Robotic catheters and manual suction catheters

Abstract

To provide robot-controlled surgical tools. [Solution] The device comprises an elongated shaft, a pull wire, a device base including a drive input assembly, and an adapter connectable to the device base, the adapter including an actuator, a coupler operably coupled to the actuator and connectable to the drive input assembly, the coupler having a gear assembly engageable with the actuator, and a tension mechanism configured to disengage the gear assembly from the actuator, wherein the actuator is operable to adjust the tension of the pull wire by operating the coupler while the gear assembly is engaged with the actuator, and the tension mechanism is operable to adjust the tension of the pull wire by operating the coupler while the gear assembly is disengaged from the actuator.

Description

Technical Field

[0001] (Cross - reference to Related Applications) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 132,864, filed Dec. 31, 2020, entitled “ROBOTIC AND MANUAL ASPIRATION CATHETERS,” the disclosure of which is incorporated herein in its entirety by reference.

Background Art

[0002] Various medical procedures involve the use of one or more medical devices to access a target anatomical site within a patient. In some instances, using an inappropriate device to access a site in connection with a procedure can potentially have an adverse effect on the patient's health, the integrity of the medical device(s), and / or the effectiveness of the procedure.

Summary of the Invention

Means for Solving the Problems

[0003] In some implementations, the present disclosure relates to a robot - controllable catheter assembly comprising an elongate shaft that includes a lumen and is configured to couple to a suction system to provide suction to a target site through the lumen, and an instrument base coupled to the elongate shaft and configured to control the operation of the elongate shaft. The instrument base includes a drive input assembly configured to couple to a drive output assembly associated with a robotic arm.

[0004] In some embodiments, the elongate shaft includes another lumen, and the robot - controllable catheter assembly further includes an elongate moving member slidably disposed within the other lumen and connected to the distal end of the elongate shaft. The drive input assembly is connected to the elongate moving member and can control the articulation of the elongate shaft.

[0005] In some embodiments, the instrument base includes a port configured to be coupled to the proximal end of an elongated shaft and to be coupled to a suction system. Furthermore, in some embodiments, the instrument base includes an identification element associated with an identifier for a robot-controllable catheter assembly. The identification element may include at least one of a radio frequency identification tag, a quick response (QR) code, a barcode, or a magnet.

[0006] In some embodiments, the robot-controllable catheter assembly further includes a handheld instrument adapter configured to receive manual input and control the operation of an elongated shaft. The handheld instrument adapter may include a coupler configured to connect to a drive input assembly at the base of the instrument, and a manual actuator connected to the coupler and configured to operate the coupler. In an example, the coupler includes a gear assembly configured to engage with the manual actuator and the drive input assembly. Furthermore, in an example, the robot-controllable catheter assembly further includes a pull wire configured to operate an elongated shaft. The coupler may include a tension mechanism configured to release the manual actuator from operating the drive input assembly and to adjust the tension of the pull wire.

[0007] In some implementations, the present disclosure relates to a manually controllable catheter comprising: an elongated shaft including a lumen and configured to be coupled to a suction system to provide suction to a target site through the lumen; and an instrument handle including a manual actuator coupled to the elongated shaft and configured to control the operation of the elongated shaft.

[0008] In some embodiments, the elongated shaft includes a wire lumen, and a manually controllable catheter is slidably positioned within the wire lumen and further comprises a pull wire connected to the distal end of the elongated shaft. A manual actuator is connected to the pull wire and can control the articular movement of the elongated shaft. Furthermore, in some embodiments, the instrument handle includes a port coupled to the proximal end of the elongated shaft and configured to connect to a suction system.

[0009] In some embodiments, the manual actuator is configured to be operated by the user's thumb when the instrument handle is held by the user in an overhand position. Furthermore, in some embodiments, the manual actuator is configured to be operated by the user's thumb when the instrument handle is held by the user in an underhand position.

[0010] In some implementations, the present disclosure relates to a system comprising a base, a coupler rotatably supported within the base, and a first manual actuator operably coupled to the coupler. The coupler is configured to be coupled to the drive input assembly of a robot-controllable medical device. The first manual actuator is configured to operate the coupler to articulate the robot-controllable medical device.

[0011] In some embodiments, the coupler includes an engagement assembly configured to be coupled to a first manual actuator and to a drive input assembly of a robot-controllable medical device. In an example, the engagement assembly includes (i) a first engagement member that engages with the manual actuator, (ii) a second engagement member configured to engage with the drive input assembly, and (iii) a disengagement mechanism configured to disengage the coupling of the first engagement member to the second engagement member. Furthermore, in the example, the disengagement mechanism includes a second manual actuator configured to receive a manual input and release the coupling of the first engagement member to the second engagement member.

[0012] In some embodiments, the system further includes a robot-controllable medical device comprising (i) an elongated shaft configured to be coupled to a suction system to provide suction to a target site, and (ii) an instrument base coupled to the elongated shaft and configured to control the operation of the elongated shaft. The instrument base may include a drive input assembly. In the example, the elongated shaft includes a lumen, and the robot-controllable medical device further includes an elongated moving member slidably positioned within the lumen and connected to the distal end of the elongated shaft. The drive input assembly is connected to the elongated moving member and can control the articulation of the elongated shaft. Furthermore, in the example, a coupler is configured to release a first manual actuator from operating the drive input assembly and includes a tension mechanism configured to adjust the tension of the elongated moving member. Furthermore, in the example, the instrument base includes a port coupled to the proximal end of the elongated shaft and configured to be coupled to a suction system.

[0013] In some embodiments, the coupler includes a gear assembly configured to engage with a first manual actuator and a drive input assembly.

[0014] In some implementations, this disclosure relates to a system comprising an elongated shaft and a handle coupled to the elongated shaft. The elongated shaft comprises a distal end portion, a proximal end portion, and a lumen. The elongated shaft is coupled to a suction system and configured to provide suction through the lumen. The handle is configured to operate in a robotic mode in which the handle receives robotic input for controlling the joint movement of the elongated shaft, and in a manual mode in which the handle receives manual input for controlling the joint movement of the elongated shaft.

[0015] In some embodiments, the system further includes a robotic arm comprising a drive output assembly configured to provide robotic input to a handle. The handle may be coupled to the drive output assembly of the robotic arm. Furthermore, in some embodiments, the handle includes a manual actuator coupled to an elongated shaft and configured to receive manual input.

[0016] In some embodiments, the handle includes a tool base configured to receive robotic input and an adapter configured to couple to the tool base. The adapter may include a manual actuator configured to receive manual input. In an example, the adapter includes a coupler configured to couple to a drive input assembly of the tool base. The coupler may include (i) a first engaging member that engages with the manual actuator, (ii) a second engaging member configured to engage with the drive input assembly, and (iii) a disengagement mechanism configured to disengage the coupling of the first engaging member to the second engaging member. Furthermore, in an example, the disengagement mechanism may include another manual actuator configured to receive manual input and disengage the coupling of the first engaging member to the second engaging member.

[0017] In some embodiments, the elongated shaft includes a pull wire configured to operate the distal end portion of the elongated shaft. In one example, the handle includes a tensioning mechanism configured to adjust the tension of the pull wire.

[0018] In some embodiments, the handle includes a port configured to connect to a lumen and a suction system.

[0019] For the purpose of summarizing this disclosure, certain aspects, advantages, and features are described. It should be understood that not all such advantages can necessarily be realized by any particular embodiment. Accordingly, the disclosed embodiments may realize or optimize one or more advantages or groups of advantages taught herein without necessarily realizing other advantages that may be taught or suggested herein.

Brief Description of the Drawings

[0020] The various embodiments are shown in the accompanying drawings for the purpose of explanation and should not be construed as in any way limiting the scope of the present disclosure. Additionally, various features of different disclosed embodiments can be combined to form further embodiments that are part of the present disclosure. Throughout the drawings, reference numbers may be reused to indicate corresponding relationships between reference elements. [Figure 1] FIG. showing an exemplary robotic medical system configured for ureteroscopy procedures for diagnosis and / or treatment according to one or more embodiments. [Figure 2] FIG. showing an exemplary robotic medical system configured for bronchoscopy procedures for diagnosis and / or treatment according to one or more embodiments. [Figure 3] FIG. showing an exemplary table - based robotic system according to one or more embodiments. [Figure 4] FIG. showing exemplary medical system components that can be implemented in any of the medical systems of FIGS. 1 - 3 according to one or more embodiments. [Figure 5] FIG. showing an exemplary catheter disposed in a patient's kidney according to one or more embodiments. [Figure 6] FIG. showing an exemplary catheter including a shaft and a handle according to one or more embodiments. [Figure 7A] FIG. showing a side view of the shaft of the catheter of FIG. 6 according to one or more embodiments. [Figure 7B] FIG. showing a cross - sectional view of the shaft of the catheter of FIG. 6 according to one or more embodiments. [Figure 8A] FIG. showing a perspective view of an exemplary robot - controllable catheter according to one or more embodiments. [Figure 8B] FIG. showing a bottom view of the exemplary robot - controllable catheter of FIG. 8A according to one or more embodiments. [Figure 8C]Perspective view of the bottom of an exemplary robot - controllable catheter according to one or more embodiments, as shown in FIGS. 8A - 8B. [Figure 9-1] Top view of the instrument base of the catheter according to one or more embodiments, as shown in FIGS. 8A - 8C. [Figure 9-2] Top view of the instrument base of the catheter according to one or more embodiments, with the upper portion of the instrument base removed, as shown in FIGS. 8A - 8C. [Figure 10] Diagram showing exemplary components of the instrument base of the catheter according to one or more embodiments, as shown in FIGS. 8A - 8C. [Figure 11] Exploded view of an exemplary instrument device manipulator assembly associated with a robotic arm according to one or more embodiments. [Figure 12-1] Diagram showing an exemplary manual adapter configured to couple to a robot - controllable medical instrument according to one or more embodiments. [Figure 12-2] Exploded view showing exemplary components of the adapter of FIG. 18 - 1 according to one or more embodiments. [Figure 12-3] Diagram showing an exemplary engagement assembly engaged with the manual actuator of the adapter of FIG. 12 - 1 according to one or more embodiments. [Figure 12-4] Exploded view showing the engagement assembly of FIG. 12 - 3 according to one or more embodiments. [Figure 12-5] Bottom view of the exemplary manual actuator and gear / coupler of the adapter of FIG. 12 - 1 according to one or more embodiments. [Figure 13A] Diagram showing the adapter of FIG. 12 - 1 coupled to a robot - controllable catheter according to one or more embodiments. [Figure 13B] Diagram showing the adapter of FIG. 12 - 1 coupled to a robot - controllable catheter according to one or more embodiments. [Figure 14A] Perspective view, side view, and top view, respectively, of an exemplary manually - controllable catheter according to one or more embodiments. [Figure 14B]These are perspective, side, and top views, respectively, of exemplary manually controllable catheters according to one or more embodiments. [Figure 14C] These are perspective, side, and top views, respectively, of exemplary manually controllable catheters according to one or more embodiments. [Figure 15A] Figures 14A to 14C show side and perspective views of exemplary manually controllable catheters according to one or more embodiments. [Figure 15B] Figures 14A to 14C show side and perspective views of exemplary manually controllable catheters according to one or more embodiments. [Figure 15C] Figures 14A to 14C show side and perspective views of exemplary manually controllable catheters according to one or more embodiments. [Figure 16] Figures 14A to 14C show the manual actuator and other features of an exemplary manually controllable catheter according to one or more embodiments. [Figure 17] Figures 14A-14C show exemplary manually controllable catheters, held by a user, according to one or more embodiments. [Figure 18-1] This figure shows another exemplary manually controllable catheter according to one or more embodiments. [Figure 18-2] This figure shows exemplary internal components of a manually controllable catheter according to one or more embodiments of Figure 18-1. [Figure 19] Figures 18-1 and 18-2 show exemplary manually controllable catheters, held by a user, according to one or more embodiments. [Figure 20-1] This figure shows a further exemplary manually controllable catheter according to one or more embodiments. [Figure 20-2] This figure shows exemplary internal components of a manually controllable catheter according to one or more embodiments of Figure 20-1. [Modes for carrying out the invention]

[0021] The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the disclosure. While specific embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as modifications and their equivalents. Therefore, any claims arising from this specification are not limited by any of the specific embodiments described below. For example, in any method or process disclosed herein, the actions or operations of the method or process may be performed in any preferred order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as a number of distinct operations in a manner that may be helpful in understanding a particular embodiment. However, the order of description should not be construed as meaning that these operations are order-dependent. Furthermore, the structures, systems, and / or devices described herein may be embodied as integrated components or separate components. For the purpose of comparing various embodiments, specific aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily realized by any particular embodiment. Therefore, various embodiments can be carried out in a manner that, for example, realizes or optimizes one or more advantages as taught herein, without necessarily realizing other embodiments or advantages that may also be taught or suggested herein.

[0022] Certain spatially relative terms, such as “outside,” “inside,” “upside,” “downside,” “below,” “upper,” “vertical,” “horizontal,” “top,” “bottom,” and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure. However, these terms are used herein for the purpose of simplifying explanation to describe the positional relationships between elements / structures, as illustrated in the drawings. It should be understood that spatially relative terms are intended to encompass different orientations of elements / structures in use or operation, in addition to the orientations shown in the drawings. For example, when an element / structure is described as being “above” another element / structure, it may mean that it is located below or beside such other element / structure with respect to the patient or an alternative orientation of the element / structure, and vice versa. It should be understood that spatially relative terms, including those listed above, are to be understood in relation to the respective illustrated orientations of the referenced drawings.

[0023] For convenience of devices, components, systems, feature parts, and / or modules having similar characteristics in one or more respects, certain reference numerals are reused across different drawings in the set of drawings of this disclosure. However, with respect to any embodiment disclosed herein, the reuse of a common reference numeral in the drawings does not necessarily mean that such feature parts, devices, components, or modules are identical or similar. Rather, those skilled in the art may be notified by the context to the extent that the use of a common reference numeral may imply similarity between the referenced subjects. The use of a particular reference numeral in the context of the description of a particular drawing may be understood to relate to a device, component, aspect, feature part, module, or system identified in that particular drawing, and not necessarily to any device, component, aspect, feature part, module, or system identified by the same reference numeral in another drawing. Furthermore, aspects of separate drawings identified by a common reference numeral may be interpreted as sharing characteristics or as being completely independent of one another.

[0024] This disclosure relates to aspiration / irrigation catheters / devices. With respect to percutaneous access devices and other medical devices relating to this disclosure, the term “device” is used in its broad and ordinary sense and may refer to any type of tool, instrument, assembly, system, apparatus, component, etc. In some contexts herein, the term “instrument” may be used substantially interchangeably with the term “device.”

[0025] Certain aspects of this disclosure are described in detail herein in the context of renal, urinary, and / or nephrological procedures, such as the removal / treatment of kidney stones. However, such context is provided for convenience, and it should be understood that the concepts disclosed herein are applicable to any appropriate medical procedure, such as bronchoscopy. Nevertheless, as mentioned above, a description of the anatomical structure of the kidney / urinary tract and related medical issues and procedures is presented below to help explain the concepts disclosed herein.

[0026] Kidney stones, also known as urolithiasis, are a medical condition involving the formation of solid fragments of a substance in the urinary tract, referred to as “kidney stones,” “urinary tract stones,” “kidney stones,” “urolithiasis,” or “urolithiasis.” Urinary tract stones may form and / or be found in the kidneys, ureters, and bladder (referred to as “bladder stones”). Such urinary tract stones can form as a result of the concentration of minerals in the urine, and when such stones grow large enough to obstruct the flow of urine through the ureters or urethra, they can cause significant abdominal pain. Urinary tract stones may form from calcium, magnesium, ammonia, uric acid, cysteine, and / or other compounds, or combinations thereof.

[0027] Several methods can be used to treat patients with kidney stones, including observation, medical treatment (such as elimination therapy), non-invasive treatment (such as extracorporeal shock wave lithotripsy (ESWL)), and surgical treatment (such as ureteroscopy and percutaneous nephrolithotomy ("PCNL"). In some approaches (e.g., ureteroscopy and PCNL), a physician accesses the stone, which is then broken into smaller fragments or pieces, and the relatively small stone fragments / particles are extracted from the kidney using a basket device and / or aspiration.

