proximal arm 541. Line 588 in FIG. 18 indicates where the edge of the proximal arm would be located if the proximal arm extended in a straight line between axes 537 and 538 instead of having an asymmetric shape. This open space 559 allows the manipulator 540 to be placed in a pose that would not otherwise be possible with a similarly sized straight proximal arm. For example, if the proximal arm 541 is rotated upward and toward the platform assembly 510, whereas a straight proximal arm would need to be stopped at a given point to avoid a collision between the arm and the patient, the platform assembly 510, or other object, the proximal arm 541 disclosed herein can continue to rotate some distance beyond that given point because the patient, table, or other object that would otherwise collide with the straight arm can instead fit within the open space 559 along the concave side 541a of the proximal arm 541. For example, if a virtual object 601 is placed adjacent to the proximal arm as shown in FIG. 18, the straight proximal arm will need to stop rotating toward the object 601 at the point shown in FIG. 18 (to avoid a collision with the object 601), whereas the asymmetric proximal arm 541 can continue rotating toward the object 601 beyond the point shown in FIG. 18 due to the space provided by the open space 559.This additional rotational range of the proximal arm 541 allows the intermediate joint 542 to be raised higher and / or directed more inward toward the centerline of the platform assembly 510, which allows the manipulator 540 to reach farther beyond the platform assembly 510. Moreover, when the manipulator 540 is retracted, the open space 559 allows for a more compact pose of the manipulator 540, as described in more detail below.

[0159] 15-18 and 20-24 show an exemplary embodiment in which the asymmetric shape of the proximal arm 541 is a smoothly curved shape, such as a circular arc. However, in other embodiments, the proximal arm 541 can have other asymmetric shapes that meet the above criteria, including smoothly curved shapes that follow a different curve than the illustrated curve, such as a curved shape, including a portion of a circle, a portion of an ellipse, a portion of a parabola, a portion of a hyperbola, or any other smooth curve. As another example, in some embodiments, the proximal arm has a segmented shape that includes multiple straight and / or curved segments joined together at an angle. For example, FIG. 18 shows an embodiment of a proximal arm 541' that is a variation of the proximal arm 540, in which the asymmetric shape of the proximal arm 541' includes an L-shape with two straight segments joined together at a right angle. As can be seen in FIG. 19, the center line 589' of the proximal arm 541' deviates from the line 591, as described above with respect to the proximal arm 541. Although concave and convex are often associated with curved lines, as used herein the terms concave and convex are also applicable to segmented shapes having straight line segments, such as the L-shape shown in Figure 19. Thus, proximal arm 541' has a concave side 541a' and a convex side 541b'.

[0160] 20-24 show the manipulator 240 in a stored state (note that other stored states than those shown are possible). As shown in FIGS. 20 and 21, in the illustrated stored state, the manipulator 240 is positioned below the platform assembly 210 in a compact folded configuration. As shown in FIGS. 20 and 21, in this stored state, the first and second proximal joint housings 564 and 565 are positioned directly below the rail 521. Moreover, as shown in FIGS. 20-24, the proximal arm 541 is positioned laterally adjacent to and inboard of the second proximal joint housing 565. The intermediate arm 542 is positioned laterally adjacent to and outboard of the proximal arm 541. Moreover, as shown in FIGS. 20-24, the intermediate arm 542 is positioned directly below the second proximal joint housing 565 (and the rail 521). As shown in FIGS. 20-24, the distal arm 543 is positioned laterally adjacent to and inside the intermediate arm 542. Additionally, the distal arm 543 is parallel to the intermediate arm 542 (i.e., their respective longitudinal axes are parallel), or in other words, the distal arm 543 and the intermediate arm 542 are aligned along a direction parallel to the lateral dimension of the platform assembly 510 (e.g., along the y-axis) and at least partially overlap. Furthermore, as shown in FIGS. 22-24, at least a portion of the distal arm 543 is positioned directly below the proximal arm 541, and the distal arm 543 extends into the open space 559 along the concave side of the proximal arm 541 (i.e., the proximal arm 541 and the distal arm 543 partially overlap along a direction parallel to the height dimension of the platform assembly 510, or in other words, along the z-axis). The instrument holding portion 569 is laterally adjacent to the distal arm 543, and the instrument holder base member 555 extends parallel to the distal arm 543. In addition, the wrist 547 and a portion of the instrument holder base member 555 are positioned below the proximal arm 541.As shown in FIG. 22, the instrument retaining portion 569 may protrude somewhat laterally relative to the edges of the proximal arm 541, particularly the accessory mount portion 556 and the instrument holder 544.

