Orientation of user input device for controlling surgical arm

Abstract

This invention provides a method for bending and curving without affecting ergonomic comfort and convenience. [Solution] The surgical system comprises a multi-joint mechanical arm 102 including arm segments connected in series by flexible and rotating arm joints, and first and second input devices. The second input device includes a handle that can be configured to face any orientation in xyz space. The arm joints are actuated by a handle joint member and have the same degrees of freedom as the handle joint member. The method of use includes the steps of bending the arm, transferring control of the arm from the first input device to the second input device, and performing a surgical action, wherein the displacement vector or turning arc of the handle member in xyz space is converted to a corresponding displacement vector or corresponding turning arc of the end effector 174 in the same xyz space.

Description

Technical Field

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] The present invention claims the benefit of U.S. Provisional Application No. 62 / 944,351, filed on December 5, 2019, the entire contents of which are incorporated herein by reference.

[0003] The present invention relates to a surgical system for use in performing surgical procedures and to methods of using such a system, and in particular to controlling bending and rotation of portions of an articulated mechanical arm using a plurality of operating modes and input devices. Background Art

[0004] This section is intended to introduce the reader to various aspects of technology that may be related to various aspects of the present invention described and / or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present invention. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.

[0005] The advantages of minimally invasive surgery are well established. Instruments for such surgery typically comprise a surgical end effector located at the distal end of an articulated surgical arm (preferably having a minimal diameter) that is inserted through a small opening (e.g., a body wall incision, a natural orifice) to reach the surgical site. In some examples, the surgical instrument can be passed through a cannula and an endoscope can be used to provide an image of the surgical site.

[0006] For convenience, precision, and patient health, surgical instruments utilizing end-effectors (e.g., surgical tools for tissue fusion or cutting, or measuring tools) have been developed. In some cases, a multi-joint surgical arm has one or more bends that are remotely controlled using various input devices (e.g., hand or foot controls) to ultimately control the position of the end-effector and change the orientation of the end-effector relative to the longitudinal axis of the surgical arm. In some cases, the surgical arm can be bent backward relative to its longitudinal axis.

[0007] Clinical studies have demonstrated that minimally invasive transvaginal approaches in gynecological surgery are superior to intraperitoneal approaches. Advantages include shorter recovery times, lower morbidity, fewer infections, lower mortality, fewer complications, less blood loss, and reduced patient satisfaction. The American College of Gynecologists (ACOG) now explicitly states that transvaginal approaches are preferred for gynecological surgery whenever possible. To enable gynecological surgery using transvaginally accessible medical devices, it is necessary to be able to bend multi-jointed surgical arms into an arched position.

[0008] The current state of this technology lacks devices and methods that can provide optimal control elements and usage methods for reliably performing preliminary bending steps in a risk-free approach without affecting the ergonomic comfort and convenience provided by input devices optimized for difficult surgical procedures. Therefore, there is a need for a solution that is suitable for reducing the risks during bending of the surgical arm while not affecting the surgeon's ergonomics, and that allows for maximum freedom of movement during surgical procedures. [Overview of the project]

[0009] A method for operating a surgical system is disclosed. The system comprises (i) a multi-joint mechanical arm (the arm having a surgical end effector at its distal end and comprising a plurality of arm segments, the plurality of arm segments being connected in series by a plurality of arm joints configured to have degrees of freedom and to bend and rotate), and (ii) first and second input devices (the second input device comprising a handle member configured to be directed in any one of a plurality of selectable orientations in xyz space, the handle member comprising a segment member and a joint member corresponding to the arm segments and arm joints of the arm, respectively, each of the arm joints being actuated by the corresponding joint member and having the same degrees of freedom as the joint member). The aforementioned method, (a) The step of bending the arm in response to an electronically controlled output from the first input device (the electronically controlled output is effective in adjusting the flexion and rotation of the arm joint to bring the end effector to the bent position), (b) Following the step of bending the arm, a step of transferring control of the arm from the first input device to the second input device, (c) After the transition step, the handle member is reoriented to displace and reorient the segment member and the joint member, respectively, thereby causing the corresponding arm segment and arm joint of the curved arm to be displaced and reoriented, respectively, and the end effector is used to perform surgery (the orientation of the handle member is such that the displacement vector or reorientation arc of the handle member in the xyz space is converted into the corresponding displacement vector or corresponding reorientation arc of the end effector in the same xyz space).

[0010] In some embodiments, when performing the bend-back step using the first input device, it is not necessary to change the orientation of the handle member from the selected orientation in the xyz space; in other words, the change of orientation can be omitted. In some embodiments, when performing the bend-back step using the first input device, it may not be necessary to change the orientation of the handle member from the selected orientation in the xyz space. In some embodiments, the step of performing the bend-back step using the first input device may not require changing the orientation of the handle member by more than 90° from the selected orientation in the xyz space.

[0011] In some embodiments, the surgical system may further include a control circuit effective in triggering the transition step.