[0028] In a ureteroscopy procedure, a physician may insert a ureteroscope through the urethra into the ureter to remove urinary tract stones from the bladder and ureters. Typically, the ureteroscope includes an imaging device at its distal end, configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotomy device for capturing or fragmenting urinary tract stones. During the ureteroscopy procedure, one physician / technician may control the position of the ureteroscope, while another physician / technician may control the lithotomy device(s).

[0029] In PCNL procedures, which may be used to remove relatively large stones, a physician may insert a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site for fragmenting and / or removing the stone(s). During a PCNL procedure, fluid mechanics may be applied to remove stone fragments, small pieces, and / or thrombi from the treatment site and / or field of view. In some cases, relatively linear and / or rigid nephroscopes are used, and the physician positions the tip of the nephroscope in the appropriate location within the kidney (e.g., renal calyces) by pressing / leveraging the device against the patient's body. This movement can be harmful to the patient (e.g., causing tissue damage).

[0030] In other procedures, such as one or more of the procedures discussed in more detail below, a physician may use multiple instruments via percutaneous and / or direct access routes to remove kidney stones. For example, a physician may navigate a scope through the patient's urethra to a target site within the kidney and insert a catheter device into the target site through the patient's skin. The physician may use the scope and catheter device in conjunction to fragment the kidney stone and extract the fragments from the patient's body.

[0031] This disclosure relates to systems, devices, and methods for navigating to and / or aspirating / irrigating a target site in order to perform a medical procedure. For example, a catheter may be realized that includes an elongated shaft and a handle / base coupled to the shaft and configured to control the movement of the shaft (at least in the distal portion of the shaft). The shaft may include a lumen coupled to an aspiration / irrigation system and configured to provide aspiration / irrigation to a target site, such as for removing an object from a patient. The handle / base of the catheter may be controlled by robotic and / or manual control to articulate the distal portion of the shaft, thereby allowing the catheter to be navigated within the anatomical structure of a patient. For example, the catheter may include multiple pull wires or other elongated moving members coupled to the distal portion of the shaft and one or more operating components in the handle of the catheter. The pull wires / elongated moving members can be manipulated (using the handle) to control the movement of the distal portion of the shaft. In addition to, or instead of, the handle of the catheter may be moved to control the movement of the distal portion of the catheter, such as for inserting / retiring the tip of the catheter.

[0032] In some embodiments, the techniques and devices discussed herein may enable the removal of an object from a patient's body in an efficient manner that prevents damage to the patient's anatomical structures and / or damage to the removal device. For example, the articulated catheter structures described herein may enable a physician to navigate the distal portion of a catheter within a patient's body without moving the entire catheter (e.g., by controlling one or more elements within the catheter's handle / base). In contrast, some nephroscopy procedures require a physician to use leverage to move the proximal portion of a nephroscope to position the tip of the nephroscope in the appropriate location within the patient's body, resulting in damage to the patient's anatomical structures.

[0033] In some embodiments, the techniques described herein implement robot-assisted medical procedures, where the robotic tool may enable a physician to perform endoscopic and / or percutaneous access, and / or endoscopic and / or percutaneous procedures, for a target anatomical site. For example, the robotic tool may engage with and / or control one or more medical instruments, such as a scope, catheter, or other instrument, to access and / or perform a procedure at a target site within the patient. In some cases, the robotic tool is guided / controlled by a physician. In other cases, the robotic tool operates automatically or semi-automatically. While some techniques are discussed in the context of robot-assisted medical procedures, these techniques may also be applicable to other types of medical procedures, such as procedures that do not implement a robotic tool, or that implement a robotic tool only for a relatively small number of movements (e.g., below a threshold number). For example, the techniques may be applicable to procedures that implement manually operated medical instruments, such as manual catheters and / or scopes, which are fully controlled by a physician.

[0034] Certain aspects of this disclosure are described herein in the context of kidney, urinary tract, and / or kidney procedures, such as kidney stone removal / treatment procedures. However, such contexts are provided for convenience, and it should be understood that the concepts disclosed herein are applicable to any suitable medical procedure. For example, the following descriptions also apply to other surgical / medical operations or medical procedures relating to the removal of objects from a patient, including any objects that can be removed percutaneously and / or via endoscopic access from the treatment site or the patient's body cavities (e.g., esophagus, ureters, intestines, eyes, etc.), such as gallstone removal, lung (lung / transthoracic) tumor biopsy, or cataract removal. However, as stated above, a description of the anatomical structure of the kidney / urinary tract and related medical issues and procedures is provided below to help illustrate the concepts disclosed herein.

[0035] Figure 1 shows an exemplary robotic medical system 100 configured for a ureteroscopy procedure for diagnosis and / or treatment according to one or more embodiments. The medical system 100 includes a robotic system 110 configured to engage with and / or control one or more medical instruments / devices to perform a procedure on a patient 120. In the example of Figure 1, the robotic system 110 is coupled to a scope 130 and a catheter 140. However, the robotic system 110 can be coupled to any type of medical instrument. The medical system 100 also includes a control system 150 configured to interface with the robotic system 110 and / or a physician 160, providing information about the procedure and / or performing various other actions. For example, the control system 150 may include a display 156 configured to present specific information to assist the physician 160 when performing the procedure. The medical system 100 may also include a fluid management system 170 (sometimes referred to as the “suction system 170” or “irrigation system 170”) configured to provide aspiration and / or irrigation to a target site via a catheter 140, a scope 130, an instrument / device 142, and / or other instruments / devices, etc. The medical system 100 may also include a table 180 (e.g., a bed) configured to hold a patient 120. Various actions are described herein as being performed by a physician 160. These actions may be performed directly by the physician 160, a user under the direction of the physician 160, another user (e.g., a technician), a combination thereof, and / or any other user. The devices / components of the medical system 100 may be configured in various ways depending on the type of procedure, the stage of the procedure, the user’s preferences, etc.

[0036] The control system 150 can generally work in cooperation with the robot system 110 to perform medical procedures. For example, the control system 150 can communicate with the robot system 110 via wireless or wired connection to control medical instruments connected to the robot system 110 and receive images(s) captured by the medical instruments. For example, the control system 150 can receive image data from the scope 130 (e.g., an imaging device associated with the scope 130) and display the image data (and / or a representation thereof) to the physician 160 to help the physician 160 navigate the scope 130 and / or catheter 140 within the patient 120. The physician 160 can provide input via an input / output (I / O) device such as a controller, and the control system 150 can send control signals to the robot system 110 to control the movement of the scope 130 and / or catheter 140 connected to the robot system 110. The scope 130 and / or catheter 140 (and / or other medical device) may be configured to move in various ways, such as articulating, rotating, etc.

[0037] In some embodiments, the control system 150 may provide power to the robot system 110 via one or more electrical connections, or provide optics to the robot system 110 via one or more optical fibers or other components. In an example, the control system 150 may communicate with a medical device to receive sensor data (via the robot system 110 and / or directly from the medical device). The sensor data may indicate or be used to determine the position and / or orientation of the medical device. Furthermore, in an example, the control system 150 may communicate with a table 180 to position the table 180 in a specific orientation or otherwise control the table 180. Also in an example, the control system 150 may communicate with an EM field generator (not illustrated) to control the generation of an EM field around the patient 120.

[0038] The robotic system 110 may include one or more robotic arms 112 configured to engage with or control medical instruments / devices. Each robotic arm 112 may include multiple arm segments coupled to a joint, thereby providing multiple degrees of motion. The distal end of a robotic arm 112 (e.g., an end effector) may be configured to couple to an instrument / device. In the example in Figure 1, robotic arm 112(A) is coupled to the handle 141 of a catheter 140. A second robotic arm 112(B) is coupled to a scope-driver instrument coupling / device 131 that can facilitate robotic control / advancement of the scope 130. Furthermore, a third robotic arm 112(C) is coupled to the handle 132 of the scope 130, which may be configured to facilitate the advancement and / or movement of the scope 130 and / or medical instruments that can be deployed through the scope 130, such as instruments deployed through the working channels of the scope 130. In this example, the second robotic arm 112(B) and / or the third robotic arm 112(C) can control the movement of the scope 130 (e.g., joint movement, rotation, etc.). Although three robotic arms are connected to a specific medical instrument in Figure 1, the robotic system 110 can include any number of robotic arms configured to connect to any type of medical instrument / device.

[0039] The robot system 110 can be communicatively coupled to any component of the medical system 100. For example, in one example, the robot system 110 can be communicatively coupled to a control system 150 to receive control signals from the control system 150 and perform actions such as controlling a robotic arm 112 in a specific manner or operating medical instruments. Furthermore, the robot system 110 can be configured to receive images (also referred to as image data) showing the internal anatomical structure of a patient 120 from a scope 130 and / or transmit the images to the control system 150, after which the images can be displayed on a display 156. In addition, the robot system 110 can be coupled to components of the medical system 100, such as the control system 150 and / or a fluid management system 170, in a manner that allows it to receive fluids, optics, power, data, etc., from the components.

[0040] The fluid management system 170 may be configured to provide / control aspiration and / or irrigation to a target site. As shown in the figure, the fluid management system 170 may be configured to hold one or more fluid bags / containers 171 and / or control the fluid flow thereto. For example, an irrigation line 172 may be coupled to one or more of the bags / containers 171 and to an irrigation port of a percutaneous access device / assembly 142. The irrigation fluid may be delivered to the target anatomical structure via the irrigation line 172 and the percutaneous access device / assembly 142. The fluid management system 170 may include certain electronic components, such as a display 173, a flow control mechanism, and / or certain associated control circuits. The fluid management cart 170 may include a freestanding tower / cart having one or more IV bags 171 suspended from one or more sides thereof. The cart 170 may include a pump from which aspiration fluid can be drawn into a collection container / cartridge via a suction channel / tube 174. The suction channel / tube 174 may be coupled to the catheter handle 141 to facilitate suction through the lumen within the catheter 140.

[0041] In the illustrated system 100, a percutaneous access device 142 is implemented to provide percutaneous access to the kidney 190 of a patient 120. The percutaneous access device 142 may include one or more sheaths and / or shafts through which the device and / or fluid can access a target biostructure where the distal end of the device 142 is located. In this example, a catheter 140 accesses the anatomical structure of the kidney through the percutaneous access device 142. That is, the catheter 140 is inserted into the device 142 to access the target site.

[0042] While various examples are discussed in the context of providing irrigation / suction via catheter 140 and / or percutaneous access device / assembly 142, the irrigation fluid and / or suction may, in some cases, be delivered to the treatment site (e.g., kidney) through another device such as scope 130. Furthermore, irrigation and suction may or may not be delivered through the same instrument(s). If one or more of the instruments provide irrigation and / or suction functions, one or more of those instruments may be used for other functions, such as disassembling the object to be removed.

[0043] Medical instruments can include various types of instruments such as scopes (sometimes referred to as “endoscopes”), catheters, needles, guidewires, lithotomizers, basket retrieval devices, forceps, vacuums, needles, surgical scalpels, imaging probes, imaging devices, grippers, scissors, capture devices, needle holders, micro-dissection instruments, staple applicators, tackers, suction / irrigation tools, and clip applicators. Medical instruments can include direct penetration instruments, percutaneous penetration instruments, and / or other types of instruments. In some embodiments, medical instruments are maneuverable devices, while in other embodiments, medical instruments are non-maneuverable devices. In some embodiments, surgical tools refer to devices such as needles, surgical scalpels, and guidewires that are configured to puncture or be inserted through human tissue structures. However, surgical tools can also refer to other types of medical instruments.

[0044] The terms “scope” or “endoscope” can refer to any type of elongated medical instrument having image generation, visualization, and / or acquisition functions (or configured to provide such functions using an imaging device deployed through a working channel) and configured to be introduced into any type of organ, body cavity, lumen, chamber, and / or space of the body. For example, a scope or endoscope such as Scope 130 could refer to a ureteroscope (for accessing the urinary tract), a laparoscope, a nephroscope (for accessing the kidneys), a bronchoscope (for accessing the airways such as the bronchi), a colonoscope (for accessing the colon), an arthroscope (for accessing joints), a cystoscope (for accessing the bladder), a borescope, and the like. In some examples, a scope / endoscope may include a rigid or flexible tube and may be sized to pass through an outer sheath, catheter, introducer, or other tubular device, or may be used without such a device. In some embodiments, the scope includes one or more working channels that allow further tools / medical instruments, such as lithotomizers, basket devices, forceps, laser devices, and imaging devices, to be introduced into the treatment site.

[0045] The terms “direct penetration” or “direct access” can refer to any penetration of an instrument through a natural or artificial orifice within a patient’s body. For example, since Scope 130 penetrates the patient’s urinary tract through the urethra, Scope 130 may be referred to as a direct access instrument.

[0046] The term “percutaneous penetration” or “percutaneous access” can refer to the penetration of an instrument through puncture and / or a small incision, etc., through the patient’s skin and any other body layer necessary to reach a target anatomical site associated with the procedure (e.g., the renal calyx retina of the kidney). Thus, percutaneous access instruments can refer to medical instruments, devices, or assemblies configured to puncture or be inserted through the skin and / or other tissues / anatomical structures, such as needles, surgical scalpels, guidewires, sheaths, shafts, scopes, and catheters. However, it should be understood that percutaneous access instruments can refer to other types of medical instruments in the context of this disclosure. In some embodiments, percutaneous access instruments refer to instruments / devices that are inserted or implemented by a device that facilitates puncture and / or a small incision through the patient’s skin. For example, catheter 140 may be referred to as a percutaneous access instrument when catheter 140 is inserted through a sheath / shaft inserted into the patient’s skin.

[0047] In some embodiments, the medical device includes a sensor (also referred to as a position sensor) configured to generate sensor data. For example, the sensor data may indicate the position and / or orientation of the medical device and / or can be used to determine the position and / or orientation of the medical device. For example, the sensor data may indicate the position and / or orientation of a scope, which may include rotation of the distal end of the scope. The position and orientation of the medical device may be referred to as the posture of the medical device. The sensor may be positioned at the distal end of the medical device and / or any other location. In some embodiments, the sensor may provide sensor data to a control system 150, a robotic system 110, and / or another system / device to perform one or more positioning techniques for determining / tracking the position and / or orientation of the medical device.

[0048] In some embodiments, the sensor may include an electromagnetic (EM) sensor with a coil of conductive material, where the EM field generator can produce an EM field that is detected by the EM sensor on a medical device. The magnetic field can induce a small current in the coil of the EM sensor, and by analyzing this small current, the distance and / or angle / orientation between the EM sensor and the EM field generator can be determined. Furthermore, the sensor may include other types of sensors such as cameras, distance sensors (e.g., depth sensors), radar devices, shape-sensing fibers, accelerometers, gyroscopes, satellite-based positioning sensors (e.g., Global Positioning System, GPS), and radio frequency transceivers.

[0049] In some embodiments, the medical system 100 may also include an imaging device (not illustrated in Figure 1) which may be integrated with a C-arm and / or configured to take images during a procedure, such as in the case of a fluoroscopy-type procedure. The imaging device may be configured to capture / generate one or more images of the patient 120 during the procedure, such as one or more X-ray or CT images. In an example, images from the imaging device may be provided in real time to allow the physician 160 to visualize anatomical structures and / or medical instruments within the patient 120 to assist in performing the procedure. The imaging device may be used to perform fluoroscopy or another type of imaging technique (e.g., with a contrast agent within the patient 120).

[0050] Various components of the medical system 100 can be connected to communicate with one another via a network that may include wireless and / or wired networks. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), body area networks (BANs), cellular networks, and the Internet. Furthermore, in some embodiments, the components of the medical system 100 are connected via one or more support cables, tubes, etc., for purposes such as data communication, fluid / gas exchange, and power exchange.