[0161] The stored pose of the manipulator 540 described above is very compact. This compact pose may not be possible if the proximal arm 541 were straight instead of asymmetrically shaped. For example, as shown in FIG. 24, the distal arm 543 and the instrument holding portion 569 extend into the open area 559, which would not be possible if the distal arm 543 were straight. Thus, to avoid collisions with a straight distal arm, the distal arm 543 may need to be angled inward such that the distal end of the distal arm 543 is laterally adjacent to the proximal arm 541, resulting in the distal arm 543 being at an angle to the intermediate arm 542 instead of being parallel to the intermediate arm 542. However, this configuration is not very compact. Other stored configurations can be used with a straight distal arm to avoid collisions, but these other stored configurations would similarly require modifications to the pose of the arms described above, resulting in less compact shapes. Thus, the asymmetric shape of the proximal arm 541 allows for a much more compact stored configuration than might otherwise be possible.

[0162] In an embodiment, the manipulator 540 can be selectively deployable in two different deployment configurations, including a first deployment configuration in which the proximal arm 541 is in a concave orientation and a second deployment configuration in which the proximal arm 541 is in a convex orientation. These configurations can be referred to herein as a concave configuration and a convex configuration. The concave orientation of the proximal arm 541 refers to an orientation in which the concave side 541a' faces generally upward if the proximal arm 541 faces horizontally away from the table assembly 501. Moreover, in the concave orientation, the second proximal joint housing 565 extends generally outwardly (i.e., away from the centerline of the table assembly 501) from the rail. Conversely, the convex orientation of the proximal arm 541 refers to an orientation in which the concave side 541a' faces generally downward if the proximal arm 541 extends horizontally away from the table assembly 501. Moreover, in the convex orientation, the second proximal joint housing 565 extends generally inwardly from the rail (i.e., toward the centerline of the table assembly 501). For example, Figure 15 shows manipulator 540_1 in a concave configuration and manipulator 540_2 in a convex configuration.

[0163] In some embodiments, the manipulator 540 can be transitioned between a concave configuration and a convex configuration. For example, when the manipulator 540 is moved from the stored configuration to the deployed configuration, the manipulator 540 can be selectively deployed to either the concave configuration or the convex configuration as desired. From the stored configuration, the second proximal joint housing 565 is rotated to face outward (away from the table assembly 501), and then the proximal arm 541, the intermediate arm 542, and the distal arm 543 are deployed to achieve the concave configuration. To achieve the convex configuration, from the stored structure, the second proximal joint housing 565 is rotated to face inward (away from the table assembly 501), and then the proximal arm 541, the intermediate arm 542, and the distal arm 543 are deployed.

[0164] These concave and convex configurations of the manipulator 540 can provide the user with increased flexibility in obtaining a desired pose, because some poses that may be difficult or not possible in one configuration may be possible or easier in the other configuration, and vice versa. For example, in the concave configuration of the manipulator 540 (with a concave orientation of the proximal arm 541), the manipulator 540 can reach farther beyond the platform assembly 510. As another example, in the convex configuration of the manipulator 540 (with a convex orientation of the proximal arm 541), the manipulator 540 can position the proximal end portion of the middle arm 542 further downward and further inward, which allows the instrument holding portion 569 to be angled farther backward relative to the distal arm 543 when utilizing an entry port that is located low on the patient on the same side as the manipulator 540.

[0165] 25-27, several additional embodiments of manipulator arms 640, 740, and 840 are shown. FIGS. 25-27 show these manipulator arms 640, 740, and 840 in exemplary stored positions. Manipulator arms 640, 740, and 840 are configurations of manipulator arm 140 and include multiple links movably coupled to each other via joints, as described above in connection with manipulator arms 140, 240, and 540. Elements of manipulator arms 640, 740, and 840 that are similar to elements described above in connection with manipulator arms 140 and / or 540 are given similar reference numbers (same last two digits) and duplicate descriptions thereof will be omitted below.

[0166] 25 illustrates an exemplary manipulator arm 640. The manipulator arm 640 is similar to the manipulator arm 540 described above, except that the manipulator arm 640 has a straight proximal arm 641, unlike the asymmetrical proximal arm 541 of the manipulator arm 540. The manipulator arm 640 also includes a first proximal joint housing 664 configured to be coupled to a rail, a second proximal joint housing 665 coupled to the first proximal joint housing 664 and the proximal arm 641, the first and second proximal joint housings 664, 665 forming a proximal joint 630. The manipulator arm 640 includes an intermediate arm 642 coupled to a distal end portion of the proximal arm 641 via one or more intermediate joints 645, a distal arm 643 coupled to the intermediate arm 642 via one or more distal joints 646, and an instrument holding portion (not shown) coupled to the distal arm 643. As shown in FIG. 25, the manipulator arm 640 can be stored in a similar manner as the manipulator arm 540. However, because the proximal arm 641 is straight, the stored configuration of the manipulator arm 640 is not as compact as the manipulator arm 540. For example, the distal arm 643 can protrude downward farther than the middle arm 643, so the distal arm 643 and the middle arm 643 are not horizontally aligned with each other. This may be necessary to prevent interference between the distal arm 643 and the proximal arm 641. In contrast, in the manipulator arm 540, such interference is avoided due to the asymmetric shape of the proximal arm 541, so that the distal arm 543 can be positioned horizontally aligned with the middle arm 542.