[0012] In some embodiments, the first input device may be deactivated after the transition step. In some embodiments, the first device may be disconnected from the arm after the transition step.

[0013] In some embodiments, the surgical system may or may further include a user input device for operating the linear forward and backward movement of the arm. This user input device may be an add-on to another user input device, such as a button or a nipple.

[0014] According to embodiments of the present invention, a surgical system for use with a surgical end effector is (a) A multi-jointed mechanical arm (the arm has a surgical end effector at its distal end and comprises a plurality of arm segments, each of which is connected in series by a plurality of arm joints configured to have degrees of freedom and to bend and rotate), (b) A first input device configured to provide electronically controlled outputs for controlling the flexion speed and rotation speed of each of the arm joints in response to a change in position, such as causing the distal end of the arm and the end effector to bend to a bend position, and (c) A second input device comprising a handle member configured to be directed in any one of a plurality of selectable orientations in xyz space (the handle member comprises a segment member and a joint member corresponding to the arm segment and the arm joint of the arm, respectively, and each arm joint is actuated by the corresponding joint member and has the same degrees of freedom as the joint member), (i) The surgical system is configured such that after the arm bends back, the control of the arm is transferred from the first input device to the second input device. (ii) Following the transition step, the step of reorienting the handle member to displace and reorient the segment member and the joint member, respectively, is effective in causing the corresponding arm segment and arm joint of the curved arm to be displaced and reoriented, respectively, so that the orientation of the handle member is converted to the corresponding displacement vector or reorientation arc of the handle member in xyz space to the corresponding displacement vector or corresponding reorientation arc of the end effector in the same xyz space.

[0015] In some embodiments, when the bending step is performed using the first input device, it is not necessary to change the orientation of the handle member from the selected orientation in the xyz space, i.e., the change of orientation can be omitted. In some embodiments, when the bending step is performed using the first input device, it may not be necessary to change the orientation of the handle member from the selected orientation in the xyz space. In some embodiments, when the bending step is performed using the first input device, it may not be necessary to change the orientation of the handle member by more than 90° from the selected orientation in the xyz space.

[0016] In some embodiments, the surgical system may further include a control circuit effective in triggering the transition step.

[0017] In some embodiments, the first input device may be configured to be deactivated after the transition step. In some embodiments, the first device may be configured to be disconnected from the arm after the transition step.

[0018] In some embodiments, the surgical system may include a user input device for operating the linear forward and backward movement of the arm.

[0019] According to the embodiment, a method of operating a surgical system is disclosed. The system is (i) A multi-jointed mechanical arm (the arm having a surgical end effector at its distal end and comprising multiple arm joints, each having a degree of freedom), and (ii) comprising an input device array of one or more user input devices configured to control the flexion and rotation of an arm joint, The aforementioned method, (a) in response to an electronic control output from a first user input device, converting user input into respective flexion and rotation of arm joints using a first coordinate transformation matrix, and warping the distal end portion of said arm to bring said end effector to a warped operating position, (b) transitioning to a second coordinate transformation matrix based on the warped position of said end effector in response to, and conditioned on, detection that said end effector is at said warped operating position, and c. after said transitioning step, and in response to an electronic control output from a second user input device, converting user input into respective flexion and rotation of arm joints using said second coordinate transformation matrix, and performing a surgical operation using said end effector.

[0020] In some embodiments, said first and second input devices can be the same input device, and / or said first and second coordinate transformation matrices can be not the same three-dimensional coordinate transformation matrix.

[0021] In some embodiments, said first and second input devices can be not the same input device, and / or said first and second coordinate transformation matrices can be not the same three-dimensional coordinate transformation matrix.

[0022] In some embodiments, before said transitioning step and during said warping step, proximal displacement of said first user input device or a portion thereof is converted to proximal displacement of said end effector, and / or in a state where said end effector is at said warped position after said transitioning step, proximal displacement of said second user input device or a portion thereof can be converted to distal displacement of said end effector.

[0023] In some embodiments, said surgical system can further comprise a control circuit effective to cause said transitioning step.

[0024] In some embodiments, after the transition step, the first input device may be deactivated. In some embodiments, after the transition step, the connection between the first device and the arm may be disconnected.

[0025] According to an embodiment, a surgical system for use with a surgical end effector comprises: (a) an array of one or more input devices, and (b) an articulated mechanical arm (said arm has a surgical end effector at its distal end and comprises a plurality of arm segments, the plurality of arm segments being connected by a plurality of arm joints configured to bend and rotate in response to control signals generated by the input device). The surgical system is: (i) configured to, in response to an electronic control output from a first user input device, convert said user input into respective bending and rotation of each arm joint using a first coordinate transformation matrix, and warp the distal end of said arm to bring said end effector into a warped operating position, (ii) configured to transition to a second coordinate transformation matrix based on the current orientation of said end effector in response to, and conditional on, detection that the current orientation of said end effector corresponds to the current orientation of a second user input device, (iii) configured to, after the transition step and in response to an electronic control output from said second user input device, convert user input into respective bending and rotation of each arm joint using said second coordinate transformation matrix, and perform a surgical procedure using said end effector.