[0051] In some examples, the medical system 100 is implemented to perform medical procedures related to the anatomical structure of the kidney, such as treating kidney stones. For example, robotic-assisted percutaneous procedures can be realized when robotic tools (e.g., one or more components of the medical system 100) enable a physician / urologist to perform endoscopic (e.g., ureteroscopy) targeted access and percutaneous access / treatment. However, this disclosure is not limited to kidney stone removal and / or robotic-assisted procedures. In some embodiments, robotic medical solutions can provide relatively high precision, superior control, and / or superior eye-hand coordination for certain instruments compared to strictly manual procedures. For example, robotic-assisted percutaneous access to the kidney by some procedures can advantageously enable a urologist to perform both direct-invasion endoscopic kidney access and percutaneous kidney access. While some embodiments of this disclosure are presented in the context of catheters, nephroscopes, ureteroscopes, and / or the anatomical structure of the human kidney, it should be understood that the principles disclosed herein can be implemented in any type of endoscopic / percutaneous procedure or another type of procedure.

[0052] In one exemplary and non-limiting procedure, the medical system 100 may be used to remove kidney stones 191 from a patient 120. During setup for the procedure, the physician 160 can position the robotic arm 112 of the robotic system 110 into a desired configuration and / or attach appropriate medical instruments. For example, the physician 160 may position the first robotic arm 112(A) near the treatment site and attach an EM field generator (not shown), which can help track the location of the scope 130 and / or other instruments / devices during the procedure. Furthermore, the physician 160 may position the second robotic arm 112(B) between the legs of the patient 120 and attach a scope-driver instrument coupling 131, which can facilitate robotic control / advancement of the scope 130. In some examples, the physician 160 may insert a sheath / access instrument 135 into the urethra 192 of the patient 120 and / or through the bladder 193 into the ureter 194. The physician 160 can connect the sheath / access instrument 135 to the scope-drive instrument connector 131. The sheath / access instrument 135 may include a lumen-type device configured to receive the scope 130, thereby assisting in the insertion of the scope 130 into the anatomical structure of the patient 120. However, in some embodiments, the sheath / access instrument 135 is not used (for example, the scope 130 is inserted directly into the urethra 192). The physician 160 can then insert the scope 130 into the sheath / access instrument 135 manually, robotically, or a combination thereof. The physician 160 may attach the handle 132 of the scope 130 to a third robotic arm 112(C), which may be configured to facilitate the advancement and / or movement of a basket device, laser device, and / or other medical instrument deployed through the scope 130.

[0053] The physician 160 can interact with the control system 150 to cause the robotic system 110 to advance and / or navigate the scope 130 into the kidney 190. For example, the physician 160 can use a controller or other I / O device to navigate the scope 130 to locate the kidney stone 191. The control system 150 may provide information about the scope 130 via the display(s) 156 to assist the physician 160 in navigating the scope 130, such as viewing image representations (e.g., real-time images acquired using the scope 130). In some embodiments, the control system 150 may use localization techniques to determine the position and / or orientation of the scope 130, which may, in some cases, be visually represented by the physician 160 via the display(s) 156. Furthermore, other types of information, such as X-ray images of the patient's internal anatomical structures, may also be presented via the display(s) 156 to assist the physician 160 in controlling the scope 130.

[0054] Upon reaching the site of the kidney stone 191 (for example, within the renal calyces of the kidney 190), the scope 130 can be used to designate / tag a target site for the catheter to percutaneously access the kidney 190. To minimize damage to the kidney 190 and / or surrounding anatomical structures, the physician 160 may designate the papilla as a target site for percutaneous entry into the kidney 190 using the catheter. However, other target sites can be designated or determined. In some embodiments of designating the papilla, the physician 160 may navigate the scope 130 to make contact with the papilla, and the control system 150 may use localization techniques to determine the location of the scope 130 (e.g., the location of the distal end of the scope 130), and the control system 150 may associate the location of the scope 130 with the target site. Furthermore, in some embodiments, the physician 160 may navigate the scope 130 to be within a certain distance of the papilla (e.g., placed in front of the papilla) and provide input indicating that the target site is within the field of view of the scope 130. The control system 150 may perform image analysis and / or other localization techniques to determine the location of the target location. Furthermore, in some embodiments, the scope 130 may deliver reference points for marking the nipple as the target location.

[0055] Once a target location is specified, the catheter 140 can be inserted into the patient 120 through a percutaneous access pathway to reach the target site (e.g., by joining with the scope 130). For example, the catheter 140 can be connected to a first robotic arm 112(A) (without the EM field generator), and the physician 160 can interact with a control system 150, as shown in Figure 1, to have the robotic system 110 advance and / or navigate the catheter 140. Alternatively or additionally, the catheter 140 may be manually inserted and / or controlled, such as when the catheter 140 is implemented as a manually controllable catheter. In some embodiments, a needle or another medical device is inserted into the patient 120 to form a percutaneous access pathway. The control system 150 can provide information about the catheter 140 via a display 156 to assist the physician 160 in navigating the catheter. For example, a display(s) 156 can provide image data from the viewpoint of the scope 130, and the image data can depict the catheter 140 (for example, when it is within the field of view of the imaging device of the scope 130).

[0056] Once the scope 130 and / or catheter 140 are positioned at the target site, the physician 160 can use the scope 130 to break up the kidney stone 191 and / or use the catheter 140 to remove the fragments of the kidney stone 191 from the patient 120. For example, the scope 130 can deploy a tool (e.g., a laser, cutting instrument, lithotomer, etc.) through its working channel to fragment the kidney stone 191 into fragments, and the catheter 140 can aspirate the fragments from the kidney 190 through a percutaneous access route. The catheter 140 can provide aspirate to maintain / hold the kidney stone 191 at the distal end of the catheter 140 and / or in a relatively fixed position, and the scope 130 can fragment the kidney stone 191 using a tool (e.g., a laser), as shown in Figure 1. The fluid management system 170 can provide irrigation to a target site via a percutaneous access device / assembly 142 and / or provide aspiration to a target site via a catheter 140 (e.g., a lumen within the catheter 140).

[0057] While various exemplary procedures are discussed in the context of realizing a robot-controlled catheter 140, the procedures can also be realized using a manually controllable catheter. For example, the catheter 140 may include a manually controllable handle configured to be held / operated by a physician 160. The physician 160 can navigate the catheter 140 by rotating, inserting, retracting, or otherwise manipulating the handle and / or manual actuator, which can result in articular movement of the distal portion of the catheter 140. Exemplary robot-controlled and manually controllable catheters are described in further detail below.

[0058] Medical system 100 (and / or other medical systems discussed herein) provides various benefits, such as guidance to assist physicians in performing procedures (e.g., instrument tracking, instrument navigation, instrument calibration), enabling physicians to perform procedures from ergonomic positions without requiring skilled arm movements and / or postures, allowing one physician to perform procedures with one or more medical instruments, avoiding radiation exposure (e.g., associated with fluoroscopy techniques), performing procedures in a single surgical setting, and providing continuous aspiration / irrigation for more efficient removal of objects (e.g., removing kidney stones). For example, medical system 100 provides guidance information to assist physicians in accessing target anatomical features with various medical instruments while minimizing bleeding and / or damage to anatomical structures (e.g., organs, blood vessels, etc.). Furthermore, medical system 100 can provide non-radiation-based navigation and / or localization techniques to reduce physician and patient radiation exposure and / or reduce the amount of equipment in the operating room. Furthermore, the medical system 100 can provide distributed functions between at least the control system 150 and the robotic system 110, thereby enabling them to be independently mobile. Such distribution of functions and / or mobility can allow the control system 150 and / or the robotic system 110 to be positioned in locations that are optimal for specific medical procedures, thereby maximizing the work area around the patient and / or providing an optimized location for the physician to perform the procedure.

[0059] While various techniques and systems are discussed as being implemented as robot-assisted procedures (e.g., procedures using medical system 100 in at least part), these techniques and systems can also be implemented in other procedures, such as fully robotic medical procedures (e.g., procedures performed solely by humans without a robotic system). For example, medical system 100 can be used to perform procedures (e.g., fully robotic procedures that rely on relatively little input to direct the procedure) without the physician holding / manipulating medical instruments and without the physician controlling the movement of the robotic system / arm. That is, each medical instrument used during the procedure can be held / controlled by a component of medical system 100, such as the robotic arm 112 of robotic system 110.

[0060] Figure 2 shows an exemplary robotic medical system 100 configured for a diagnostic and / or therapeutic bronchoscopy procedure according to one or more embodiments. During the bronchoscopy, the arm(s) 112 of the robotic system 110 may be configured to deliver medical instruments, such as a maneuverable endoscope 210 which may be a bronchoscope specific to the bronchoscopy procedure, to a natural opening access point (i.e., the mouth of the patient 120 positioned on the table 180 in this example) for delivering the diagnostic and / or therapeutic instruments. As shown, the robotic system 110 (e.g., cart) may be positioned close to the upper torso of the patient to provide access to the access point. Similarly, the robotic arm 112 may be actuated to position the bronchoscope 210 relative to the access point. The configuration in Figure 2 may also be used when performing gastrointestinal (GI) procedures using a gastroscope, which is an endoscope specifically designed for GI procedures.

[0061] Once the robotic system 110 is properly positioned, the robotic arm 112 can insert the maneuverable endoscope 210 into the patient robotically, manually, or a combination thereof. The maneuverable endoscope 210 may include at least two nested parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument driver from a set of instrument drivers, and / or each instrument driver coupled to the distal end of an individual robotic arm 112. Such a linear configuration of instrument drivers creates a “virtual rail” 220 that can be repositioned in space by manipulating one or more robotic arms 112 to various angles and / or positions. The virtual rail / path described herein is depicted in the figures using dashed lines that do not depict any physical structure of the system. Translation of one or more instrument drivers along the virtual rail 220 can move the endoscope 210 forward or backward from the patient 120.

[0062] The endoscope 210 may be directed downstream of the patient's trachea and lungs after insertion using precise commands from the robotic system 110 until it reaches the target surgical site. The use of separate instrument drivers can allow independent driving of separate parts of the endoscope / assembly 210. For example, the endoscope 210 can be directed to deliver a biopsy needle to a target such as a lesion or nodule in the patient's lung. The needle may be deployed downstream of the working channel along the length of the endoscope 210 to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathological results, further biopsies may be performed by deploying further tools through the working channel of the endoscope 210. For example, if a nodule is identified as malignant, the endoscope 210 may endoscopically deliver a tool to excise the potentially cancerous tissue. In some cases, diagnostic and therapeutic procedures can be performed in separate procedures. In these situations, the endoscope 210 can also be used to deliver a reference to "mark" the location of the target nodule. In other cases, diagnostic and therapeutic procedures can be performed during the same procedure.

[0063] In the configuration of system 100 shown in Figure 2, the patient introduction device 230 is attached to the patient 120 via a port (not shown) (e.g., a surgical tube). The patient introduction device 230 can be fixed to the table 180 (e.g., via a patient introduction device holder configured to support the introduction device 230 and fix its position relative to the table 180 or other structure). In some embodiments, the patient introduction device 230 may include a proximal end, a distal end, and an introduction tube between them. The proximal end of the patient introduction device 230 may provide an opening / orifice that can be configured to receive an instrument 210 (e.g., a bronchoscope), and the distal end of the patient introduction device 230 may provide a second opening that can be configured to guide the instrument 210 into the patient access port. A curved tube component of the introduction device 230 connects its proximal and distal ends and can guide the instrument 210 through the introduction device 230.

[0064] The curvature of the introduction device 230 allows the robotic system 110 to operate the instrument 210 from a position not directly axially aligned with the patient access port, thereby providing greater flexibility in positioning the robotic system 110 within the room. Furthermore, the curvature of the introduction device 230 allows the robotic arm 112 of the robotic system 110 to be positioned substantially horizontally with the patient introduction device 230, which can facilitate manual movement of the robotic arm(s) 112 if necessary.

[0065] In some embodiments, one or more of the catheters described herein may be implemented in a bronchoscopy procedure, such as the one illustrated in Figure 2. For example, the catheter may be implemented in cooperation with or instead of an endoscope 210 to remove an object from a patient 120. In one example, the catheter and endoscope 210 are exchanged on a robotic arm 112 and used separately to investigate / treat a target site. Here, the catheter may be inserted through a patient introduction device 230 and used to provide aspiration / irrigation, such as removing an object from a patient 120. In another example, the catheter is deployed through a working channel on the endoscope 210 to provide irrigation / aspiration.

[0066] Figure 3 shows a table-based robotic system 300 configured to perform medical procedures according to one or more embodiments. Here, one or more robotic components of the robotic medical system 100 may be incorporated into the table 302, which would reduce the amount of capital equipment in the operating room and / or provide greater access to the patient 120 compared to a cart-based robotic system. For example, the system 300 may include one or more components of a control system 150, a robotic system 110, and / or a fluid management system 170.

[0067] As shown in the figures, the table 302 may include one or more robotic arms 304 configured to engage with and / or control a medical instrument / device. Each robotic arm 304 may include multiple arm segments coupled to a joint, thereby providing multiple degrees of motion. The distal end (i.e., end effector 306) of the robotic arm 304 may be configured to couple with an instrument / device, which may include any of the medical instruments / devices described herein, such as catheters, needles, and scopes. Each robotic arm 304 may be similar to or different from the robotic arm 112 of system 100 in Figures 1 and 2. Furthermore, each end effector 306 may be similar to or different from the end effector of robotic system 100.

[0068] As shown in the figure, the robot-enabled table system 300 may include a column 310 coupled to one or more carriages 312 (e.g., a ring-shaped movable structure) from which one or more robotic arms 304 can extend. The carriages 312 may translate along a vertical column joint extending over at least a portion of the length of the column 310, providing various viewpoints from which the robotic arms 304 can be positioned to reach the patient 120. In some embodiments, the carriages 312 may rotate around the column 310 using a mechanical motor positioned within the column 310, allowing the robotic arms 304 to gain access to multiple sides of the table 302. The rotation and / or translation of the carriages 312 allows the system 300 to align medical instruments such as endoscopes and / or catheters with different access points on the patient 120. By providing vertical adjustment, the robotic arms 304 may be configured to be compactly housed below the platform of the table system 300 and then raised during the procedure. The robot arm 304 may be mounted on the carriage(s) 312 via one or more arm mounts 314, which may include a series of joints that can rotate independently and / or extend in a nesting manner to provide additional configurability for the robot arm 304. The column 310 structurally provides support for the table platform and a path for the vertical translation of the carriage(s) 312. The column 310 may also transmit power and control signals to the carriage(s) 312 and / or the robot arm 304 mounted thereon.

[0069] In some embodiments, the table-based robotic system 300 may include, or be associated with, a control system similar to the control system 150, to interact with a physician and / or provide information regarding medical procedures. For example, the control system may include input components(s) that enable a physician to control one or more robotic arms 304 and / or medical devices attached to one or more robotic arms 304. In some implementations, the input components(s) may enable a physician to provide inputs for controlling medical devices as if the physician were physically holding / operating the medical devices.

[0070] Figure 4 shows medical system components that may be implemented in any of the medical systems of Figures 1 to 3 according to one or more embodiments of the present disclosure. While certain components are shown in Figure 4, it should be understood that additional components not shown may be included in embodiments of the present disclosure. Furthermore, any of the exemplified components may be omitted, replaced, and / or integrated into other devices / systems such as Table 180, medical instruments, etc.

[0071] The control system 150 may include, separately and / or in combination, one or more of the following components, devices, modules, and / or units (hereinafter referred to as “Components”), namely, a control circuit 401, one or more communication interfaces 402, one or more power supply units 403, one or more I / O components 404, and / or one or more movable components 405 (e.g., casters or other types of wheels). In some embodiments, the control system 150 may have a housing / enclosure configured and / or dimensioned to house or include at least one or more of the components of the control system 150. In this example, the control system 150 is exemplified as a cart-based system that is movable with one or more movable components 405. In some cases, after reaching a suitable position, one or more movable components 405 can be fixed in place using wheel locks to hold the control system 150 in place. However, the control system 150 may be implemented as a fixed system and integrated with another system / device, etc.