[0167] 26, the manipulator arm 740 is similar to the manipulator arm 640 described above, except that the manipulator arm 740 has an extendable, straight proximal arm 741. That is, the proximal arm 741 can include two portions that can translate (and possibly rotate) relative to each other, like the proximal arm 241 described above. The manipulator 740 also includes a first proximal joint housing 764 coupled to the rail, and a second proximal joint housing 765 coupled to the first proximal joint housing 764 and the proximal arm 741, the first and second proximal joint housings 764, 765 forming a proximal joint 730. The manipulator 740 also includes an intermediate arm 742 coupled to a distal end portion of the proximal arm 741 via one or more intermediate joints 745, a distal arm 743 coupled to the intermediate arm 742 via one or more distal joints 746, and an instrument holding portion coupled to the distal arm 743. As shown in FIG. 26, the manipulator arm 740 can be stored in a configuration in which the proximal arm 741 and the intermediate arm 742 are aligned horizontally, and the distal arm 743 is positioned below the intermediate arm 742 and aligned vertically with the intermediate arm 742.

[0168] 27 illustrates a manipulator arm 840 similar to the manipulator arm 540 described above, except that the manipulator arm 840 has an extension 899 coupled to the second proximal joint housing 865 such that the second proximal joint housing 865 is positioned lower than the second proximal joint housing 541. In addition, the proximal arm 841 of the manipulator 840 is longer than the proximal arm 541. The manipulator arm 840 also includes a first proximal joint housing 864 configured to be coupled to the rail, and a second proximal joint housing 865 coupled to the first proximal joint housing 864 and the proximal arm 841, the first and second proximal joint housings 864, 865 forming a proximal joint 830. The manipulator arm 840 also includes an intermediate arm 842 coupled to a distal end portion of the proximal arm 841 via one or more intermediate joints 845, a distal arm 843 coupled to the intermediate arm 842 via one or more distal joints 846, and an instrument holding portion 869 coupled to the distal arm 843. As shown in FIG. 27, the manipulator arm 840 can be stored in a manner that is inverted relative to how the manipulator arm 540 is stored. That is, instead of the proximal arm 841 curving downward as the proximal arm 541, the proximal arm 841 curving upward. Moreover, the distal arm 843 is positioned above the proximal arm 841 instead of below. However, similar to the manipulator 540, the distal arm 843 is horizontally aligned with the intermediate arm 842.

[0169] The embodiments described herein may be well suited for use in any of a variety of medical procedures, as discussed above. Such procedures may be performed, for example, on human patients, animal patients, human cadavers, animal cadavers, and parts of the human or animal anatomy. Medical procedures contemplated herein include any of those described herein, including cosmetic procedures, imaging of the human or animal anatomy, collection of data from the human or animal anatomy, for non-surgical diagnosis, training of medical or non-medical personnel, and procedures on tissue removed from the human or animal anatomy (without returning to the human or animal anatomy). Although suitable for use in such medical procedures, the embodiments may also be used for bench-top procedures on non-living materials and forms that are not part of the human or animal anatomy. Moreover, some embodiments are also suitable for use in non-medical applications, such as industrial robotics applications, and sensing, inspecting, and / or manipulating non-tissue workpieces. In a non-limiting embodiment, the techniques, methods, and devices described herein can be used in or be part of a computer-assisted surgical system that uses robotic technology, such as the da Vinci® Surgical Systems commercialized by Intuitive Surgical, Inc. of Sunnyvale, California. However, those skilled in the art will understand that the aspects disclosed herein can be embodied and implemented in a variety of methods and systems, including manually operated instruments and computer-assisted remotely operated systems, in both medical and non-medical applications. Reference to the da Vinci® Surgical Systems is exemplary and does not limit the scope of the disclosure herein.

[0170] As used herein and in the claims, terms such as computer-assisted manipulator system, teleoperated manipulator system, and the like, should be understood to refer broadly to any system including one or more controllable kinematic structures ("manipulators") that are movable and controllable at least in part through the aid of an electronic controller (with or without human input). Such systems are sometimes referred to in the art and generally as robot-assisted systems or robotic systems. Such systems include systems controlled by a user (e.g., through teleoperation), automatically by a computer (so-called autonomous control), or by some combination of these. In instances where a user controls at least a portion of the manipulator's movements, an electronic controller (e.g., a computer) can facilitate or assist the operation. The term "computer" as used in "computer-assisted manipulator system" refers broadly to any electronic control device for controlling the operation of a manipulator or for assisting a user in controlling a manipulator, and is not intended to be limited to those formally defined or referred to as "computers." For example, the electronic control devices in a computer-aided manipulator system can range from a traditional "computer" (e.g., a general-purpose processor plus memory that stores instructions that the processor executes) to low-level dedicated hardware devices (analog or digital) such as discrete logic circuits or application specific integrated circuits (ASICs), or anything in between. Furthermore, manipulator systems can be implemented in a variety of contexts to perform a variety of procedures, both medical and non-medical. Thus, while some examples described in more detail herein may focus on the medical context, the devices and principles described herein are applicable to other contexts, such as industrial manipulator systems.