[0026] In some embodiments, said first and second input devices can be the same input device, and / or said first and second coordinate transformation matrices can be different three-dimensional coordinate transformation matrices.

[0027] In some embodiments, the first and second input devices may not be the same input device, and / or the first and second coordinate transformation matrices may not be the same three-dimensional coordinate transformation matrices.

[0028] In some embodiments, the surgical system may be configured such that, before the transition step and during the bending step, the proximal displacement of the first user input device or a part thereof is converted to the proximal displacement of the end effector, and / or, after the transition step and with the end effector in the bending position, the proximal displacement of the second user input device or a part thereof is converted to the distal displacement of the end effector.

[0029] In some embodiments, the surgical system may further include a control circuit effective in triggering the transition step.

[0030] In some embodiments, the first input device may be configured to be deactivated after the transition step. In some embodiments, the first device may be configured to be disconnected from the arm after the transition step.

[0031] According to the embodiment, a method of operating a surgical system is disclosed. The system is (i) A given user input device, and (ii) A multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from a given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm, The aforementioned method, (a) Steps for starting the operation of the surgical system in a first operating mode, (b) While the surgical system is in the first operating mode, (i) modify the curve shape of the arm by at least one of one of the mechanized bending and mechanized rotation of one or more of the joints of the articulated mechanical arm; (ii) monitor the shape state of the mechanical arm and detect whether at least a portion thereof has a curve shape that matches the currently dominant curve shape defined by the given user input device; (c) In response to the detection that the curved shape of the mechanical arm matches the curved shape of the given user input device, and on the condition of such detection, the step of transitioning the operation of the surgical system from the first mode to the second mode, (d) The step of operating the surgical system in the second mode in order to perform a surgical procedure using the end effector, such that the output of the given user input device modifies the configuration of the arm or a section or element of the arm.

[0032] In some embodiments, the transition step may include handing off user control of the arm configuration from a user input device other than the given user input device to the given user input device.

[0033] In some embodiments, the first mode is defined with respect to (i) a suitable subset of the plurality of arm joints, (ii) a control signal from a given user input device that excludes the operation of any arm joint of the arm that is not a member of the suitable subset of arm joints, and (iii) allows control of the operation of one or more arm joints belonging to the suitable subset, thereby causing flexion and / or rotation of one or more arm joints of the suitable subset.

[0034] In some embodiments, during the transition step from the first mode to the second mode, the given user input device can enable control of flexion and rotation of arm joints that were excluded in at least one of the first modes.

[0035] In some embodiments, the step of modifying the shape of the arm can be performed in response to an electronic control signal provided by a given user input device. In some embodiments, the step of modifying the shape of the arm can be performed in response to an electronic control signal provided by a user input device other than the given user input device. The step of modifying the curved shape of the arm can be performed automatically.

[0036] According to the embodiment, the surgical system is (i) A given user input device, and (ii) A multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from a given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm. The system is configured to start operating in a first operating mode, and during operation in the first operating mode, to change the curve shape of the arm by at least one of one or more mechanized bending and mechanized rotation of the joints of the articulated mechanical arm. The system is further configured to monitor the shape state of the mechanical arm and to detect whether at least a portion thereof has a curve shape that matches a currently dominant curve shape defined by a given user input device. In response to and conditional upon detection that the curve shape of the mechanical arm matches the curve shape of the given user input device, the system is further configured to transition the operation of the surgical system from the first mode to a second mode, and to operate the output of the given user input device in the second mode to modify the configuration of the arm or this section or element to perform surgery using the end effector.

[0037] In some embodiments, the system can be configured such that the transition step includes a step of handing off user control of the arm configuration from a user input device other than the given user input device to the given user input device.

[0038] In some embodiments, the first mode can be defined with respect to (i) a suitable subset of the plurality of arm joints, (ii) by a control signal from a given user input device, the operation of any arm joint of the arm that is not a member of the suitable subset of arm joints, and (iii) the system can be configured to allow control of the operation of one or more arm joints belonging to the suitable subset, causing flexion and / or rotation of one or more arm joints of the suitable subset.

[0039] In some embodiments, the system can be configured such that, during the transition step from the first mode to the second mode, the given user input device enables control of flexion and rotation of arm joints that were excluded in at least one of the first modes.

[0040] In some embodiments, the system can be configured so that the modification step of the shape of the arm is performed in response to an electronic control signal provided by a given user input device. In some embodiments, the system can be configured so that the modification step of the shape of the arm is performed in response to an electronic control signal provided by a user input device other than the given user input device. The system can be configured so that the modification step of the curved shape of the arm is performed automatically.