[0072] Various components of the control system 150 can be electrically and / or communicatively coupled using specific connecting circuits / devices / features, which may or may not be part of the control circuit. For example, a connecting feature(s) may include one or more printed circuit boards configured to facilitate the mounting and / or interconnection of at least some of the various components / circuits of the control system 150. In some embodiments, two or more components of the control system 150 can be electrically and / or communicatively coupled to one another.

[0073] One or more communication interfaces 402 can be configured to communicate with one or more devices / sensors / systems. For example, one or more communication interfaces 402 can transmit / receive data wirelessly and / or via a wired method over a network. In some embodiments, one or more communication interfaces 402 can implement wireless technologies such as Bluetooth, Wi-Fi, and near-field communication (NFC).

[0074] One or more power units 403 may be configured to manage and / or provide power to the control system 150 (and / or optionally to the robot system 110 / fluid management system 170). In some embodiments, one or more power units 403 include one or more batteries, such as lithium-ion batteries, lead-acid batteries, alkaline batteries, and / or other types of batteries. That is, one or more power units 403 may comprise one or more devices and / or circuits configured to provide power and / or power management functions. Furthermore, in some embodiments, one or more power units 403 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power supply.

[0075] One or more I / O components / devices 404 may include various components for receiving inputs and / or providing outputs, such as to serve as an interface with a user to assist in performing medical procedures. One or more I / O components 404 may be configured to receive touch, speech, gestures, or any other type of input. In the example, one or more I / O components 404 may be used to provide inputs for controlling a device / system, such as controlling a robotic system 110, navigating a scope / catheter or other medical instrument attached to (and / or deployed via a scope) the robotic system 110, controlling a table 180, or controlling a fluoroscopy device. For example, a physician (not shown) may provide inputs via an I / O component(s) 404, to which a control system 150 may send control signals to the robotic system 110 to operate a medical instrument. In the example, the physician may use the same I / O device to control multiple medical instruments (e.g., to switch control between instruments).

[0076] As shown in the figure, one or more I / O components 404 may include one or more displays 156 configured to display data (sometimes referred to as "one or more display devices 156"). One or more displays 156 may include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type(s) of technology. In some embodiments, one or more displays 156 may include one or more touchscreens configured to receive input and / or display data. Furthermore, one or more I / O components 404 may include one or more I / O devices / controllers 406 that may include touchpads, controllers (e.g., handheld controllers, video game type controllers, finger-based controls / finger clutches that enable finger-like movements, etc.), mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual reality devices or augmented reality devices (e.g., head-mounted displays), foot panels (e.g., buttons under the user's feet), etc. Furthermore, one or more I / O components 404 may include one or more speakers configured to output sound based on an audio signal, and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, one or more I / O components 404 include or are implemented as a console.

[0077] In some embodiments, one or more I / O components 404 can output information related to the procedure. For example, the control system 150 can receive real-time images captured by the scope and display the real-time images and / or visual / image representations of the real-time images via a display(s) 156. The display(s) 156 can present an interface(s) that may include image data from the scope and / or other medical devices. Furthermore or alternatively, the control system 150 can receive signals (e.g., analog signals, digital signals, electrical signals, acoustic / sound wave signals, pneumatic signals, tactile signals, hydraulic signals, etc.) from medical monitors and / or sensors associated with the patient, and the display(s) 156 can present information related to the patient's health or the environment. Such information may include, for example, information displayed via a medical monitor, such as heart rate (e.g., ECG, HRV), blood pressure / blood flow velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, electroencephalogram (e.g., EEG), ambient temperature and / or local or core body temperature.

[0078] In some embodiments, the control system 150 may be coupled to the robot system 110, the table 180 or another table, and / or medical instruments via one or more cables or connectors (not shown). In some embodiments, support functions from the control system 150 can be provided via a single cable, simplifying and tidying up the operating room. In other embodiments, specific functions may be coupled via separate cables and connectors. For example, power may be provided via a single power cable, while support for control, optics, fluid mechanics, and / or navigation may be provided via separate cables.

[0079] The robot system 110 generally includes an elongated support structure 410 (also referred to as the “column”), a robot system base 411, and a console 412 at the top of the column 410. The column 410 may include one or more carriages 413 (also referred to as “arm support members 413”) for supporting the deployment of one or more robot arms 112. The carriages 413 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robot arm 112 for positioning relative to a patient. The carriages 413 also include a carriage interface 414 that allows the carriages 413 to translate vertically along the column 410. The carriage interface 414 may be connected to the column 410 through slots such as slots 415 located on both sides of the column 410 to guide the vertical translation of the carriages 413. The slots 415 may include a vertical translation interface for positioning and / or holding the carriages 413 at various vertical heights relative to the base 411. As the carriage 413 is vertically translated, the robot system 110 can adjust the reach of the robot arm 112 to accommodate various table heights, patient sizes, physician preferences, etc. Similarly, the robot arm base 416 of the robot arm 112 can be angled in various configurations by individually configurable arm mounts on the carriage 413. The column 410 may contain a mechanism, such as gears and / or motors, designed to use vertically aligned lead screws to translate the carriage 413 in a mechanized manner in response to control signals generated from user inputs, such as inputs from I / O devices.

[0080] The base 411 can balance the weight of the column 410, carriage 413, and / or robot arm 112 on a surface such as the floor. Thus, the base 411 can accommodate one or more heavier components such as electronics, motors, power supplies, and components that enable and / or fix the movement of the robot system 110. For example, the base 411 may include swivel wheels 417 (also referred to as “casters 417” or “movable components 417”) that allow the robot system 110 to move around a room for treatment. After reaching a suitable position, the casters 417 can be locked using wheel locks to hold the robot system 110 in place during treatment. As shown in the figure, the robot system 110 also includes handles 418 to assist in maneuvering and / or stabilizing the robot system 110. In this example, the robot system 110 is shown as a movable cart-based system. However, the robot system 110 can be implemented as a fixed system or integrated into a table, etc.

[0081] The robotic arm 112 may generally comprise a robotic arm base 416 and an end effector 419, separated by a series of linkage mechanisms 420 (also referred to as “arm segments 420”) connected by a series of joints 421. Each joint 421 may have an independent actuator, and each actuator may have an independently controllable motor. Each independently controllable joint 421 represents an independent degree of freedom available to the robotic arm 112. For example, each arm 112 may have seven joints and thus seven degrees of freedom. However, any number of joints can be implemented with any number of degrees of freedom. In the example, a large number of joints can provide a large number of degrees of freedom, enabling “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 112 to position each end effector 419 to a specific position, orientation, and / or trajectory in space using different linkage mechanism positions and / or joint angles. In some embodiments, the end effectors 419 may be configured to engage with and / or control medical instruments, devices, objects, etc. The degrees of freedom of motion of the arm 112 allow the robotic system 110 to position and / or orient a medical instrument from a desired point in space, and / or allow a physician to move the arm 112 to a clinically convenient position away from the patient, thereby avoiding collisions with the arm and providing access to the instrument.

[0082] Each end effector 419 of the robotic arm 112 may be equipped with an instrument device manipulator (IDM). In some embodiments, the IDM can be removed and replaced with a different type of IDM. For example, a first type of IDM may be able to operate an endoscope, a second type of IDM may be able to operate a catheter, a third type of IDM may be able to hold an EM field generator, and so on. However, the same IDM may be used. In some examples, the IDM may include connectors for transmitting pneumatic, electrical, electrical, and / or optical signals to and from the robotic arm 112. The IDM may be configured to operate a medical instrument using techniques including, for example, direct drive, harmonic drive, gear drive, belt / pulley, magnetic drive, etc. In some embodiments, the IDM may be attached to one of each of the robotic arms 112, and the robotic arms 112 are configured to insert or withdraw each coupled medical instrument into or from a treatment site.

[0083] In some embodiments, the robotic arm 112 can be configured to control the position, orientation, and / or joint movement of medical instruments attached to it (e.g., the sheath and / or leader of the scope). For example, the robotic arm 112 can be configured to manipulate the scope / catheter using elongated moving members. Examples of elongated moving members include one or more pull wires, cables, fibers, and / or flexible shafts. For example, the robotic arm 112 can be configured to actuate multiple pull wires coupled to the scope / catheter to deflect the tip of the scope / catheter. The pull wires can include any suitable or desirable materials such as metallic materials and / or non-metallic materials such as stainless steel, Kevlar, tungsten, and carbon fiber. In some embodiments, the scope / catheter is configured to exhibit nonlinear behavior in response to forces applied by the elongated moving members. The nonlinear behavior may be based on the stiffness and / or compressibility of the scope / catheter, as well as the variability of slack or stiffness between different elongated moving members.

[0084] As shown in the figure, the console 412 is positioned at the upper end of column 410 of the robotic system 110. The console 412 may include a display(s) that provides a user interface for receiving user input and / or providing output (e.g., a dual-purpose device such as a touchscreen) to provide the physician / user with preoperative and / or intraoperative data, information for configuring the robotic system 110, etc. Potential preoperative data may include preoperative planning, navigation, and / or mapping data derived from preoperative computed tomography (CT) scans, and / or notes from preoperative patient interviews. Intraoperative data may include optical information provided by tools, sensor information and / or coordinate information from sensors, and vital patient statistics such as respiration, heart rate, and / or pulse. The console 412 may be positioned and tilted to allow the physician to access the console 412 from the opposite side of column 410 of the arm base 416. From this position, the physician may operate the console 412 from behind the robotic system 110 while viewing the console 412, the robotic arm 112, and the patient.

[0085] The robot system 110 may also include a control circuit 422, one or more communication interfaces 423, one or more power supply units 424, one or more input / output components 425, and one or more actuators / hardware 426. One or more communication interfaces 423 may be configured to communicate with one or more devices / sensors / systems. For example, one or more communication interfaces 423 may transmit / receive data wirelessly and / or via a wired connection over a network.

[0086] One or more power units 424 can be configured to manage and / or provide power to the robot system 110. In some embodiments, one or more power units 424 include one or more batteries, such as lithium-ion batteries, lead-acid batteries, alkaline batteries, and / or other types of batteries. That is, one or more power units 424 may comprise one or more devices and / or circuits configured to provide power and / or power management functions. Furthermore, in some embodiments, one or more power units 424 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power supply. Furthermore, in some embodiments, one or more power units 424 include a connector configured to couple to the control system 150 to receive power from the control system 150.

[0087] One or more I / O components / devices 425 may be configured to receive input and / or provide output, for example, to interact with a user. One or more I / O components 425 may be configured to receive touch, speech, gesture, or any other type of input. In an example, one or more I / O components 425 can be used to provide input for controlling a device / system, for example, to control / configure a robotic system 110. One or more I / O components 425 may include one or more displays configured to display data. One or more displays may include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type of technology. In some embodiments, one or more displays may include one or more touchscreens configured to receive input and / or display data. Furthermore, one or more I / O components 425 may include touchpads, controllers, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual reality devices or augmented reality devices (e.g., head-mounted displays), etc. Furthermore, one or more I / O components 425 may include one or more speakers configured to output sound based on an audio signal, and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, one or more I / O components 425 may include or be implemented as a console 412. Furthermore, one or more I / O components 425 may include one or more physically pressable buttons, such as a button on the distal end of the robot arm 112 (which can enable / disable the admittance control mode of the robot arm 112 for manual operation / movement of the robot arm 112).

[0088] One or more actuators / hardware 426 can be configured to smooth the movement of the robot arm 112. Each actuator 426 may include a motor, which can be mounted at a joint or elsewhere within the robot arm 112 to smooth the movement of the joint and / or connected arm segment / link mechanism. In some embodiments, the user can manually operate the robot arm 112 without using an electronic user control device. For example, during setup in a surgical room or at any point during a procedure, the user may select a button on the distal end of the robot arm 112 to enable admittance control mode, and then manually move the robot arm 112 to a specific orientation / position.

[0089] Various components of the robot system 110 can be electrically and / or communicatively coupled using specific connection circuits / devices / features, which may or may not be part of the control circuit 422. For example, a connection feature(s) may include one or more printed circuit boards configured to facilitate the mounting and / or interconnection of at least some of the various components / circuits of the robot system 110. In some embodiments, two or more components of the robot system 110 can be electrically and / or communicatively coupled to one another.

[0090] The robot fluid management system 170 may include a control circuit 430, one or more communication interfaces 432, one or more power supply units 433, one or more input / output components 434, one or more pumps 435, one or more pressure reducers 436, and an irrigation fluid source 437. The one or more communication interfaces 432 may be configured to communicate with one or more devices / sensors / systems. For example, the one or more communication interfaces 432 may transmit / receive data wirelessly and / or via a wired connection over a network.

[0091] One or more power supply units 433 can be configured to manage and / or provide power to the fluid management system 170. In some embodiments, one or more power supply units 433 include one or more batteries, such as lithium-ion batteries, lead-acid batteries, alkaline batteries, and / or other types of batteries. That is, one or more power supply units 433 can comprise one or more devices and / or circuits configured to provide power and / or power management functions. Furthermore, in some embodiments, one or more power supply units 433 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power supply. Furthermore, in some embodiments, one or more power supply units 433 include a connector configured to couple to the control system 150 to receive power from the control system 150.

[0092] One or more I / O components / devices 434 may be configured to receive input and / or provide output, for example, to interact with a user. One or more I / O components 434 may be configured to receive touch, speech, gesture, or any other type of input. One or more I / O components 434 may include displays, touchpads, controllers, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual or augmented reality devices (e.g., head-mounted displays), speakers, microphones, etc. Furthermore, one or more I / O components 434 may include one or more buttons that can be physically pressed down.

[0093] The fluid management system 170 may be configured to control pumps 435 and / or pressure reducers 436 to provide irrigation / suction. For example, a medical device may be attached to pumps 435 / pressure reducers 436 to provide irrigation / suction to a target site via the medical device. In this example, the fluid management system 170 may include one or more flow meters, valve control devices, and / or other fluid / flow control components (e.g., sensor devices such as pressure sensors) to provide controlled irrigation and / or suction / suction capabilities for the medical device. In some embodiments, a control system 150 and / or a robotic system 110 may generate and provide one or more signals to the fluid management system 170 to control irrigation / suction.

[0094] Pumps 435 can be attached to an irrigation fluid source 437, which may include fluid lines 438 for connecting to fluid bags 171 and / or medical devices 438. Pumps 435 can pump irrigation fluid (e.g., saline solution) into the treatment site through one or more medical devices. In some examples, pumps 435 are peristaltic pumps. In some embodiments, pumps 435 can be replaced with pressure reducers configured to apply vacuum pressure to draw irrigation fluid out of the irrigation fluid source 437 through their respective connected medical devices. Figure 4 shows pumps 435, but in some embodiments, irrigation fluid flow is achieved without the use of pumps, and such flow is primarily driven by gravity.

[0095] The pressure reducer(s) 436 may be configured to facilitate fluid suction. For example, the pressure reducer(s) 436 may be configured to apply negative pressure to draw fluid from the treatment site. The pressure reducer(s) 436 may be connected to a collection container from which the recovered fluid is collected. In some examples, suction may be facilitated by one or more pumps rather than the pressure reducer. Furthermore, in some embodiments, suction is primarily passive rather than by active suction. It should be understood that embodiments of the present disclosure do not necessarily have to include pressure reducer components.

[0096] As referenced above, systems 150, 110, and 170 may include control circuits 401, 422, and 430, respectively, configured to perform specific functionalities as described herein. The term “control circuit” can mean one or more processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connection circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, graphics processing units, field-programmable gate arrays, application-specific integrated circuits, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any set of any devices that manipulate signals (analog and / or digital) based on hardcoding of circuits and / or operation instructions. A control circuit may further include one or more memory devices, which can be embodied in a single memory device, multiple memory devices, and / or embedded circuits of a device. Examples of such data storage devices include read-only memory, random-access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information. In embodiments in which the control circuit includes a hardware state machine (and / or implements a software state machine) and includes analog circuits, digital circuits, and / or logic circuits, it should be noted that data storage devices / registers(s) that store any associated operation instructions can be embedded inside or outside the circuit including the state machine, analog circuits, digital circuits, and / or logic circuits.