[0171] It should be understood that both the general description and the detailed description are explanatory in nature and provide exemplary embodiments intended to provide an understanding of the present disclosure without limiting the scope of the disclosure. Various mechanical, compositional, structural, electrical, and operational changes can be made without departing from the spirit and scope of this description and the claims. In some instances, well-known circuits, structures, and techniques have not been shown or described in detail so as not to obscure the embodiments. Like numbers in two or more figures represent the same or similar elements.

[0172] Furthermore, terms used herein to describe aspects of the invention, such as spatial or relational terms, are selected to aid the reader in understanding exemplary embodiments of the invention, but are not intended to limit the invention. For example, spatial terms such as "beneath," "below," "lower," "above," "upper," "proximal," "distal," "up," "down," and the like, may be used herein to describe the orientation or spatial relationship of one element or feature to another element or feature as shown in the figures. These spatial terms are used with respect to the figures and are not limited to a particular reference frame in the real world. Thus, for example, an "up" direction in a figure does not necessarily correspond to "up" in a world reference frame (e.g., away from the surface of the Earth). Furthermore, if a reference frame different from that shown in the figures is considered, the spatial terms used herein need to be interpreted differently in that different reference frame. For example, a direction referred to as "upper" with respect to one of the figures may correspond to a direction referred to as "lower" with respect to a different frame of reference that is rotated 180 degrees from the frame of reference of the figure. As another example, if the device is rotated 180 degrees or more in the world frame of reference compared to how it is illustrated in the figure, an item described herein as being "upper" or "above" a second item with respect to the figure is "lower" or "below" the second item with respect to the world frame of reference. Thus, the same spatial relationship or orientation can be described using different spatial terms depending on which frame of reference is being considered. Moreover, the poses of the items shown in the figures are selected for convenience of illustration and description, but in implementation the items can be posed differently.

[0173] In addition, the singular forms "a," "an," and "the" are intended to include the plural, unless the context indicates otherwise. And terms such as "comprises," "comprising," "includes," and the like specify the presence of described structures, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other structures, steps, operations, elements, components, and / or groups. Components described as being coupled may be directly coupled electrically or mechanically, or they may be indirectly coupled through one or more intermediate components, unless specifically stated otherwise. Mathematical and geometric terms are not necessarily intended to be used according to their strict definitions, unless the context of the specification indicates otherwise, because one skilled in the art will understand that, for example, substantially similar elements that function in a substantially similar manner will readily fall within the scope of a described term, even if that term has a strict definition.

[0174] Elements and their associated aspects that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and not with reference to a second embodiment, the element may nevertheless be claimed as being included in the second embodiment.

[0175] As used herein, "proximal" and "distal" are spatial / directional terms that describe locations or directions based on their relationship to opposite ends of the kinetic chain. "Proximal" is associated with the end of the kinetic chain that is closer to the base or support of the kinetic chain, while "distal" is associated with the opposite end of the kinetic chain, which often includes the end effector of an instrument. When used to refer to a location or part of a component, proximal and distal indicate the relative position of the location or part to the base of the chain, with the proximal location or part being closer to the base (closer here refers to proximity along the kinetic chain, not absolute distance). When used to refer to a direction, "proximal" generally refers to the direction from a given location along the kinetic chain toward a more proximal location along the kinetic chain, and "distal" refers to the direction from a given location toward a more distal location along the kinetic chain.

[0176] Unless stated herein or implied by context, when approximation terms such as "substantially," "approximately," "about," "aroura," "roughly," and the like are used in conjunction with stated numerical values, characteristics, or relationships, such as the endpoints of a range or a geometric characteristic / relationship (e.g., parallel, perpendicular, linear, etc.), this should be understood to mean that mathematical precision is not required for that value, characteristic, or relationship, and that a range of variation is being recited instead that includes, but is not limited to, the stated value, characteristic, or relationship. In particular, the range of variation around a stated value, characteristic, or relationship includes at least any insignificant variation, variation that is typical in the relevant art for the type of item in question due to manufacturing or other tolerances, and / or a variation within ±5% of the stated value, characteristic, or relationship, unless otherwise indicated.

[0177] As used herein, "transverse" refers to a positional relationship between two items in which one item is oriented laterally at an angle to the other item such that the item is substantially or approximately perpendicular to the other item. As used herein, "transverse" includes, but does not require, an exact perpendicular relationship.

[0178] Further modifications and alternative embodiments will be apparent to those skilled in the art in view of the disclosure herein. For example, the devices and methods may include additional components or steps omitted from the drawings and descriptions for clarity of operation. Thus, this description should be interpreted merely as illustrative and is intended to teach those skilled in the art the general manner of implementing the present teachings. It should be understood that the various embodiments shown and described herein should be interpreted as illustrative. Elements and materials, and the arrangements of those elements and materials, may be substituted for those shown and described herein, parts and processes may be reversed, and specific configurations of the present teachings may be utilized independently, all as would be apparent to those skilled in the art after having had the benefit of being described herein. Changes may be made to the elements described herein without departing from the spirit and scope of the present teachings and the following claims.