[0041] According to the embodiment, a method of operating a surgical system is disclosed. The aforementioned system, (i) a given user input device, and (ii) a multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from the given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm, The aforementioned method, (a) Steps for starting the operation of the surgical system in a first operating mode, and (b) While the surgical system is in the first operating mode, the system includes (i) modifying the curved shape of the articulated mechanical arm by at least one of one of the articulated bending and articulated rotation of one or more of the joints of the articulated mechanical arm, and (ii) monitoring the shape state of the mechanical arm and detecting whether at least a portion of the mechanical arm has a curved shape that matches a predetermined curved shape. Furthermore, the above method is (c) In response to the detection that the curved shape of the mechanical arm matches the predetermined curved shape, and on the condition of such detection, the step of transitioning the operation of the surgical system from the first mode to the second mode, (d) The step of operating the surgical system in the second mode such that the output of the given user input device modifies the configuration of the arm or a section or element of the arm in order to perform a surgical procedure using the end effector.

[0042] In some embodiments, the step of detecting whether the curved shape of the mechanical arm or a part thereof matches the predetermined curved shape may include at least one of the following steps: (i) detecting whether the curved shape of the mechanical arm or a part thereof matches the two-dimensional projection of the predetermined curved shape; (ii) detecting whether the two-dimensional projection of the curved shape of the mechanical arm or a part thereof matches the predetermined curved shape; and / or (iii) detecting whether the two-dimensional projection of the curved shape of the mechanical arm or a part thereof matches the two-dimensional projection of the predetermined curved shape.

[0043] In some embodiments, the predetermined curve shape may have one or more local minimums or maximums. In some embodiments, the predetermined curve shape may have one or more inflection points. In some embodiments, the predetermined curve shape or its two-dimensional projection may be an "S" shaped curve.

[0044] In some embodiments, the transition step may include handing off user control of the arm configuration from a user input device other than the given user input device to the given user input device.

[0045] In some embodiments, the first mode is defined with respect to (i) a suitable subset of the plurality of arm joints, (ii) a control signal from a given user input device that excludes the operation of any arm joint of the arm that is not a member of the suitable subset of arm joints, and (iii) allows control of the operation of one or more arm joints belonging to the suitable subset, thereby causing flexion and / or rotation of one or more arm joints of the suitable subset.

[0046] In some embodiments, during the transition step from the first mode to the second mode, the given user input device can enable control of flexion and rotation of arm joints that were excluded in at least one of the first modes.

[0047] In some embodiments, the step of modifying the shape of the arm can be performed in response to an electronic control signal provided by a given user input device. In some embodiments, the step of modifying the shape of the arm can be performed in response to an electronic control signal provided by a user input device other than the given user input device. The step of modifying the curved shape of the arm is performed automatically.

[0048] According to the embodiment, the surgical system is (i) A given user input device, and (ii) A multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from a given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm. The system is configured to start operating in a first operating mode, and during the first operating mode, modify the curve shape of the articulated mechanical arm by at least one of mechanical bending and mechanical rotation of one or more of the arm joints of the articulated mechanical arm, and to monitor the shape state of the mechanical arm to detect whether at least a portion of it has a curve that matches a predetermined curve shape. The system is further configured to respond to and be conditional upon detection that the curve shape of the mechanical arm matches the predetermined curve shape, and to transition the operation of the surgical system from the first mode to the second mode, and the surgical system is configured to operate in the second mode such that the output of the given user input device modifies the configuration of the arm or this section or element in order to perform surgery using the end effector.

[0049] In some embodiments, the system can be configured such that the step of detecting whether the curved shape of the mechanical arm or a part thereof matches the predetermined curved shape includes at least one of the following steps: (i) detecting whether the curved shape of the mechanical arm or a part thereof matches the two-dimensional projection of the predetermined curved shape; (ii) detecting whether the two-dimensional projection of the curved shape of the mechanical arm or a part thereof matches the predetermined curved shape; and / or (iii) detecting whether the two-dimensional projection of the curved shape of the mechanical arm or a part thereof matches the two-dimensional projection of the predetermined curved shape.

[0050] In some embodiments, the system can be configured such that the predetermined curve shape has one or more local minimums or maximums. In some embodiments, the system can be configured such that the predetermined curve shape has one or more inflection points. In some embodiments, the system can be configured such that the predetermined curve shape or its two-dimensional projection is an "S" shaped curve.

[0051] In some embodiments, the system can be configured so that the transition step includes a step of handing off user control of the arm configuration from a user input device other than the given user input device to the given user input device.

[0052] In some embodiments, the first mode can be defined with respect to (i) a suitable subset of the plurality of arm joints, (ii) by a control signal from a given user input device, the operation of any arm joint of the arm that is not a member of the suitable subset of arm joints, and (iii) the system can be configured to allow control of the operation of one or more arm joints belonging to the suitable subset, causing flexion and / or rotation of one or more arm joints of the suitable subset.