[0097] Although the control circuit is illustrated as a separate component from the other components of the control system 150 / robot system 110 / fluid management system 170, it should be understood that any or all of the other components of the control system 150 / robot system 110 / fluid management system 170 can be at least partially embodied in the control circuit. For example, the control circuit may include various devices (active and / or passive), semiconductor materials and / or areas, layers, regions and / or parts thereof, conductors, leads, vias, connections, etc., and one or more and / or parts thereof of the other components of the control system 150 / robot system 110 / fluid management system 170 can be at least partially formed and / or embodied in such circuit components / devices.

[0098] Furthermore, although not shown in Figure 4, one or more of the control system 150, the robot system 110, and / or the fluid management system 170 may each include data storage / memory configured to store data / instructions. For example, a data storage device / memory may store instructions that can be executed by a control circuit to perform a particular function / operation. The term “memory” can refer to any preferred or desirable type of computer-readable medium. For example, one or more computer-readable media may include one or more volatile data storage devices, non-volatile data storage devices, removable data storage devices, and / or non-removable data storage devices, implemented using any technology, layout, and / or data structure / protocol, which may include any preferred or desirable computer-readable instructions, data structures, program modules, or other types of data. One or more computer-readable media that may be implemented in accordance with embodiments of this disclosure include, but are not limited to, phase-change memory, static random-access memory (SRAM), dynamic random-access memory (DRAM), other types of random-access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technologies, compact disc read-only memory (CD-ROM), digital purpose disc (DVD) or other optical storage devices, magnetic cassettes, magnetic tapes, magnetic disk storage devices or other magnetic storage devices, or any other non-temporary media that may be used to store information for access by a computing device. In the specific contexts used herein, computer-readable media may not generally include communication media such as modulated data signals and carrier waves. Therefore, computer-readable media should be understood to generally refer to non-temporary media.

[0099] In some examples, the control system 150 and / or the robotic system 110 are configured to implement one or more localization techniques to determine / track the orientation / position of an object / medical device. For example, one or more localization techniques can process input data to generate position / orientation data for a medical device. The position / orientation data of an object / medical device can indicate the position / orientation of the object / medical device relative to a reference frame. The reference frame can be a reference frame relative to the anatomical structure of a patient, a known object (e.g., an EM field generator, system, etc.), a coordinate system / space, etc. In some embodiments, the position / orientation data can indicate the position and / or orientation of the distal end (and / or possibly the proximal end) of the medical device. For example, the position / orientation data of a scope can indicate the position and orientation of the distal end of the scope, including the amount of rotation of the distal end of the scope. The position and orientation of an object can be said to be the orientation of the object.

[0100] Exemplary input data that can be used to generate object / medical device position / orientation data may include sensor data from sensors associated with the medical device (e.g., EM field sensor data, visual / image data captured by imaging devices / depth sensors / radar devices on the medical device, accelerometer data from accelerometers on the medical device, gyroscope data from gyroscopes on the medical device, satellite-based positioning data from satellite-based sensors (e.g., Global Positioning System (GPS)), feedback data (also referred to as "kinematic data") from robotic arms / components (e.g., data indicating how the robotic arm / component moved / operated), robot command data for robotic arms / components (e.g., control signals sent to robotic system 110 / robot arm 112 to control the movement of robotic arm 112 / medical device), shape sensing data from shape sensing fibers (which can provide information about the location / shape of the medical device), model data relating to the patient's anatomical structure (e.g., models of internal / external parts of the patient's anatomical structure), patient position data (e.g., data indicating how the patient is positioned on a table), preoperative data, etc.

[0101] Figure 5 shows an exemplary catheter 502 and percutaneous access device 504 at least partially positioned within a patient's kidney 506 according to one or more embodiments. The catheter 502 and percutaneous access device 504 may represent any of the catheters and percutaneous access devices discussed herein. In this example, the instruments 502 and 504 are shown in connection with a urological procedure for treating / removing kidney stones 508 from the kidney 506. However, the instruments 502 and 504 may also be used in other types of procedures. As described above, urological procedures and / or other types of procedural procedures can be performed at least partially manually and / or using robotic technology.

[0102] The catheter 502 may be configured to articulate with respect to at least its distal end / tip. For example, the distal end / tip of the catheter 502 can be deflected in various directions. In one example, the catheter 502 may be configured to move with two degrees of freedom (2-DOF) (e.g., two of x, y, z, yaw, pitch, or roll motion). For example, the distal end of the catheter 502 may be configured to move right / left or up / down (e.g., x, y, or z motion), and also to move to insert / retract the catheter 502 (e.g., translate along the x, y, or z axis). In another embodiment, the catheter 502 may be configured to move with three degrees of freedom (e.g., three of x, y, z, yaw, pitch, or roll motion). For example, the distal end portion of the catheter 502 may be configured to move right / left and up / down (e.g., two of x, y, or z movements), and also to move to insert / retract the catheter 502. However, the catheter 502 may also be configured to move in 4-DOF (e.g., x, y, z, and pitch / yaw / roll movements), 6-DOF (e.g., x, y, z, pitch, yaw, and roll movements), etc. In some embodiments, the catheter 502 is not configured for rolling movements, such as when the catheter 502 is realized with a robot-controllable handle. However, in some cases, the catheter 502 may be configured for rotation and / or other types of movements, such as when the catheter 502 is configured with a manually controllable handle or in some robot-controllable cases.

[0103] As shown, the catheter 502 may be implemented together with a percutaneous access device 504 to provide aspiration / irrigation to the kidney 506. The percutaneous access device 504 may include one or more sheaths and / or shafts through which an instrument (e.g., catheter 502) and / or fluid can access a target biostructure where the distal end of the device 504 is located. In some embodiments, active aspiration / suction may be drawn through the lumen 510 of the catheter 502 to the proximal end of the catheter 502 (e.g., the handle of the catheter 502). Furthermore, in some embodiments, irrigation may be provided via the percutaneous access device 504, such as between concentric sheaths. For example, a fluid management system (not shown) can be connected to a port of the irrigation port 512 to provide irrigation to the percutaneous access device 504, which then travels down the percutaneous access device 504 to the target site. Figure 5 shows an example of the flow of aspirated fluid into the lumen 510 of the catheter 502 and the flow of irrigation fluid from the percutaneous access device 504. In some embodiments, a passive aspirated outflow channel may be formed in the space between the outer wall of the catheter 502 and the inner wall / sheath of the percutaneous access device / assembly 504. When the catheter 502 is positioned within the percutaneous access device 504, the shaft(s) / sheath(s) of the catheter 502 and the percutaneous access device 504 may be substantially concentric. The catheter 502 and the percutaneous access device 504 may have a substantially circular cross-sectional shape over at least a portion thereof.

[0104] The catheter 502 may be controllable in any preferred or desired manner based on either manual control and / or robotic control. In Figure 5, handles / bases 514, 516 provide examples of how they may be used to control the catheter 502. Handle 514 shows a handheld / manual handle configured to be operated by a physician / user to control the movement of the catheter 502. Handle 516, on the other hand, shows a robot-controllable handle configured to be operated by a robotic arm, such as an end effector of a robotic arm, to control the movement of the catheter 502. Exemplary robot-controllable and manually controllable catheters are described in further detail below. By realizing an articulated catheter, the technique / structure can enable access to various locations within the patient's body in a manner that prevents / minimizes damage to the patient's anatomical structures. For example, a physician can navigate the distal portion of the catheter 502 to reach a specific cavity in the kidney 506 (e.g., the renal calyce) where a kidney stone is located, without repositioning the rest of the shaft of the catheter 502 and / or the percutaneous access device 504.

[0105] In some embodiments, the catheter 502 does not include an imaging device. That is, the catheter 502 is implemented without an imaging device / camera at its distal end to capture image data of the patient's internal anatomical structure. However, in other embodiments, the catheter 502 may include one imaging device at the tip of the catheter 502 or elsewhere. Furthermore, in some embodiments, the catheter 502 is implemented without a position sensor (i.e., does not include a position sensor). However, the catheter 502 may, in some cases, be implemented with a position sensor at the distal end of the catheter 502 or elsewhere.

[0106] Figures 6 and 7 illustrate exemplary features of a robot-controlled / manually controllable catheter 602 according to one or more embodiments of the present disclosure. Features of the catheter 602 may be realized in the context of one or more of the catheters described herein. The catheter 602 includes an elongated shaft 604 connected to a handle / base 606 (also referred to as the “instrument base 606”), the handle / base being configured to control the operation of at least a portion of the elongated shaft 604. As shown in Figure 6, the handle 606 may be implemented as a robot-controlled handle configured to be coupled to a robot arm (e.g., handle 606(A)) and / or a manually controllable handle configured to be held / operated by a user (e.g., handles 606(B), 606(C), and 606(D)). In some embodiments, the elongated shaft 604 may extend through the handle 606 to a port 608 of the handle 606, which may be connected to a fluid management system and / or another system to facilitate aspiration, irrigation, deployment of instruments through the working channel of the catheter 602, etc. While certain handles are discussed in the context of being implemented in manually controllable or robotically controllable catheters, such catheters may be implemented in other contexts. For example, a manually controllable catheter may include robotic components implemented as a robotically controllable catheter (e.g., for secondary use as a robotic catheter), and / or a robotically controllable catheter may include manual components implemented as a manually controllable catheter (e.g., for secondary use as a manual catheter). Thus, in some cases, the catheter may be configured for both manual and robotic operation.

[0107] As shown in Figures 7A and 7B (and other figures), the shaft 604 may include a distal / tip section / part 702 (sometimes referred to as the “distal end part 702”), an intermediate / medial section / part 704, a proximal section / part 706 (sometimes referred to as the “proximal end part 706”), and / or a lumen 708 extending through at least a portion of the shaft 604. For example, the lumen 708 may extend through the entire shaft 604 from the distal section 702 (which may be located at the patient’s target site) to the proximal section 706 (which may be connected to the port 608 of the handle 606). However, the lumen 708 may extend only a different distance through the catheter 602. In this example, the lumen 708 may also be referred to as the working channel. The distal section 702, the intermediate section 704, and / or the proximal section 706 may each be implemented with arbitrary longitudinal lengths. The terms distal, intermediate / medial, proximal, and / or other terms are used to describe the location of a feature relative to another feature. For example, the proximal feature of catheter 602 may refer to the feature furthest from the target or anatomical site (e.g., during use / procedure), while the distal feature of catheter 602 may refer to the feature closest to the target or anatomical site.

[0108] In some embodiments, the distal section 702 of the shaft 604 may include a filter / container / feature section 716 (also called the “tip structure 716”) configured to prevent certain objects from entering the rest of the shaft 604, such as when aspirating through the shaft 604, and / or to contain objects at the distal end of the shaft 604. For example, in connection with a urological procedure, the distal portion 702 of a catheter 602 may be positioned at a target site and used to aspirate one or more kidney stone fragments from a kidney. Here, the tip structure 716 may be configured to hold the kidney stone while it is being fragmented into smaller pieces, such as by an instrument deployed from another device at the target site. The tip structure 716 can also prevent fragments larger than a certain size from being drawn into the rest of the shaft 604, which could clog the shaft 604 and obstruct / stop the aspirate flow. The tip structure 716 may be implemented as a separate component from the rest of the shaft 604, but it may also be implemented in any other way, such as being integrated with the rest of the shaft 604.

[0109] If the tip structure 716 is implemented as a separate component from the rest of the shaft 604, the tip structure 716 may be attached to the rest of the shaft 604 using adhesives, fasteners, interlocking mechanisms, etc. (e.g., tabs, grooves, etc.). In some embodiments, the shaft 604 includes a ring portion 1102 (as shown in Figure 11 and elsewhere) to facilitate the coupling of the tip structure 716 to the rest of the shaft 604 and / or to cover the tip structure 716 after it has been fixed to the rest of the shaft 604. In this example, the shaft 604 (including the tip structure 716) is implemented in a substantially cylindrical form (e.g., having a circular cross-section). However, the shaft 604 can take other forms, such as a rectangular / square form or another shape.

[0110] In some embodiments, at least a portion of the shaft 604 may be formed from a variety of materials such as plastic, rubber, vertebral links, metal, or plastic braids / coils, so that at least a portion of the shaft 604 is flexible for joint movement. In some embodiments, the shaft 604 includes reinforcing material (e.g., braid) to enhance and / or enhance the flexibility of the shaft 604. For example, the shaft 604 may include braided reinforcement for hoop strength and / or to prevent twisting of the shaft 604 when the shaft 604 is navigated within the anatomical structure of a patient. Furthermore, in some embodiments, the shaft 604 includes multiple layers of material implemented in various configurations to facilitate the features of the shaft 604 discussed herein. In some cases, the tip structure 716 is formed from a different material than the rest of the shaft 604. For example, the tip structure 716 may be implemented from a material that avoids degradation in certain situations, such as catastrophic degradation. The tip structure 716 may be made of stainless steel (or other types of steel), titanium, tungsten, and / or other materials (materials that may have a relatively high melting point above a threshold) that can largely maintain their structure even if the laser beam unintentionally and / or occasionally comes into contact with the tip structure 716. However, the tip structure 716 and / or any other parts of the shaft 604 may be made of other materials.

[0111] The shaft 604 may include one or more lumens 710 (also referred to as "one or more wire lumens 710") located within the wall 712 of the shaft 604, such as the outer wall, as shown in the cross-sectional view of Figure 7B taken along the line shown in Figure 7A. The one or more lumens 710 may be equidistant from each other around the wall of the shaft 604 or elsewhere. The catheter 604 may include one or more elongated moving members 714 slidably positioned within the one or more wire lumens 710. Examples of one or more elongated moving members 714 include one or more pull wires, cables, fibers, and / or flexible shafts. The one or more elongated moving members 714 may include any preferred or desired material, such as metallic materials and non-metallic materials, such as stainless steel, Kevlar, tungsten, and carbon fiber. In some embodiments, the catheter 602 is configured to exhibit nonlinear behavior in response to a force applied by one or more elongated moving members 714. Nonlinear behavior may be due to the stiffness and / or compressibility of the catheter 602, as well as variations in slack or stiffness between different elongated moving members 714. Although a specific number of wire lumens 710 and elongated moving members 714 are shown in the figure, any number of lumens and / or elongated moving members can be implemented.

[0112] One or more elongated moving members 714 may be attached to or extend to the distal section 702 of the shaft 604. Proximal to the shaft, one or more elongated moving members 714 may be coupled to components (e.g., input assembly) of a handle 606 configured to control the articular movement of the shaft 604, such as by deflecting the distal section 702 of the shaft 604. The handle 606 may be configured to pull (and / or release tension on) one or more elongated moving members 714 within one or more lumens 710 to deflect the distal section 702 from the longitudinal axis. In some embodiments, the catheter 602 is configured to move in two directions (e.g., up / down or right / left) based on the operation of one or more elongated moving members 714. In other embodiments, the catheter 602 is configured to move in four directions (e.g., up / down and right / left) based on the operation of one or more elongated moving members 714. In yet another embodiment, the catheter 602 is configured to move in other directions. In some robotic examples, the catheter 602 can move in any direction by using a combination of four principal directions and four elongated moving members.

[0113] Figures 8–11 show exemplary robot-controllable catheters 1402 (sometimes referred to as “robot-controllable catheter assemblies 1402”) according to one or more embodiments of the present disclosure. In particular, Figure 8A shows a perspective view of the catheter 1402, Figure 8B shows a bottom view of the catheter 1402, and Figure 8C shows a perspective view of the bottom of the catheter 1402. As shown in Figures 8A–8C, the catheter 1402 includes an elongated shaft 1404 coupled to a handle / base 1406 (also referred to as “instrument base 1406”), the handle / base configured to control the operation of at least a portion of the elongated shaft 1404. The shaft 1404 can represent any of the shafts discussed herein. For example, the shaft 1404 may include a distal end portion 1408 configured to be positioned within the patient's body, a proximal end portion 1410 configured to connect to a port 1412 on the instrument base 1406, and a lumen (not shown) extending between the distal end portion 1408 and the proximal end portion 1410. The port 1412 may be configured to connect to a fluid management system via a suction channel / tube or the like. The port 1412 may protrude from the surface of the instrument base 1406 and / or include other forms / structures to facilitate connection with a channel / tube. The instrument base 1406 is shown in a substantially circular form, but the instrument base 1406 may also take other forms, such as a rectangular form.