[0179] It should be understood that the specific examples and embodiments described herein are non-limiting, and that modifications to construction, dimensions, materials, and methods can be made without departing from the scope of the present teachings.

[0180] Other embodiments in accordance with the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, and that the following claims are entitled to the fullest breadth, including equivalents, under applicable law.

Claims

1. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator includes a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; The length of the proximal arm is extendable. A remotely controlled manipulator system.

2. the manipulator includes an intermediate link assembly including an intermediate arm coupled to the proximal arm; The length of the intermediate arm is extendable.

2. The remotely operable manipulator system of claim 1.

3. The one or more proximal joints include: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail; 3. A remotely operable manipulator system according to claim 1 or 2.

4. 2. The remotely operable manipulator system of claim 1, wherein the manipulator is configured to extend beyond and above the platform to a position adjacent a side of the platform opposite to a side on which the rail is disposed.

5. the proximal link assembly includes a first joint housing and a second joint housing; the first joint housing is coupled to the rail and rotatably coupled to the second joint housing by the second proximal joint; the first joint housing is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing include a 90 degree bend; 4. A remotely operable manipulator system according to claim 3.

6. the proximal link assembly includes a first joint portion and a second joint portion; the first joint part is coupled to the rail and rotatably coupled to the second joint part by the second proximal joint; the first joint portion is rotatably coupled to the proximal arm by the first proximal joint; the first joint portion and the second joint portion include engagement portions oriented at a 45 degree angle with respect to the rail; 4. A remotely operable manipulator system according to claim 3.

7. The manipulator comprises: an intermediate link assembly including an intermediate arm coupled to the proximal arm; a distal link assembly including a distal arm coupled to the intermediate arm; A list, an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the distal arm by the wrist.

2. The remotely operable manipulator system of claim 1.

8. The teleoperated manipulator system of claim 7 , wherein the wrist includes three rotational degrees of freedom of movement.

9. 9. The teleoperated manipulator system of claim 8, wherein two of the degrees of freedom of movement are provided by two wrist joints in the wrist, the wrist joints being driven by actuation elements coupled to actuators located remotely from the wrist.

10. The teleoperable manipulator system of claim 9 , wherein the actuator is disposed within the distal arm.

11. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; an intermediate link assembly including an intermediate arm coupled to the proximal arm; The length of the intermediate arm is extendable. A remotely controlled manipulator system.

12. The teleoperable manipulator system of claim 11 , wherein the proximal arm is extendable.

13. The one or more proximal joints include: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail; A remotely operable manipulator system according to claim 11 or 12.

14. 12. The remotely operable manipulator system of claim 11, wherein the manipulator is configured to extend beyond and above the platform to a position adjacent a side of the platform opposite to a side on which the rail is disposed.

15. the proximal link assembly includes a first joint housing and a second joint housing; the first joint housing is coupled to the rail and rotatably coupled to the second joint housing by the second proximal joint; the first joint housing is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing include a 90 degree bend; 14. A remotely operable manipulator system according to claim 13.

16. the proximal link assembly includes a first joint portion and a second joint portion; the first joint part is coupled to the rail and rotatably coupled to the second joint part by the second proximal joint; the first joint portion is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing are oriented at a 45 degree angle with respect to the rail; 14. A remotely operable manipulator system according to claim 13.

17. The manipulator comprises: a distal link assembly including a distal arm coupled to the intermediate arm; A list, an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the distal arm by the wrist.

12. A remotely operable manipulator system according to claim 11.

18. 20. The teleoperated manipulator system of claim 17, wherein the wrist includes three rotational degrees of freedom of movement.

19. 20. The teleoperated manipulator system of claim 18, wherein two of the rotational degrees of freedom are provided by two wrist joints in the wrist, the wrist joints being driven by actuation elements coupled to actuators located remotely from the wrist.

20. 20. The teleoperable manipulator system of claim 19, wherein the actuator is disposed in a distal arm.

21. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator includes a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; the one or more proximal joints are configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm and about a second axis perpendicular to the first axis and parallel to the rail. A remotely controlled manipulator system.

22. The one or more proximal joints include: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail.

22. A remotely operable manipulator system according to claim 21.

23. 23. The teleoperable manipulator system of claim 22, wherein the proximal arm is extendable.

24. The manipulator includes an intermediate link assembly including an intermediate arm coupled to a proximal arm; The intermediate arm is extendable.

22. A remotely operable manipulator system according to claim 21.

25. 22. The remotely operable manipulator system of claim 21, wherein the manipulator is configured to extend beyond and above the platform to a position adjacent a side of the platform opposite to a side on which the rail is disposed.