[0053] In some embodiments, the system can be configured such that, during the transition step from the first mode to the second mode, the given user input device can enable control of flexion and rotation of arm joints that were excluded in at least one of the first modes.

[0054] In some embodiments, the system can be configured so that the step of modifying the shape of the arm is performed in response to an electronic control signal provided by a given user input device. In some embodiments, the system can be configured so that the step of modifying the shape of the arm is performed in response to an electronic control signal provided by a user input device other than the given user input device. The system can be configured so that the step of modifying the curve shape of the arm is performed automatically. [Brief explanation of the drawing]

[0055] Next, the present invention will be further described by reference to the attached drawings. The dimensions of the components and features shown in the drawings have been selected for convenience and clarity of presentation and are not necessarily to scale.

[0056] [Figure 1] Figure 1 is a schematic diagram of a surgical system according to an embodiment of the present invention.

[0057] [Figure 2] Figure 2A is a schematic perspective view of a surgical system equipped with a mechanical surgical arm according to an embodiment of the present invention. Figure 2B shows the distal portion of the mechanical surgical arm according to an embodiment of the present invention.

[0058] [Figure 3] Figures 3A to 3C show the distal portions of a mechanical surgical arm in various bent and curved positions according to embodiments of the present invention.

[0059] [Figure 4] Figure 4 shows the distal portion of a mechanical surgical arm having an arm curve shape according to an embodiment of the present invention. [Figure 5] Figure 5 shows the distal portion of a mechanical surgical arm having an arm curve shape according to an embodiment of the present invention.

[0060] [Figure 6] Figure 6 is a flowchart illustrating the operation method of a surgical machine arm using two operating modes according to an embodiment of the present invention.

[0061] [Figure 7] Figure 7 is a schematic diagram of a control console for a surgical system having an input device positioned in close proximity to the surgical system, according to an embodiment of the present invention.

[0062] [Figure 8] Figure 8 is a schematic diagram of a user input device according to an embodiment of the present invention.

[0063] [Figure 9] Figure 9 is a chart illustrating an exemplary scheme for using an input device to control the flexion and rotation of an arm joint, according to an embodiment of the present invention.

[0064] [Figure 10] Figure 10 is a schematic diagram showing a multi-joint user input device according to an embodiment of the present invention.

[0065] [Figure 11] Figure 11 is a schematic diagram of the handle member of the user input device shown in Figure 10 according to an embodiment of the present invention.

[0066] [Figure 12] Figures 12A and 12B show exemplary graphical aids for use in aligning the positions of a mechanical surgical arm and a multi-joint user input device according to embodiments of the present invention.

[0067] [Figure 13] Figure 13 shows an example of a screen display used for aligning the positions of a mechanical surgical arm and a multi-joint user input device according to an embodiment of the present invention.

[0068] [Figure 14A] Figure 14A is a time-sequential image showing exemplary control of a surgical machine arm using an input device according to an embodiment of the present invention. [Figure 14B] Figure 14B is a time-sequential image showing exemplary control of a surgical machine arm using an input device according to an embodiment of the present invention. [Figure 14C] Figure 14C is a time-sequential image showing exemplary control of a surgical machine arm using an input device according to an embodiment of the present invention. [Figure 14D]Figure 14D is a series of time-sequential images illustrating exemplary control of a surgical machine arm using an input device according to an embodiment of the present invention. [Figure 14E] Figure 14E is a time-sequential image showing exemplary control of a surgical machine arm using an input device according to an embodiment of the present invention.

[0069] [Figure 15] Figure 15 is a block diagram of a surgical system according to an embodiment of the present invention.

[0070] [Figure 16] Figure 16 is a flowchart illustrating the operation method of a surgical system in two different operating modes according to an embodiment of the present invention.

[0071] [Figure 17] Figure 17 is a schematic diagram of a first user input device directed to a given xyz space according to an embodiment of the present invention.

[0072] [Figure 18] Figure 18 is a schematic diagram showing a portion of the surgical arm directed toward the first given xyz space in Figure 17, according to an embodiment of the present invention.

[0073] [Figure 19] Figure 19 is a schematic diagram of a user input device according to an embodiment of the present invention, having a handle member that has been repositioned to face an xyz space other than the first given xyz space of Figure 17.

[0074] [Figure 20] Figure 20 is a schematic diagram of the surgical arm of Figure 18, which is curved in the given xyz space of the first arm of Figure 17, according to an embodiment of the present invention.

[0075] [Figure 21]Figure 21 is a schematic diagram of the user input device of Figure 19 directed to the first given xyz space of Figure 17, according to an embodiment of the present invention.

[0076] [Figure 22] Figure 22A schematically shows a user input device having a given curved shape according to an embodiment of the present invention. Figure 22B schematically shows a surgical arm in a first time period having a curved shape that does not match the given curved shape in Figure 22A. Figure 22C schematically shows a surgical arm in a second time period having a curved shape that matches the given curved shape in Figure 22A.