[0114] The robot-controllable catheter 1402 may include one or more mounting mechanisms 1414 configured to connect the instrument base 1406 to a robotic arm and / or another device / interface (e.g., a sterile adapter). The one or more mounting mechanisms 1414 may include one or more fasteners such as clips, pins, hooks, buckles, clamps, screws, bolts, flanges, hook-and-loops, magnets, and adhesives. The device / interface configured to connect to the one or more mounting mechanisms 1414 may include one or more features for receiving / connecting the one or more mounting mechanisms 1414. In some embodiments, the one or more mounting mechanisms 1414 are integrated with the upper portion 1406(A) of the instrument base 1406. However, the one or more mounting mechanisms 1414 may be mounted separately from the upper portion 1406(A), integrated with the bottom portion 1406(B) of the instrument base 1406, or mounted in a different manner.

[0115] As shown in Figures 8 to 10, the robot-controllable catheter 1402 may also include a drive input assembly 1416 configured to connect to a drive output assembly of a robot arm and / or another device / interface. Figure 9-1 shows the instrument base 1406 with an upper portion 1406(A), and Figure 9-2 shows the instrument base 1406 with the upper portion 1406(A) removed to show the drive input assembly 1416 and other feature parts. The drive output assembly may interact with the drive input assembly 1416 to control the articular movement of the shaft 1404 of the catheter 1402. For example, the drive input assembly 1416 may be connected to one or more elongated moving members 1502 (shown in Figures 9 and 10). One or more elongated moving members 1502 may be slidably positioned within a portion of the shaft 1404 and attached to the distal end portion 1408 of the shaft 1404. One or more elongated moving members 1502 can exit the shaft 1404 in the instrument base 1406 (e.g., toward the proximal end portion 1410) and be coupled to the drive input assembly 1416 in the instrument base 1406. One or more elongated moving members 1502 can exit the shaft 1404 through one or more holes 1504 in the outer wall of the shaft 1404. The drive output assembly can actuate (e.g., rotate) the drive input assembly 1416 to pull (and / or release the tension from) one or more elongated moving members 1502, resulting in the actuation of the distal end portion 1408 of the shaft 1404. Various embodiments illustrate spline interface couplings in which a series of teeth on the outer and inner diameters of the output and input portions mesh, but the drive output assembly and the drive input assembly 1416 may be coupled via any of various teeth, protrusions, or other meshing engagement features and configurations.

[0116] In this example, the drive input assembly 1416 includes one or more pulleys / spools 1602 configured to couple with one or more elongated moving members 1502. Figure 10 shows illustrative details of the drive input assembly 1416(A), where the elongated moving member 1502(A) (implemented in this case as a wire) exits the shaft 1404 within the fixture base 1406, wraps around the spool 1602(A) to attach it to the spool 1602(A), and / or removes slack in the pull wire 1502(A). The pull wire 1502(A) can exit the shaft 1404 at appropriate locations to avoid contact with other internal components of the fixture base 1406. For example, the shaft 1404 may include one or more holes 1504 in its outer wall at a certain distance from its proximal end, so that one or more pull wires 1502 can exit from one or more wire lumens in the outer wall of the shaft 1404 and be attached to one or more pulleys 1602 without interfering with other components of the fixture base 1406. The one or more pull wires 1502 can exit the shaft 1404 at the same or different distances from the proximal end of the shaft 1414.

[0117] At the upper end 1604(A) of the spool 1602(A), the pull wire 1502(A) can be wound into the channel / groove 1606(A), and the distal end of the pull wire 1502(A) can be fixed / anchored in the cavity 1608(A) using the stopper / enlargement / end feature 1610(A). However, other types of mounting mechanisms may be used, such as any type of fastener, adhesive, wire clamping / tightening, soldering a metal ball at the end to create an anchor, or laser melting the end into a ball shape that can be used as an anchor. In this example, the ring 1612(A) is positioned above the upper end 1604(A) to hold / secure the pull wire 1502(A). The pull wire 1502(A) may be coupled to the spool 1602(A) by friction of the pull wire 1502(A) against the spool 1602(A), tension of the pull wire 1502(A), a stopper 1610(A), and / or a ring 1612(A). At the bottom end 1614(A) of the spool 1602(A), the spool 1602(A) may include a coupling mechanism / coupler 1616(A) configured to interact with the drive output assembly. For example, the coupling mechanism 1616(A) may include gears or other mechanisms. Although various exemplary features of the drive input assembly 1416 are shown, the drive input assembly 1416 may be implemented in various other ways.

[0118] To control the articular movement of shaft 1404, one or more spools 1602 / 1416 can be rotated to pull (or release the tension of) one or more pull wires 1502 attached thereto. For example, by rotating spool 1602(A) counterclockwise relative to Figure 10, the pull wire 1502(A) can be completely wrapped around spool 1602(A), resulting in a pulling motion of the pull wire 1502(A). Thus, the amount of slack / tension of the pull wire 1502(A) can be controlled by rotating spool 1602(A). In some examples, multiple spools are rotated simultaneously (e.g., cooperatively) to facilitate articular movement of shaft 1404 in a particular direction. The spools can be rotated in the same direction or in different directions to facilitate a particular movement. As described above, a drive output assembly such as the one shown in Figure 11 can control the rotation of one or more spools. In some embodiments, the catheter 1402 is configured to move in two directions, such as up and down or left and right, based on the operation of one or more elongated moving members 1502. In other embodiments, the catheter 1402 is configured to move in four directions, such as up and down or left and right, based on the operation of one or more elongated moving members 1502. In any case, the catheter 1402 can also be configured to be inserted / retracted along a virtual rail or the like, based on the movement of the instrument base 1406 (for example, the movement of a robot arm attached to the instrument base 1406).

[0119] In some embodiments, the robot-controllable catheter 1402 may include a radio frequency identification (RFID) tag 1418 and / or one or more other elements 1420 to facilitate calibration and / or identification of the catheter 1402, as shown in various figures. For example, the RFID tag 1418 can provide information to an RFID reader located on an instrument driver device (e.g., a robotic arm, a sterile adapter, etc.) configured to connect to the instrument base 1406. The RFID reader may be configured to wirelessly acquire / read data from the RFID tag 1418 to calibrate the catheter 1402. One or more elements 1420 may include one or more magnets, one or more quick response (QR) codes, one or more barcodes, etc. In the example, the type of device may be indicated by the arrangement / location of one or more magnets 1420 on the instrument base 1406, the magnetic polarity of one or more magnets 1420, and / or the magnetic field strength. For example, an instrument driver device (coupled to an instrument base 1406) may be configured to detect the arrangement, magnetic field strength, and / or magnetic polarity of one or more magnets 1420 and determine the type of device coupled to the instrument driver device based on such information (e.g., using two magnets in the device to identify four devices: North-North, North-South, North-South, and South-South). Furthermore, in some examples, a visual / optical system may scan one or more barcodes / QR codes 1420 to identify the type of device coupled to the instrument driver. In some embodiments, an RFID tag 1418 and / or one or more elements 1420 are referred to as identification elements. While the RFID tag 1418 and one or more elements 1420 are generally described in the context of providing calibration data and / or identification information, respectively, the RFID tag 1418 and / or one or more elements 1420 can each provide calibration data and / or identification information.

[0120] Figure 11 shows an exploded view of an exemplary instrument device manipulator assembly 1702 associated with a robotic arm 1704, according to one or more embodiments. The instrument manipulator assembly 1702 includes an instrument driver 1706 (e.g., an end effector) associated with the distal end of the robotic arm 1704. The instrument manipulator assembly 1702 further includes an instrument handle / base 1406 associated with a catheter 1402. The instrument handle 1406 may incorporate electromechanical means for acting on the instrument 1402 / shaft 1404. In this example, the instrument 1402 is described as a suction catheter, but the instrument 1402 may be any type of medical / surgical instrument. The descriptions herein of upward and downward surfaces, plates, faces, components, and / or other features or structures may be understood in reference to a particular orientation of the device manipulator assembly 1702 shown in Figure 11. In other words, the fixture driver 1706 may generally be configured to face and / or be oriented in a range of directions and orientations, but for convenience, the description of such configurations herein may be in the context of the generally perpendicular orientation of the fixture driver 1706 shown in Figure 11.

[0121] In some embodiments, the instrument device manipulator assembly 1702 further includes an adapter 1708 configured to provide a driver interface between the instrument driver 1706 and the instrument handle 1406. The adapter 1708 and / or the instrument handle 1406 may be detachable or separable from the robotic arm 1704 and, in some embodiments, may lack any electromechanical components such as motors. This dichotomy may be caused by the need to sterilize medical instruments used in medical procedures and / or the inability to adequately sterilize expensive capital equipment due to the complex mechanical assembly and sensitive electronics of the medical instruments. Therefore, the instrument handle 1406 and / or the adapter 1708 may be designed to be separated, detached, and / or replaced from the instrument driver 1706 (and thus the system) for individual sterilization or disposal. In contrast, the instrument driver 1706 may, in some examples, not need to be replaced or sterilized and may be draped for protection.

[0122] The adapter 1708 (sometimes referred to as the "sterilization adapter 1708") may include connectors for transmitting pneumatic, electric, electrical, mechanical, and / or optical signals from the robot arm 1704 and / or instrument driver 1706 to the instrument handle 1406. For example, the adapter 1708 may include a drive input assembly(s) coupled to a drive output assembly(s) 170 of the end effector 1706, and a drive output assembly(s) configured to coupled to a drive input assembly(s) of the instrument handle 1406. The drive input and drive output assemblies of the adapter 1708 may be coupled to each other to transmit control / actuation from the instrument driver 1706 to the instrument handle 1406.

[0123] The instrument handle 1406 may be configured to operate the catheter 1402 using one or more direct drives, harmonic drives, gear drives, belts / pulleys, magnetic drives, and / or other manipulator means or mechanisms. The robotic arm 1704 can advance / insert the coupled catheter 1402 into or retract it from the treatment site. In some embodiments, the instrument handle 1406 may be removed and replaced with a different type of instrument handle, for example, to operate a different type of instrument.

[0124] The end effector 1706 of the robotic arm 1704 (e.g., instrument driver) may include various components / elements configured to connect to and / or align with components of the adapter 1708, handle 1406, and / or catheter 1402. For example, the end effector 1706 may include a drive output assembly 1710 for controlling / articular movement of a medical device (e.g., a drive spline, gear, or rotatable disk with engaging features), a reader 1712 for reading data from the medical device (e.g., a radio frequency identification (RFID) reader for reading serial numbers and / or other data / information from the medical device), one or more fasteners 1714 for attaching the catheter 1402 and / or adapter 1708 to the instrument driver 1706, and a marker 1716 for aligning with a device that is manually attached to the patient (e.g., an access sheath) and / or defining the front surface of the device manipulator assembly 1702. One or more fasteners 1714 may be configured to connect to one or more mounting mechanisms 1718 of the adapter 1708 and / or one or more mounting mechanisms 1414 of the handle 1406. In some embodiments, the end effector 1706 and / or the robot arm 1704 include a button 1720 for enabling an admittance control mode that allows the robot arm 1704 to be moved manually.

[0125] In some configurations, a sterile drape 1722, such as a plastic sheet, may be placed between the instrument driver 1706 and the adapter 1708 to provide a sterile barrier between the robot arm 1704 and the catheter 1402. For example, the drape 1722 may be coupled to the adapter 1708 to allow the transmission of mechanical torque from the driver 1706 to the adapter 1708. The adapter 1708 may generally be configured to maintain a seal around its operating components so that the adapter 1708 itself provides a sterile barrier. The use of the drape 1722 coupled to the adapter 1708 and / or more other components of the device manipulator assembly 1702 may also provide a sterile barrier between the robot arm 1704 and the surgical field, thereby enabling the use of the robot system associated with the arm 1704 in a sterile surgical field. The driver 1706 may be configured to be coupled to various types of sterile adapters that can be loaded onto and / or removed from the driver 1706 of the robot arm 1704. With arm 1704 draped in plastic, a physician and / or other technician(s) may interact with arm 1704 and / or other components of the robot cart (e.g., screens) during the procedure. The draping further protects the equipment from biohazardous contamination and / or minimizes post-procedure cleaning.

[0126] While a particular adapter 1708 shown in Figure 11 may be configured to connect with a catheter handle 1406, such as a suction catheter handle, adapters for use with device manipulator assemblies according to embodiments of this disclosure may be configured to connect with any type of surgical or medical device or instrument, such as an endoscope (e.g., a ureteroscope), a basket device, or a laser fiber driver.

[0127] Figures 12 and 13 show exemplary adapters 1802 (sometimes referred to as “handheld instrument adapters 1802” or “manual adapters 1802”) configured to be coupled to robotically controllable medical instruments, according to one or more embodiments. Handheld instrument adapters 1802 can be configured to convert medical instruments generally configured for robotic operation into manually controllable instruments. For example, a manual adapter 1802 may be configured to be coupled to a robotically controllable medical instrument and to receive manual input for controlling the robotically controllable medical instrument manually instead of using robotic control. Thus, in some embodiments, the medical instrument may be configured to operate in a robotic mode in which the instrument base is separated from the manual adapter 1802 and receives robotic input for controlling the medical instrument, such as joint movement of the instrument's shaft, and in a manual mode in which the instrument base is coupled to the manual adapter 1802 and receives manual input for controlling the medical instrument.

[0128] As shown in Figure 12-1, the manual adapter 1802 may include a base / housing 1804, one or more couplers 1806, 1808 supported within the base 1804, and a manual actuator 1810 coupled to the couplers 1806, 1808. The couplers 1806, 1808 may be configured to couple to a drive input assembly of a robot-controllable medical device. The manual actuator 1810 may be configured to operate the couplers 1806, 1808 to articulate a robot-controllable medical device (shown in Figure 19). For example, the manual actuator 1810 may rotate one or more of the couplers 1806, 1808, thereby rotating one or more components of the drive input assembly coupled to the couplers 1806, 1808. Although two couplers 1806, 1808 are shown, the couplers 1806, 1808 may include any number of couplers. In the example, the base 1804 includes an upper portion 1804(A) and a bottom portion 1804(B). However, the base 1804 may be implemented in various forms, such as a single component.

[0129] As shown in Figures 12-2 to 12-4, couplers 1806, 1808 each include / can be attached to an engagement / disengagement assembly, which may be configured to engage / disengage a manual actuator 1810 to control a medical device. Each engagement assembly 1806, 1808 may allow adjustment of the tension of one or more elongated moving members associated with the medical device. For example, coupler / engagement assembly 1806 may include a first engagement / coupling member 1806(A) configured to engage with the manual actuator 1810, a second engagement member 1806(B) configured to engage with the drive input assembly of the medical device, and / or a manual actuator / tab 1806(C) configured to join the first engagement member 1806(A) and the second engagement member 1806(B). Tab 1806(C) may be configured to receive manual input to disengage the coupling of the first engaging member 1806(A) to the second engaging member 1806(B), as will be described in more detail below. In some embodiments, each engaging assembly 1806, 1808 is implemented as a gear assembly (e.g., one or more gears and / or drive input assemblies configured to engage / disengage each other). Furthermore, although engaging / disengaging assemblies are shown in many figures, in some cases such features are not implemented.