26. the manipulator includes an intermediate link assembly including an intermediate arm coupled to the proximal arm; The intermediate link assembly includes a first joint housing and a second joint housing. the first joint housing is coupled to the rail and rotatably coupled to the second joint housing by the second proximal joint; the first joint housing is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing include a 90 degree bend; 23. A remotely operable manipulator system according to claim 22.

27. the proximal link assembly includes a first joint portion and a second joint portion; the first joint part is coupled to the rail and rotatably coupled to the second joint part by the second proximal joint; the first joint portion is rotatably coupled to the proximal arm by the first proximal joint; the first joint portion and the second joint portion are oriented at a 45 degree angle with respect to the rail; 23. A remotely operable manipulator system according to claim 22.

28. The manipulator comprises: an intermediate link assembly including an intermediate arm coupled to the proximal arm; a distal link assembly including a distal arm coupled to the intermediate arm; A list, an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the distal arm by the wrist.

22. A remotely operable manipulator system according to claim 21.

29. 30. The teleoperated manipulator system of claim 28, wherein the wrist includes three rotational degrees of freedom of movement.

30. two of the degrees of freedom of movement are provided by two wrist joints in the wrist, the wrist joints being driven by actuation elements coupled to actuators located remotely from the wrist; 30. A remotely operable manipulator system according to claim 29.

31. 31. The teleoperable manipulator system of claim 30, wherein the actuator is disposed within the distal arm.

32. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; the manipulator is configured to extend above and beyond the platform to a position adjacent a side of the platform opposite the side on which the rail is disposed. A remotely controlled manipulator system.

33. The manipulator includes a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; The proximal arm is extendable.

33. A remotely operable manipulator system according to claim 32.

34. the manipulator includes an intermediate link assembly including an intermediate arm coupled to the proximal arm; The intermediate arm is extendable.

34. A remotely operable manipulator system according to claim 33.

35. The one or more proximal joints include: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail; 35. A remotely operable manipulator system according to claim 33 or 34.

36. the proximal link assembly includes a first joint housing and a second joint housing; the first joint housing is coupled to the rail and rotatably coupled to the second joint housing by the second proximal joint; the first joint housing is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing include a 90 degree bend; 36. A remotely operable manipulator system according to claim 35.

37. the proximal link assembly includes a first joint portion and a second joint portion; the first joint part is coupled to the rail and rotatably coupled to the second joint part by the second proximal joint; the first joint portion is rotatably coupled to the proximal arm by the first proximal joint; the first joint portion and the second joint portion are oriented at a 45 degree angle with respect to the rail; 36. A remotely operable manipulator system according to claim 35.

38. The manipulator comprises: a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; an intermediate link assembly including an intermediate arm coupled to the proximal arm; a distal link assembly including a distal arm coupled to the intermediate arm; A list, an instrument holding portion configured to receive an instrument and coupled to the distal arm by the wrist; 33. A remotely operable manipulator system according to claim 32.

39. 40. The teleoperated manipulator system of claim 38, wherein the wrist includes three rotational degrees of freedom of movement.

40. 39. The teleoperable manipulator system of claim 38, wherein two of the degrees of freedom of movement are provided by two wrist joints in the wrist, the wrist joints being driven by actuation elements coupled to actuators located remotely from the wrist.

41. 41. The teleoperable manipulator system of claim 40, wherein the actuator is disposed within the distal arm.

42. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: a proximal link assembly including a proximal arm coupled to the rail by one or more proximal joints; an intermediate link assembly including an intermediate arm coupled to the proximal arm; a distal link assembly including a distal arm coupled to the intermediate arm; a list containing three rotational degrees of freedom of motion; an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the distal arm by the wrist. A remotely controlled manipulator system.

43. 43. The teleoperable manipulator system of claim 42, wherein the proximal arm is extendable.

44. 44. The teleoperable manipulator system of claim 43, wherein the intermediate arm is extendable.

45. The one or more proximal joints include: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail; A remotely operable manipulator system according to any one of claims 42 to 44.

46. the proximal link assembly includes a first joint housing and a second joint housing; the first joint housing is coupled to the rail and rotatably coupled to the second joint housing by the second proximal joint; the first joint housing is rotatably coupled to the proximal arm by the first proximal joint; the first joint housing and the second joint housing include a 90 degree bend; 46. ​​A remotely operable manipulator system according to claim 45.

47. the proximal link assembly includes a first joint portion and a second joint portion; the first joint part is coupled to the rail and rotatably coupled to the second joint part by the second proximal joint; the first joint portion is rotatably coupled to the proximal arm by the first proximal joint; the first joint portion and the second joint portion are oriented at a 45 degree angle with respect to the rail; 46. ​​A remotely operable manipulator system according to claim 45.

48. 43. The teleoperable manipulator system of claim 42, wherein two of the degrees of freedom of movement of the wrist are provided by two wrist joints in the wrist, the wrist joints being driven by actuation elements coupled to actuators located remotely from the wrist.