[0077] [Figure 23] Figure 23A is a flowchart of a dual control method for a surgical arm according to an embodiment of the present invention. Figures 23B and 23C are schematic diagrams of a control console equipped with dual control means according to an embodiment of the present invention.

[0078] [Figure 24] Figure 24 is a flowchart illustrating a method for using tactile handles to control one or more surgical arms according to an embodiment of the present invention. [Modes for carrying out the invention]

[0079] In this specification, the present invention will be described only by reference to the accompanying drawings. Herein, referring in detail and specifically to the drawings, it is emphasized that the features shown are, for illustrative purposes only, for illustrative purposes of preferred embodiments of the present invention and are presented to provide what is considered to be the most useful and readily understandable explanation of the principles and conceptual aspects of the present invention. In this regard, no attempt has been made to show structural details of the present invention in more detail than is necessary for a basic understanding of the invention, and the description provided in conjunction with the drawings will be made clear to those skilled in the art how some forms of the present invention can actually be embodied. Throughout the drawings, letters that are generally similarly referenced are used to designate similar elements.

[0080] Embodiments disclosed herein relate to controlling one or more surgical mechanical arms, i.e., articulated mechanical arms, using a plurality of different operating modes and / or a plurality of different input devices.

[0081] Whenever the term “arm” is used herein or in the appended claims, it means a multi-jointed, mechanical arm that is part of a surgical system or electrosurgical system and is used to perform or assist in performing surgical (including electrosurgical) acts within the body of a human subject. “Surgical acts” include, unless otherwise specified, any medical or surgical-related or diagnostic acts performed inside the human body. This includes, but is not exhaustive, the cutting, dissection, manipulation, suturing, contraction, fusion, measurement, and imaging of tissues. A surgical arm may be desirable to be of a size and / or shape suitable for insertion into the human body. For example, an arm may be of a size and / or shape suitable for insertion through a laparoscopic port and / or for performing laparoscopic surgery. For example, an arm may be of a size and / or shape suitable for insertion through a natural opening of the body (e.g., vagina, anus, trachea, esophagus, external auditory canal).

[0082] The arm may include an end effector. Herein, the term "end effector" is used to mean a tool or device used in connection with surgical, electrosurgical, diagnostic, or imaging procedures when deployed within the human body. The end effector may be provided as part of the arm, i.e., already installed, mechanically mounted, and / or integrated with the arm's power and communication conveyors. In some embodiments, the arm and the end effector may be prepared separately for assembly and / or integration into a treatment unit before or during surgery, i.e., before insertion into the subject's body. In any case, terms such as "arm with end effector" and "arm configured for use with end effector" should be understood as equivalent for the purposes of this disclosure and the claims appended thereto.

[0083] As used herein, “input device,” or equivalently “user input device,” can be any device capable of receiving user input (i.e., input received from a user of a surgical system). Input devices may include, but are not exhaustive, buttons, switches, toggles, wheels, knobs, small sticks such as thumbsticks (also called nipples), and joysticks (whether articulated or not). Disclosure of a specific type of device for any particular input device is not intended to exclude substitution of other types of input devices for a particular input device. Input devices may be standalone, grouped on a single control member or on a number of control members, mounted on another input device, or co-located on or near, for example, a control console, display screen, etc. A user may operate an input device using one or more fingers, thumbs, hands, or feet. Furthermore, or instead, and without limitation, an input device may be operated by eye or hand movements, voice commands, or facial expressions.

[0084] The arm and input device, as well as other aspects and features of the present invention, can be understood in conjunction with any teachings of the concurrently pending U.S. Patent Application No. 16 / 121,704, filed on September 5, 2018, and published as U.S. Patent Application Publication No. 20190000574, which is incorporated herein by reference.

[0085] In this specification, the terms “handle” or equivalently “handle component” are used to describe a user input device or a hand-operated portion of a user input device that is typically operated by hand. In some embodiments, the terms are used to describe a user input device or a portion thereof that is grasped by hand or by fingers. The drawings and accompanying descriptions of handles and hand-operated user input devices in this disclosure are provided as examples, and such drawings and accompanying descriptions should not be understood as limiting the scope of embodiments relating to the design, connectivity and functionality of handles / handle components.

[0086] In this disclosure, “modules” and / or “electrical circuits” or “electronic circuits” and / or “control circuits” and / or elements and / or units and / or controllers and / or modules and / or sensors and / or detectors” may include any combination of analog circuits and / or digital circuits and / or software / computer-readable code modules and / or firmware and / or hardware elements, including but not limited to digital computers, CPUs, volatile or non-volatile memory, field-programmable logic array (FPLA) elements, hardwired logic elements, field-programmable gate array (FPGA) elements and application-specific integrated circuit (ASIC) elements. Any instruction set architecture may be used, including but not limited to reduced instruction set computer (RISC) architectures and / or composite instruction set computer (CISC) architectures.