[0130] In the illustrated example, the second engaging member 1806(B) / 1808(B) and the tab 1806(C) / 1806(C) are keyed together, allowing each element to lock into another (for example, preventing one element from rotating relative to the other when coupled together). Furthermore, as shown in Figures 12-2 and 12-4, the tab 1806(C) / 1808(C) and the first engaging member 1806(A) / 1808(A) may be coupled via gears or other mechanisms. For example, the tab 1806(C) may include a first gear 1806(C)(1) configured to engage with a second gear 1806(A)(1) on the first engaging member 1806(A). The second engaging member 1806(B), when positioned / installed within the base 1804 (e.g., in use), can hold / receive a spring 1806(B)(1) configured to apply force (e.g., axial force) to the tab 1806(C) to engage the first gear 1806(C)(1) with the second gear 1806(A)(1). In this engaged state (e.g., default / general use), the first engaging member 1806(A), the second engaging member 1806(B), and the tab 1806(C) can rotate together in direct correspondence. Thus, the second engaging member 1806(B) can be indirectly coupled to the manual actuator 1810, and the movement of the manual actuator 1810 causes the second engaging member 1806(B) to rotate within the base 1804. Therefore, the engaging assembly 1806 can be rotatably supported within the base 1804. Figure 12-3 shows the elements in which the manual actuator 1810 operates in an engaged state, rotating the second engaging members 1806(B) / 1808(B) when manually operated.

[0131] In some embodiments, the manual actuator 1810 can be disengaged from the second engaging member 1806(B) / 1808(B), thereby allowing the second engaging member 1806(B) / 1808(B) to rotate independently of the first engaging member 1806(A) / 1806(A). This may be useful for providing a manual input to rotate the drive input assembly of a medical device to adjust the tension / looseness of one or more elongated moving members of the medical device. For example, a user can press down on the tab 1806(C) to disengage the first gear 1806(C)(1) of the tab 1806(C) from the second gear 1806(A)(1) of the first engaging member 1806(A). Since tab 1806(C) and the second engaging member 1806(B) are coupled together (e.g., via pairing), this allows the second engaging member 1806(B) to be separated from the first engaging member 1806(A). Once such elements are separated / disengaged, the user can twist / rotate tab 1806(C) to rotate the second engaging member 1806(B) without affecting the position of the manual actuator 1810. Such rotation can ultimately result in adjustment of tension in one or more elongated moving members of the medical device. This allows the user to eliminate slack in one or more elongated moving members (which may occur, for example, when the medical device is removed from the robotic arm). For example, the user can prepare / calibrate the adapter 1802 for use by eliminating slack in one or more elongated moving members when the shaft of the medical device is straight and / or when the manual actuator 1810 is positioned in an intermediate position. Therefore, in some embodiments, one or more elements of assembly 1806 / 1808 may be referred to as “tension mechanisms” and / or “disengagement mechanisms”.

[0132] For the sake of clarity, the above example refers to specific exemplary features of engagement assembly 1806. It should be understood that engagement assembly 1808 may function similarly to engagement assembly 1806. Furthermore, while engagement assemblies 1806 and 1808 are implemented using various gears in this example, they could also be implemented in other ways, such as other mechanical mechanisms.

[0133] In some embodiments, the manual actuator 1810 includes an elongated member 1810(A) coupled to a gear / coupler 1810(B) configured to couple / engage with engagement assemblies 1806, 1808. As shown in Figure 12-2, the adapter 1802 may include a plate 1812 having a pin / rotating mechanism 1812(A) to facilitate the movement of the manual actuator 1810. For example, a gear 1810(B) may be rotatably positioned on the plate 1812 with a pin 1812(A) extending into a hole 1810(B)(1) on the plate 1812. The gear 1810(B) can rotate on the pin 1812(A), resulting in rotation of the elongated member 1810(A). As shown, the plate 1812 may also include a hole / recessed portion 1812(C) configured to receive / retain the engagement assemblies 1806, 1808.

[0134] In some implementations, the manual actuator 1810 can be locked in place after movement. For example, a user can push down the manual actuator 1810, move it in a forward or backward direction, and release it to lock it in place. In some examples, to facilitate such features, an elongated member 1810(A) can be connected to a pin 1814 configured to be positioned within a groove 1812(B) containing one or more teeth / recesses. The elongated member 1810(A) can move / slide within the groove 1810(B)(2) of the gear 1810(B) (as shown in Figure 12-3) and can generally be pushed outward away from the pivot point of the gear 1810(B). In this example, one or more springs 1816 (as shown in Figure 12-5) are configured to be coupled to the end / mounting feature 1810(A)(1) of the elongated member 1810(A) and to the mounting feature 1810(B)(3) of the gear 1810(B). This exerts a force that pulls the elongated member 1810(A) away from the pivot point of the gear 1810(B), ultimately causing the pin 1814 (attached to the elongated member 1810(A)) to be pulled into the teeth in the groove 1812(B). The user can push down on the elongated member 1810(A) to release the pin 1814 from the teeth and allow it to slide freely within the groove 1812(B). In the released state, the user can move / rotate the elongated member 1810(A) to another position. The locking feature is shown with a specific element, but the locking feature may be implemented in various other forms.

[0135] Figures 13A and 13B show a manual adapter 1802 coupled to a robot-controllable catheter 1402 according to one or more embodiments. In such configurations, the robot-controllable catheter 1402 can be controlled based on manual input provided by a user through the manual adapter 1802. While Figures 13A and 13B show the adapter 1802 coupled to a robot-controllable catheter 1402, the adapter 1802 may be coupled to other types of robot-controllable medical devices, such as a robot-controllable scope or another instrument, to enable the robot-controllable medical device to be controlled using manual input.

[0136] Figures 14–17 show exemplary manually controllable catheters 2002 according to one or more embodiments of the present disclosure. As shown in Figures 14A–14C, the catheter 2002 includes an elongated shaft 2004 coupled to a handle / base 2006, the handle / base configured to control the operation of at least a portion of the elongated shaft 2004. The shaft 2004 can represent any of the shafts discussed herein. For example, the shaft 2004 may include a distal end portion configured to be positioned within the patient's body, a proximal end portion configured to be coupled to a port 2008 on the handle 2006, and a suction / irrigation lumen (not shown) extending between the distal and proximal end portions. The port 2008 may be configured to be coupled to a fluid management system via a suction channel / tube or the like. The port 2008 may be detachable from the handle 2006 / shaft 2004 and / or integrated with the handle 2006 / shaft 2004. As shown in the figure, the catheter 2002 may include a manual actuator 2010 configured to control the movement of the elongated shaft 2004. For example, the manual actuator 2010 may be configured to receive manual input from a user and control the movement of the distal end portion of the elongated shaft 2004.

[0137] As shown in Figures 15A to 15C illustrating the internal components of the handle 2006 (the external enclosure is partially removed in Figure 15A and completely removed in Figures 15B and 15C), the manual actuator 2010 may be coupled to one or more elongated moving members 2102 (e.g., pull wires) at least partially positioned within the elongated shaft 2004. Here, the catheter 2002 includes two elongated moving members 2102 coupled to the distal end portion of the shaft 2004, however, any number of elongated moving members 2102 can be implemented. The elongated moving members 2102 can exit the walls of the elongated shaft 2004 within the handle 2006. In this example, the handle 2006 includes a guide / alignment structure 2104 located at the distal end of the handle 2006 to feed the elongated moving members 2102 to the manual actuator 2010. The guide structure 2104 may include one or more grooves, openings, etc. In some illustrated examples, the elongated moving member 2102 extends around one or more pins / shafts 2105 (supported / connected to a housing / enclosure) to feed the elongated moving member 2102 to a manual actuator 2010. The manual actuator 2010 may have a substantially circular form having projections / extensions 2106 for receiving one or more elongated moving members 2102. The elongated moving member 2102 may be fed through holes 2108 in the projections 2106. The projections 2106 may allow substantial movement of the distal end of the shaft 2004 (e.g., more movement than when the projections 2106 are excluded) when the manual actuator 2010 is actuated.

[0138] The manual actuator 2010 may also include a recess 2110 to align the elongated moving member 2102 with the spool / mooring member 2112. In some embodiments, the elongated moving member 2102 can wrap at least partially around the spool 2112 and enter the groove 2202, as shown in Figure 16. The distal end of the elongated moving member 2102 can be attached to / moored to the spool 2112 using a stopper / enlarged feature 2114, as shown in Figure 15A. In an example, once the elongated moving member 2102 is wrapped around the spool 2112, the spool 2112 and / or the elongated moving member 2102 can be fixed to the manual actuator 2010 using adhesive and / or fasteners. In some implementations for manufacturing / calibrating the catheter 2002, the manual actuator 2010 is positioned at an intermediate position relative to the available range of motion, and the spool 2112 is rotated to remove any slack in the elongated moving member 2102 (the shaft 2004 is positioned in a linear orientation as shown in Figures 14A-14C). Adhesive / fasteners are then applied to secure the elongated moving member 2102 and / or the spool 2112 to the manual actuator 2010.

[0139] As shown in various figures, the manual actuator 2010 may be rotatably positioned / supported on the shaft 2116 and / or sleeve 2118 to facilitate rotation of the manual actuator 2010 relative to the handle 2006. In particular, the manual actuator 2010 may include a hole in the center of the manual actuator 2010 (for example, with respect to the substantially circular structure of the manual actuator 2010 as shown in Figure 15A) to accommodate the shaft 2116 and the sleeve 2118 with the shaft 2116 positioned within the sleeve 2118. The shaft 2116 and / or sleeve 2118 may be coupled to the handle 2006, such as an external enclosure / housing of the handle 2006.

[0140] This example discusses various exemplary features of catheter 2002, but other features may be implemented. For example, the elongated moving member 2102 may be fed to and / or attached to the manual actuator 2110 in other ways, such as by using other types of fastening / feeding mechanisms. Furthermore, the manual actuator 2010, the handle 2006, and / or other features may take forms different from those shown in Figures 14 to 17. In some examples, any of the components of other exemplary catheters discussed herein (whether robotic or manual) may be implemented as alternatives or additionally. Furthermore, any of the components of catheter 2002 may be implemented in other catheters discussed herein.

[0141] In some embodiments, the manual catheter 2002 is configured to move in two directions, such as up and down or left and right, based on the operation of a manual actuator 2010, such as manual input by the user. In the example, the distal portion and each portion of the elongated shaft 2004 (and / or the elongated shaft of other catheters) can articulate only by at least 150°, 90-270°, etc., with respect to the longitudinal axis of the elongated shaft 2004, however, various other degrees of movement may be realized. The catheter 2002 may also be configured to be inserted / retracted and / or rotated based on the movement of a handle 2006 by the user, etc. In some examples, the catheter 2002 may include two elongated moving members 2102, each elongated moving member 2102 attached to different portions of the distal end of the shaft 2004, such as the upper / left portion of the tip and the bottom / right portion of the tip. During use, the manual actuator 2010 can be used to pull one of the elongated moving members 2102 and release the tension on the other elongated moving members 2102. However, in other examples, the catheter 2002 may be configured to move in two or more directions, such as up, down, left, and right, and / or the catheter 2002 may include two or more elongated moving members 2102 to facilitate such movement.

[0142] As shown in Figure 17, in some implementations, the handle 2006 of the catheter 2002 is configured to be held / operated by the user 2302 in an inverted grip manner. Here, the user's thumb is able to contact / operate the manual actuator 2010, and the rest of the user's fingers can grasp the handle 2006 to the opposite side of the handle 2006. The user 2302 can move their thumb in a forward or backward direction (relative to Figure 17) to articulate the manual actuator 2010 forward or backward, causing articulation of the distal end portion of the elongated shaft 2004. However, the catheter 2002 may be held / operated by the user in various other ways. In some examples, the user can rotate the catheter 2002 by twisting their wrist.

[0143] Figures 18-19 show another exemplary manually controllable catheter 2402 according to one or more embodiments of the present disclosure. As shown, the catheter 2402 includes an elongated shaft 2604 coupled to a handle / base 2406, the handle / base configured to control the operation of at least a portion of the elongated shaft 2404. The shaft 2404 may include any of the shafts described herein. The catheter 2402 may include a manual actuator 2408 configured to control the operation of the elongated shaft 2404. For example, the manual actuator 2408 may be configured to receive manual input from a user to control the operation of the distal end portion of the elongated shaft 2404. The handle 2406 of the catheter 2402 may include one or more housing / enclosure components. Figure 18-1 shows the handle 2406 with an enclosure / housing, and Figure 18-2 shows the handle 2406 with a portion of the housing / enclosure removed to reveal internal features.

[0144] As shown in Figure 18-2, the handle 2406 may include one or more components for feeding the elongated moving member 2410 from the shaft 2404 and attaching the elongated moving member 2410 to the manual actuator 2408. For example, the handle 2406 may include a plate structure 2412 having one or more holes / tubes / features for feeding the elongated moving member 2410 to one or more pulleys 2414. The distal end of the elongated moving member 2410 may be attached to a pulley 2414 coupled to the manual actuator 2408. The pulley 2414 may be rotatably supported within the handle 2406 and attached to the manual actuator 2408 so that the operation of the manual actuator 2408 can rotate the pulley 2414, thereby pulling (and / or releasing the tension on) the elongated moving member 2410. In this example, the pulleys 2414 are coupled to each other via one or more couplers such as gears, belts, etc. Therefore, the rotation of one pulley 2414 may cause the other pulley 2414 to rotate in the same direction or in a different direction.

[0145] The catheter 2402 may be configured to move in various directions, such as at the distal end of the shaft 2404. In one example, the end of an elongated moving member 2410 presents two elongated moving members, each elongated moving member 2410 forming a loop through the distal end of the shaft 2404. Here, the tip of the shaft 2404 may be configured to move in two directions, either up and down or left and right. In another example, the end of an elongated moving member 2410 represents the proximal ends of four elongated moving members, and the distal end of each elongated moving member 2410 is attached to the distal end of the shaft 2404. Here, the tip of the shaft 2404 may be configured to move in four directions, such as up, down, left, and right. However, any number of elongated moving members and / or directions of movement can be implemented. In some embodiments, the catheter 2402 includes one or more gears 2416 for smoothing the rotation of the elongated shaft 2404 based on manual input provided via an actuator / control device coupled to one or more gears 2416.

[0146] While catheter 2402 is shown with specific components, other components may be implemented. For example, the plate structure 2412 and / or pulley 2414 may be replaced with other components for feeding the elongated moving member 2410 and / or for facilitating the pulling / releasing of the elongated moving member 2410. In some examples, any of the components of other exemplary catheters discussed herein (whether robotic or manual) may be implemented as alternatives or additionally. Furthermore, any of the components of catheter 2402 may be implemented in other catheters discussed herein.

[0147] As shown in Figure 19, in some implementations, the handle 2406 of the catheter 2402 is configured to be held / operated by the user 2502 in an overhand position (e.g., a thumbs-up position). Here, the user's thumb can contact / operate the manual actuator 2408, and the rest of the user's fingers can grasp the handle 2406 to the opposite side of the handle 2406. The user 2502 can move their thumb in an up-and-down direction (relative to Figure 19) to articulate the manual actuator 2408 up and down, causing articulation of the distal end portion of the elongated shaft 2404. However, the catheter 2402 may be held / operated by the user in various other ways.

[0148] Figures 20-1 and 20-2 show another exemplary manually controllable catheter 2602 according to one or more embodiments of the present disclosure, where the catheter 2602 includes a plate structure for facilitating the movement of one or more elongated moving members. In particular, the catheter 2602 includes an elongated shaft 2604 coupled to a handle / base 2406, the handle / base configured to control the operation of at least a portion of the elongated shaft 2404. The shaft 2604 may include any of the shafts described herein. As shown, the catheter 2602 may include a manual actuator 2608 configured to control the operation of the elongated shaft 2404. The handle 2606 of the catheter 2602 may include one or more housing / enclosure components and / or ports 2610 configured to be coupled to a fluid management system via a suction channel / tube, etc., where the proximal end of the shaft 2604 is coupled to the port 2610. Figure 20-1 shows the handle 2606 with an enclosure / housing, and Figure 20-2 shows the handle 2606 with a portion of the housing / enclosure removed.