49. the actuator is disposed within the distal arm; the manipulator is configured to extend above and beyond the platform to a position adjacent a side of the platform opposite the side on which the rail is disposed.

49. A remotely operable manipulator system according to claim 48.

50. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: A proximal link assembly including a proximal arm, The proximal arm includes: a first proximal joint configured to provide rotation of the proximal arm about a first axis perpendicular to the proximal arm; and a second proximal joint configured to provide rotation of the proximal arm about a second axis perpendicular to the first axis and parallel to the rail. coupled to the rail; a proximal link assembly; an intermediate link assembly including an intermediate arm coupled to the proximal arm; a distal link assembly including a distal arm coupled to the intermediate arm; a list containing three rotational degrees of freedom of motion; an instrument holding portion configured to receive an instrument and coupled to the distal arm by the wrist; The length of the proximal arm and the intermediate arm are extendable. A remotely controlled manipulator system.

51. 1. A method of operating a medical system including a table assembly, a rail coupled to the table assembly, and a manipulator coupled to the rail, comprising: positioning the manipulator such that the manipulator extends above a platform of the table assembly and extends beyond the table assembly from a first longitudinally extending side of the platform to a second longitudinally extending side of the platform opposite the first longitudinally extending side. How it works.

52. 52. The method of claim 51, wherein positioning the manipulator includes extending a proximal arm of the manipulator, the proximal arm being coupled to the rail via one or more proximal joints.

53. 52. The method of claim 51, wherein positioning the manipulator includes tilting a proximal arm of the manipulator relative to the rail, the proximal arm being coupled to the rail via one or more proximal joints.

54. 54. The method of claim 53, wherein tilting the proximal arm includes rotating the proximal arm about an axis parallel to the rail via one of the proximal joints.

55. 55. The method of claim 54, further comprising rotating the proximal arm about another axis perpendicular to the rail via another one of the proximal joints.

56. 52. The method of claim 51, wherein positioning the manipulator includes tilting a proximal arm of the manipulator relative to the rail, the proximal arm being coupled to the rail via one or more proximal joints.

57. A method according to any one of claims 52 to 56, wherein positioning the manipulator comprises extending an intermediate arm of the manipulator, the intermediate arm being coupled to the proximal arm.

58. a table assembly including a platform configured to support a body; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: An arm, a wrist coupled to the arm; and an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the arm by the wrist; the list includes three rotational degrees of freedom of motion, and at least one of the degrees of freedom of motion of the list is a redundant degree of freedom of motion; A remotely controlled manipulator system.

59. 60. The teleoperated manipulator system of claim 58, wherein at least two of the degrees of freedom of movement of the wrist are redundant degrees of freedom of movement.

60. When an instrument is attached to the instrument holding portion, the instrument shaft extends along a first axis; the degrees of freedom of movement of the wrist include a yaw degree of freedom of movement about a second axis, the second axis being parallel to and offset from the first axis; 59. A remotely operable manipulator system as claimed in claim 58.

61. 61. The teleoperated manipulator system of claim 60, wherein the degrees of freedom of movement of the wrist include a pitch degree of freedom of movement about a third axis, the third axis perpendicular to the second axis, perpendicular to the first axis, and offset from the first axis.

62. 62. The teleoperated manipulator system of claim 61 , wherein the degrees of freedom of movement of the wrist include a roll degree of freedom of movement about a fourth axis, the fourth axis being perpendicular to the third axis.

63. the wrist includes a first rotational joint configured to provide a first degree of freedom of movement of the wrist and a second rotational joint configured to provide a second degree of freedom of movement of the wrist; the manipulator includes a third revolute joint disposed proximate the wrist and configured to provide a third degree of freedom of movement of the wrist.

62. A remotely operable manipulator system as claimed in claim 61.

64. 64. The teleoperable manipulator system of claim 63, wherein the arm includes two parts rotatably coupled to each other by the third revolute joint.

65. 62. The teleoperable manipulator system of claim 61 , wherein the arm is coupled to the wrist by the third revolute joint.

66. 62. The teleoperable manipulator system of claim 61 , wherein the arm is coupled to the second arm by the third revolute joint.

67. a table assembly including a platform configured to support a body; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: An arm, a wrist coupled to the arm; and an instrument holding portion configured to attach an instrument to the instrument holding portion, the instrument holding portion being coupled to the arm by the wrist; When an instrument is attached to the instrument holding portion, the instrument shaft extends along a first axis; the wrist includes a first degree of freedom of movement providing rotation of the instrument holding portion about a second axis and a second degree of freedom of movement providing rotation of the instrument holding portion about a third axis; the second axis and the third axis are offset from the first axis. A remotely controlled manipulator system.

68. 68. The teleoperable manipulator system of claim 67, wherein the wrist includes a third degree of freedom of movement providing rotation of the instrument holding portion about a fourth axis, the fourth axis being perpendicular to the third axis.