[0087] In different embodiments, any computational or analytical procedure can be performed using any combination of analog and / or digital circuits and / or software / computer-readable code modules and / or firmware and / or hardware elements, including but not limited to digital computers, CPUs, volatile or non-volatile memory, field-programmable logic array (FPLA) elements, hardwired logic elements, field-programmable gate array (FPGA) elements and application-specific integrated circuit (ASIC) elements. Any instruction set architecture can be used, including but not limited to reduced instruction set computer (RISC) architectures and / or composite instruction set computer (CISC) architectures.

[0088] Referring here to the figures, Figure 1 shows a schematic diagram of a surgical system 100 according to an embodiment. The system 100 in Figure 1 includes two surgical mechanical arms 102. Other examples of surgical systems are provided with a single surgical arm. Other examples are provided with two or more (e.g., three or four) surgical arms. The surgical mechanical arms 102 are preferably of a size and / or shape suitable for insertion into the human body or patient 106. Each surgical mechanical arm 102 is actuated by its respective motor unit 108. In this simple example, the surgical arms 102 and / or motor units 108 are supported by being attached to a patient support 116 (e.g., a bed), but may be supported by a patient-side cart or any other suitable equipment.

[0089] In embodiments where the surgical system is used in electrosurgery, power to the arm 102 and motor unit 108 can be supplied by an electrosurgical generator 112. As is known in the art of electrosurgery, an electrosurgical generator supplies alternating polarity current of high frequency (e.g., radio frequency). The electrosurgical generator 112 can be configured to supply various frequencies and / or power levels suitable, for example, tissue cutting and / or coagulation and / or sealing and / or drying and / or full grade. Power is supplied to the motor unit 108 via one or more cables 114 configured to transmit radio frequency electrosurgical power.

[0090] The movement of the surgical arm 102 is controlled by the control console 118. The movement responds to signals generated by one or more input devices. The control console 118 includes one or more user interfaces, including: an input device (e.g., an input device arm 120 configured so that the control console generates control signals based on the movement of the input device arm 120); a display screen 128 configured to receive user input and / or display, for example, system status information or imaging of the surgical zone (e.g., displaying images acquired by a camera inserted into the patient 106 using one of the surgical arms 102, or displaying the position and orientation of the arm); and one or more additional user interfaces 130 (e.g., buttons, switches, etc.).

[0091] The control console 118 includes a processor (not shown) configured to receive signals from one or more user inputs and transmit control signals to the motor unit 108 and / or the electrosurgical generator 112. The foot pedal 126 and / or the electrosurgical generator 112 include a processor (not shown) configured to receive control signals (e.g., generated when the user presses a portion of the foot pedal 126) and to change the power supplied to the motor unit 108 based on the control signals. The foot pedal control signals do not necessarily have to pass through the control unit processor.

[0092] As will be described in more detail below, in one control mode, the movement of the input device arm 120 controls the movement of each surgical device arm 102. The user 124 can position and / or move the input arm 120 by grasping the input device arm handle 127. The input arm is one form of the input device and is shown herein for illustrative purposes. In other embodiments, other types or forms of input devices may be used.

[0093] Referring here to Figures 2A and 2B, the arm unit 104 has a proximal end shaped to receive the motor unit 108 and a distal end to which an end effector 174, such as a multi-jaw grabber (shown only as a non-limiting example) illustrated on the arm 102, is attached.

[0094] The relative terms “proximal” and “distal” are used as indicated by the arrows shown in Figure 2A and are used in this manner throughout this disclosure and the appended claims. As illustrated, the distal end of the arm 102, where the end effector 174 is located, is furthest from the motor unit 108 and is the first part of the arm to be inserted into a human subject 19. Thus, the proximal end is the end opposite the distal end and closest to the motor unit 108. As used herein, the term “distal portion” means any portion of the arm 102 that includes the distal end / tip (optionally including the end effector 174) and is less than half the length of the arm 102. In Figure 2B, the bendable portion 170 of the arm 102, i.e., a portion including one or more bendable joints, is located along the longitudinal direction of the arm, near the distal end. The bendable portion 170 may comprise a series of “laminated links” 199 that give flexibility to the outer shape / surface of the arm 102. An example of multiple stacked links 199 in the bendable portion 170 of the arm 102 is shown in Figure 2B.

[0095] As used herein, “operational mode” or its equivalent “mode” (which can be used with a variety of non-exclusive descriptive terms, such as “bend mode,” “surgical operation mode,” etc.) means an operational regime imposed on the use of a surgical system or arm by hardware, firmware, or software design, or by the control circuits of the surgical system, or otherwise. For clarity, the term “operation” in “operational mode” means “operation” or “function / functional,” describing, for example, the movement of an arm, and not the performance of surgery. That is, an “operational mode” may, but may not necessarily, include the performance of surgery. An imposed operational regime may, but may not include steps that restrict or do not restrict certain operations or parts of an operational system that perform one or more operations. Restrictive or non-restrictive steps may include, and / or equivalent, enable or disable, lock or unlock, and precluding or permit, or similar phrases. In some embodiments of this specification, a mode may be assigned or directed to achieve a single objective, such as bending the distal portion of an arm, and may be limited to one or more specific time periods. In other embodiments, a mode may incorporate an unlimited number of objectives and actions, as well as unlimited or undefined time periods.