[0149] As shown in Figure 20-2, the manual actuator 2608 is coupled to the elongated moving member 2612 via the plate 2614. The elongated moving member 2612 may be coupled to the plate 2412 using adhesive, fasteners, anchors, etc. In some implementations, the elongated moving member 2612 is attached to the nearest end 2614(A) of the plate 2614 relative to the port 2610 when the plate 2614 is oriented in the manner shown in Figure 20-2 (e.g., the default state without articulation of the shaft 2604). As illustrated, the elongated moving member 2612 may exit the shaft 2604 in the handle 2606 and be attached to both ends of the plate 2614. During use, the operation of the manual actuator 2608 rotates the plate 2614 within the handle 2606, which may cause one of the elongated moving members 2612 to be pulled and the tension on the other elongated moving member 2612 to be released. For example, by rotating the manual actuator 2608 toward the proximal end of the shaft 2604 (for example, counterclockwise with respect to Figures 20-1 and 20-2), the elongated moving member 2612(A) can be released more into the shaft 2604, and the elongated moving member 2612(B) can be pulled out more from the shaft 2604.

[0150] The catheter 2606 may be configured to move in various directions, such as at the distal end of the shaft 2604. In one example, the ends of an elongated moving member 2612 form the proximal ends of two elongated moving members, and the distal ends of each elongated moving member 2612 are attached to the distal end of the shaft 2604. Here, the tip of the shaft 2604 may be configured to move in two directions, either up and down or left and right. However, any number of elongated moving members and / or directions of movement can be implemented. In the example, the catheter 2602 is configured to be held in an overhand or underhand manner.

[0151] While catheter 2602 is shown with specific components, other components may be implemented. For example, plate 2614 and / or other components may be replaced with other components. In some examples, any of the components of other exemplary catheters discussed herein (whether robotic or manual) may be implemented alternatively or additionally. Furthermore, any of the components of catheter 2602 may be implemented in other catheters discussed herein.

[0152] Further Embodiments Depending on the embodiment, any particular action, event, or function among the algorithms or processes described herein may be performed in a different order, added, merged, or completely excluded. Therefore, in some embodiments, not all of the described actions or events are necessary for the execution of the process.

[0153] In particular, conditional language used herein, such as “can,” “could,” “might,” “may,” “eg,” and equivalents, is intended in its ordinary sense unless otherwise specifically described or understood in the context in which it is used, and is generally intended to convey that a particular embodiment includes a particular feature, element, and / or step, but other embodiments do not. Therefore, such conditional language is not generally intended to suggest that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining whether these features, elements, and / or steps are included in or implemented in any particular embodiment, with or without author input or prompting. Terms such as “comprising,” “including,” “having,” and equivalents are used in their ordinary sense, in a non-restrictive and comprehensive manner, and do not exclude further elements, features, actions, behaviors, etc. Furthermore, the term “or” is used in its inclusive sense (and not its exclusive sense), and when used, for example, to connect an enumeration of elements, the term “or” means one, some, or all of the enumerated elements. Unless otherwise specifically stated, connecting language such as “at least one of X, Y, and Z” is understood in the context in which it is commonly used to convey that an item, term, element, etc., could be any of X, Y, or Z. Thus, such connecting language is not generally intended to imply that a particular embodiment requires the presence of at least one of X, at least one of Y, and at least one of Z, respectively.

[0154] In the above description of embodiments, it should be understood that various features are sometimes grouped together in a single embodiment, figure, or description for the purpose of streamlining the disclosure and aiding in the understanding of one or more of the various aspects of the invention. However, the method of the disclosure should not be construed as reflecting an intention that any claim requires more features than expressly described in that claim. Furthermore, any component, feature, or step illustrated and / or described in a particular embodiment of this specification may be applied to or used in conjunction with any other embodiment. Moreover, no component, feature, step, or group of components, features, or steps is required or essential for any particular embodiment. Accordingly, the scope of the disclosure in this specification should not be limited by the particular embodiments described above and should be determined solely by a fair reading of the following claims.

[0155] It should be understood that certain ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply any physical characteristics or ordering. Therefore, when used herein, ordinal terms (e.g., "first," "second," "third," etc.) used to modify elements such as structure, components, and actions do not necessarily indicate the priority or order of an element relative to any other element, but rather, generally, they may distinguish an element from another element having a similar or identical name (apart from the use of ordinal terms). Furthermore, when used herein, indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Additionally, actions performed "on the basis of" a condition or event may also be performed on the basis of one or more other conditions or events not explicitly listed.

[0156] Unless otherwise defined, all terms used herein (including technical and scientific terms) have the same meaning as those generally understood by those skilled in the art to which the embodiments belong. Terms such as those defined in commonly used dictionaries should be interpreted as having the meaning consistent with their meaning in the context of the relevant art, and should not be interpreted in an ideal or overly formal sense unless expressly defined herein.

[0157] The spatially relative terms “outside,” “inside,” “top,” “bottom,” “downward,” “upward,” “vertical,” and “horizontal,” and similar terms, may be used herein to facilitate explanations of the relationship between one element or component and another, as illustrated in the drawings. It should be understood that spatially relative terms are intended to encompass different orientations of a device during use or operation, in addition to the orientation depicted in the drawings. For example, if a device shown in a drawing is inverted, a device positioned “below” or “below” another device may be positioned “above” another device. Thus, the illustrative term “downward” may include both lower and upper positions. Devices may also be oriented in other directions, and therefore, spatially relative terms may be interpreted differently depending on the orientation.

[0158] Unless otherwise specified, comparative and / or quantitative terms such as "less," "more," and "greater" are intended to encompass the concept of equality. For example, "less" can mean not only "less" in the strict mathematical sense, but also "less than or equal to."

[0159] [Implementation Method] (1) An elongated shaft including a lumen, which is coupled to a suction system and configured to provide suction to a target site via the lumen, A robot-controllable catheter assembly comprising: an instrument base, which is coupled to the elongated shaft and configured to control the operation of the elongated shaft, and which includes a drive input assembly configured to be coupled to a drive output assembly associated with a robot arm. (2) The elongated shaft includes another lumen, and the robot-controllable catheter assembly is The present invention further includes an elongated movable member slidably disposed within the other lumen and connected to the distal end of the elongated shaft, The robot-controllable catheter assembly according to Embodiment 1, wherein the drive input assembly is connected to the elongated moving member to control the joint movement of the elongated shaft. (3) The robot-controllable catheter assembly according to Embodiment 1, wherein the instrument base includes a port configured to be coupled to the proximal end of the elongated shaft and to be coupled to the suction system. (4) The robot-controllable catheter assembly according to Embodiment 1, wherein the instrument base includes an identification element associated with an identifier of the robot-controllable catheter assembly, the identification element including at least one of a radio frequency identification tag, a quick response (QR) code, a barcode, or a magnet. (5) A robot-controllable catheter assembly according to Embodiment 1, further comprising a handheld instrument adapter configured to receive manual input and control the operation of the elongated shaft, the handheld instrument adapter comprising a coupler configured to connect to the drive input assembly of the instrument base, and a manual actuator connected to the coupler and configured to operate the coupler.

[0160] (6) The robot-controllable catheter assembly according to Embodiment 5, wherein the coupler includes a gear assembly configured to engage with the manual actuator and the drive input assembly. (7) Further including a pull wire configured to operate the elongated shaft, The robot-controllable catheter assembly according to Embodiment 5, wherein the coupler is configured to release the manual actuator from operating the drive input assembly and includes a tensioning mechanism configured to adjust the tension of the pull wire. (8) An elongated shaft including a lumen, which is coupled to a suction system and configured to provide suction to a target site via the lumen, A manually controllable catheter, comprising an instrument handle including a manual actuator coupled to the elongated shaft and configured to control the movement of the elongated shaft. (9) The elongated shaft includes a wire lumen, and the manually controllable catheter is The system further includes a pull wire slidably disposed within the wire lumen and connected to the distal end of the elongated shaft, The manual actuator is connected to the pull wire to control the joint movement of the elongated shaft, as described in Embodiment 8 of the manually controllable catheter. (10) The manually controllable catheter according to Embodiment 8, wherein the instrument handle includes a port configured to be coupled to the proximal end of the elongated shaft and to be coupled to the suction system.

[0161] (11) The manually controllable catheter according to Embodiment 8, wherein the manual actuator is configured to be operated by the user's thumb when the instrument handle is held by the user in an overhand position. (12) The manually controllable catheter according to Embodiment 8, wherein the manual actuator is configured to be operated by the user's thumb when the instrument handle is held by the user in an inverted grip. (13) Base and, A coupler rotatably supported within the base, configured to connect to a drive input assembly of a robot-controllable medical device, A system comprising: a first manual actuator operably coupled to the coupler and configured to operate the coupler to articulate the robot-controllable medical device. (14) The system according to embodiment 13, wherein the coupler includes an engagement assembly configured to be coupled to the first manual actuator and to the drive input assembly of the robot-controllable medical device. (15) The system according to embodiment 14, wherein the engagement assembly includes (i) a first engagement member that engages with the manual actuator, (ii) a second engagement member configured to engage with the drive input assembly, and (iii) a disengagement mechanism configured to disengage the coupling of the first engagement member to the second engagement member.

[0162] (16) The system according to embodiment 15, wherein the disengagement mechanism includes a second manual actuator configured to receive a manual input and disengage the coupling of the first engaging member to the second engaging member. (17) The system according to Embodiment 13, further comprising the robot-controllable medical instrument, the instrument comprising (i) an elongated shaft configured to be coupled to a suction system to provide suction to a target site, and (ii) an instrument base configured to be coupled to the elongated shaft to control the operation of the elongated shaft, wherein the instrument base comprises the drive input assembly. (18) The elongated shaft includes a lumen, and the robot-controllable medical device further includes an elongated movable member slidably disposed within the lumen and connected to the distal end of the elongated shaft, The system according to embodiment 17, wherein the drive input assembly is connected to the elongated moving member to control the joint movement of the elongated shaft. (19) The system according to embodiment 18, wherein the coupler is configured to release the first manual actuator from operating the drive input assembly and includes a tension mechanism configured to adjust the tension of the elongated moving member. (20) The system according to embodiment 17, wherein the instrument base includes a port configured to be coupled to the proximal end of the elongated shaft and to be coupled to the suction system.

[0163] (21) The system according to embodiment 13, wherein the coupler includes a gear assembly configured to engage with the first manual actuator and the drive input assembly. (22) A system, An elongated shaft comprising a distal end portion, a proximal end portion, and a lumen, configured to be connected to a suction system and to provide suction through the lumen, A handle connected to the aforementioned elongated shaft, The handle receives robotic input for controlling the joint movement of the elongated shaft, A system including a handle, configured to operate in a manual mode in which the handle receives manual input for controlling the joint movement of the elongated shaft. (23) A robot arm further includes a drive output assembly configured to provide the robot input to the handle, The system according to embodiment 22, wherein the handle is coupled to the drive output assembly of the robot arm. (24) The system according to embodiment 22, wherein the handle includes a manual actuator coupled to the elongated shaft and configured to receive the manual input. (25) The system according to embodiment 22, wherein the handle includes a device base configured to receive the robot input and an adapter configured to be coupled to the device base, the adapter including a manual actuator configured to receive the manual input.

[0164] (26) The system according to embodiment 25, wherein the adapter includes a coupler configured to be coupled to the drive input assembly of the device base, the coupler comprising (i) a first engaging member for engaging with the manual actuator, (ii) a second engaging member configured for engaging with the drive input assembly, and (iii) a disengagement mechanism configured for disengaging the coupling of the first engaging member to the second engaging member. (27) The system according to embodiment 26, wherein the disengagement mechanism includes another manual actuator configured to receive a manual input and disengage the coupling of the first engaging member to the second engaging member. (28) The system according to embodiment 22, wherein the elongated shaft includes a pull wire configured to operate the distal end portion of the elongated shaft. (29) The system according to embodiment 28, wherein the handle includes a tensioning mechanism configured to adjust the tension of the pull wire. (30) The system according to embodiment 22, wherein the handle includes a port configured to connect to the lumen and the suction system.

Claims

1. A robot-controlled surgical tool, A long, slender shaft, A pull wire arranged on the aforementioned elongated shaft, The device base includes a drive input assembly connected to the elongated shaft and configured to operate the elongated shaft by adjusting the tension of the pull wire, An adapter that can be connected to the base of the aforementioned device, Actuator and A coupler operably coupled to the actuator and connectable to the drive input assembly, comprising a gear assembly engageable with the actuator and a tension mechanism configured to disengage the gear assembly from the actuator, Includes an adapter, The actuator is configured to operate the coupler to adjust the tension of the pull wire while the gear assembly is engaged with the actuator. A robot-controllable surgical tool wherein the tensioning mechanism is operable to operate the coupler to adjust the tension of the pull wire while the gear assembly is disengaged from the actuator.

2. The robot-controllable surgical tool according to claim 1, wherein the elongated shaft includes a first lumen and a second lumen, and the pull wire is slidably disposed within the second lumen and connected to the distal end of the elongated shaft.

3. The robot-controllable surgical tool according to claim 2, wherein the instrument base includes a port connected to the proximal end of the elongated shaft and configured to connect the first lumen to a suction system.

4. The robot-controllable surgical tool according to claim 1, wherein the instrument base includes an identification element associated with an identifier of the robot-controllable surgical tool, the identification element including at least one of a radio frequency identification tag, a quick response (QR) code, a barcode, or a magnet.

5. The robot-controllable surgical tool according to claim 1, wherein the adapter is a handheld adapter.

6. The gear assembly is A first engaging member engaged with the actuator, A second engaging member engaged with the drive input assembly, A tab keyed to the second engaging member, wherein the tab is movable relative to the first and second engaging members between a first position in which the tab is disengaged from the first engaging member and a second position in which the tab is engaged with the first engaging member. A robot-controllable surgical tool according to claim 1, comprising:

7. The robot-controllable surgical tool according to claim 6, further comprising a spring configured to bias the tab toward the second position, around the second engaging member and the tab.

8. The robot-controllable surgical tool according to claim 6, wherein the adapter includes an enclosure, and the coupler and the actuator are at least partially located within the enclosure.

9. The robot-controllable surgical tool according to claim 8, wherein the enclosure comprises a base bonded to a plate.

10. The robot-controllable surgical tool according to claim 1, wherein the actuator includes an elongated member coupled to an actuator gear that interacts with the gear assembly.

11. The robot-controllable surgical tool according to claim 10, wherein the actuator gear includes a first groove, and the elongated member is slidable with respect to the actuator gear along the first groove between a first position and a second position.

12. The robot-controllable surgical tool according to claim 11, further comprising at least one spring that connects the elongated member to the actuator gear and biases the elongated member toward the first position.

13. The robot-controllable surgical tool according to claim 12, wherein the adapter further comprises an enclosure supporting the actuator and the gear assembly, and a pin partially disposed within the elongated member and extending into a second groove formed in the adapter.

14. The base and, A coupler rotatably supported within the base, configured to connect to a drive input assembly of a robot-controllable medical device, A system comprising: a first manual actuator operably coupled to the coupler and configured to operate the coupler to articulate the robot-controllable medical device.

15. The system according to claim 14, wherein the coupler includes an engagement assembly configured to be coupled to the first manual actuator and to the drive input assembly of the robot-controllable medical device.

16. The system according to claim 15, wherein the engagement assembly includes (i) a first engagement member that engages with the first manual actuator, (ii) a second engagement member configured to engage with the drive input assembly, and (iii) a disengagement mechanism configured to disengage the coupling of the first engagement member to the second engagement member.

17. The system according to claim 16, wherein the disengagement mechanism includes a second manual actuator configured to receive a manual input and disengage the coupling of the first engaging member to the second engaging member.

18. The system according to claim 14, further comprising the robot-controllable medical instrument, the instrument comprising: (i) an elongated shaft configured to be coupled to a suction system to provide suction to a target site; and (ii) an instrument base configured to be coupled to the elongated shaft and to control the operation of the elongated shaft, wherein the instrument base includes the drive input assembly.

19. The elongated shaft includes a lumen, and the robot-controllable medical device further includes an elongated movable member slidably positioned within the lumen and connected to the distal end of the elongated shaft. The system according to claim 18, wherein the drive input assembly is connected to the elongated moving member to control the joint movement of the elongated shaft.

20. The system according to claim 19, wherein the coupler is configured to disengage the first manual actuator by operating the drive input assembly, and includes a tension mechanism configured to adjust the tension of the elongated moving member.

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