69. the wrist includes a first rotational joint providing a first degree of freedom of movement and a second rotational joint providing a second degree of freedom of movement; the manipulator includes a third rotational joint proximal to the wrist providing a third degree of freedom of movement.

69. A remotely operable manipulator system as claimed in claim 68.

70. 70. The teleoperable manipulator system of claim 69, wherein the arm includes two parts coupled together by the third revolute joint.

71. 70. The teleoperable manipulator system of claim 69, wherein the arm is coupled to the wrist by the third revolute joint.

72. 70. The teleoperable manipulator system of claim 69, wherein the arm is coupled to the second arm by the third revolute joint.

73. 68. The teleoperated manipulator system of claim 67, wherein the first and second degrees of freedom of motion are redundant degrees of freedom of motion.

74. 68. The teleoperable manipulator system of claim 67, wherein the first axis and the second axis are parallel.

75. 75. The teleoperated manipulator system of claim 74, wherein the second axis and the third axis are perpendicular.

76. 68. The teleoperable manipulator system of claim 67, wherein the first axis and the second axis lie in a first plane.

77. 77. The teleoperated manipulator system of claim 76, wherein the wrist further includes a third degree of freedom of movement providing rotation of the instrument holding portion about a fourth axis, the fourth axis and the third axis lying in a second plane.

78. a table assembly including a platform configured to support a body; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; The manipulator comprises: a distal arm coupled to the intermediate member for rotation of the distal arm relative to the intermediate member about a pitch axis and a yaw axis orthogonal to the pitch axis; a wrist coupled to a distal portion of the distal arm; and an instrument holding portion configured to mount an instrument on the instrument holding portion, the instrument holding portion coupled to the wrist for rotation of the instrument holding portion relative to the wrist about a pitch axis and a yaw axis orthogonal to the pitch axis, the pitch axis and the yaw axis being axes of the wrist. A remotely controlled manipulator system.

79. 80. The teleoperated manipulator system of claim 78, wherein at least one of the pitch and yaw axes of the wrist is a redundant degree of freedom of movement relative to the manipulator.

80. 80. The teleoperated manipulator system of claim 79, wherein both the pitch and yaw axes of the wrist are redundant degrees of freedom of motion relative to the manipulator.

81. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; the manipulator includes a proximal arm coupled to the rail via one or more proximal joints and an intermediate arm coupled to the proximal arm via an intermediate joint; the proximal arm has an asymmetric shape such that, when extended between a proximal end portion of the proximal arm and a distal end portion of the proximal arm, a centerline of the proximal arm deviates from a straight line extending between the proximal end portion of the proximal arm and the distal end portion of the proximal arm. A remotely controlled manipulator system.

82. the one or more proximal joints include a first proximal joint having a first axis of rotation and a second proximal joint having a second axis of rotation; the intermediate joint has a third axis of rotation parallel to the second axis of rotation; the asymmetric shape of the proximal arm is such that the first axis of rotation is offset from the second axis of rotation along a first direction and along a second direction orthogonal to the first direction, the first direction being tangent to the centerline of the proximal arm at the second axis of rotation; 82. A remotely operable manipulator system according to claim 81.

83. 82. The teleoperable manipulator system of claim 81, wherein the asymmetric shape of the proximal arm comprises a smoothly curved shape.

84. 82. The teleoperable manipulator system of claim 81, wherein the asymmetric shape of the proximal arm comprises a segmented shape.

85. 82. The teleoperable manipulator system of claim 81, wherein the asymmetric shape of the proximal arm comprises a smoothly curved shape.

86. a table assembly including a platform configured to support a body, the platform including a lateral dimension, a longitudinal dimension, and a height dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; the manipulator includes a proximal arm coupled to the rail, an intermediate arm coupled to the proximal arm, and a distal arm coupled to the proximal arm; the manipulator is configured to be stored beneath the platform, and in a stored state of the manipulator, the distal and intermediate arms are parallel to one another and overlap along the lateral dimension, and the distal and proximal arms overlap along the height dimension. A remotely controlled manipulator system.

87. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; the manipulator includes a proximal arm coupled to the rail via a proximal joint housing, an intermediate arm coupled to the proximal arm, and a distal arm coupled to the proximal arm; The manipulator is configured to be deployable in a first configuration in which the proximal arm is concave relative to the platform and the proximal joint housing extends outward from the rail, and in a second configuration in which the proximal arm is convex relative to the platform and the proximal joint housing extends inward from the rail. A remotely controlled manipulator system.

88. a table assembly including a platform configured to support a body, the platform including a lateral dimension and a longitudinal dimension; a rail coupled to the table assembly; a manipulator coupled to the rail and translatable relative to the rail along a longitudinal dimension of the rail; the manipulator includes a proximal arm coupled to the rail via one or more proximal joints and an intermediate arm coupled to the proximal arm via an intermediate joint; the proximal arm follows a non-linear path between the proximal joint and the intermediate joint; A remotely controlled manipulator system.

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