[0096] The operation of surgical systems can be distinguished between different modes in various ways, as will be further described below. For example, the distinctions can be based on (but are not exhaustive): Differences in dedicated input devices (or multiple input devices) for each mode, Differences in the movement of a specific arm and / or constraints or limitations on specific arm joints and arm segments. Differences in the conversion scheme from the displacement of the input device or the control element of the input device to the movement of the arm (e.g., displacement to velocity, displacement to displacement) (whether the conversion from user input to arm movement is robotic / semi-autonomous or remotely controlled), and Whether the operation of the input device directly addresses the flexion and rotation of the arm joint (through the mechanisms and electronics of the surgical system) or indirectly addresses the displacement of the arm segment, thereby generating the flexion and rotation necessary to displace the arm segment as instructed. Such distinctions can be used in combination and, in a multi-arm system, can be varied for each arm. In some embodiments, the distinctions can be changed while the system is in a given mode.

[0097] Some mode distinctions can be implemented in more than one way. As a non-limiting example, if a mode distinction involves restricting or limiting certain arm movements (e.g., flexion and rotation of specific joints) or permitting only certain arm movements, the distinction can be implemented by using different input devices for each mode, or by enforcing user-switchable or system-enforceable software or hardware constraints that use a single input device for both modes. Regardless of whether an embodiment requires one or more input devices, a software or hardware implementation solution may actively permit the operation of one given arm joint, or actively prevent or exclude the operation of any other arm joint (of the same arm) other than this one arm joint.

[0098] Where the operation or movement of a single “arm” (in contrast to multiple “arms”) is discussed herein, it should be noted that this is for convenience only and is not intended to indicate whether a second arm (or other multiple arms) is operated or moved in the same or other manner. Each arm can be controlled and actuated independently of any other arm by its respective input device. On the other hand, where an “arm” (singular) is disclosed to be constrained or limited with respect to its operation or movement, the constraint or limitation may apply equally to both / all arms of the surgical system, for example, during a mode of operation characterized by such constraint or limitation. However, in some embodiments, the constraint or limitation may apply to one or more given arms, while other arms may not be constrained or limited at all, or similarly not constrained or limited.

[0099] In embodiments employing two different operating modes, the first operating mode is typically used when introducing or withdrawing a surgical arm or arm into or out of a body (or from a first point to a second point inside the body) and / or guiding it, in particular towards or away from a target surgical site. The second operating mode is typically used when performing a surgical procedure (e.g., dissection of tissue, manipulation of tissue, suturing of tissue, performing measurements, imaging, etc.). The “guidance” in the first mode may include the step of bending one or more arms so that at least a portion of the arm or the distal portion of the arm is in a bent position, or equivalently, so that the end effector is in a bent operating position (procedure position).

[0100] It may be desirable to have a clearly defined transition or "handoff" from one operating mode to another. In some embodiments, the transition includes a handoff from one input device (or more input devices) to another. In other embodiments, the transition is entirely related to a change in control behavior that distinguishes one mode from the other. Tasks assigned to both modes can be performed by a single input device or by the same (or multiple) input devices. The transition can be initiated and managed by the surgical system or initiated by a user.

[0101] In a non-limiting example relating to the transition from a first mode to a second mode, the transition may include a step of ending any restrictions or constraints imposed during the first mode operation, such as limiting joint flexion and rotation to a given joint (e.g., the elbow joint) of any particular arm. Furthermore, or alternatively, the transition may include a step of enabling the operation of arm joints that were disabled (or not specifically enabled) during the first mode operation (i.e., enabling them in addition to a given joint that was enabled in the first mode). Enabling may include allowing the joint to move unrestricted according to the respective degrees of freedom of each joint. For example, if a given arm joint is configured only for rotation and not for flexion, the enabling will be effective only for rotation. Furthermore, or alternatively, the transition may enable the operation of all arm joints. Furthermore, or alternatively, the transition may change the processing of the control output from a user input device from displacement-velocity conversion to displacement-displacement conversion. In a further non-limiting example, the transition may be performed automatically by a control circuit in response to an event. For example, it can be implemented based on user input such as a pressed button or a rotated switch, or it can be implemented by noting that the user has finished using a first input device and started using a second input device. In a further non-restrictive example, the transition is an mediated transition based on the user interface.

[0102] In a non-limiting example relating to the transition from the second mode to the first mode, the transition may include restoring any restrictions or constraints removed during the transition to the second mode operation, such as restrictions on joint flexion and rotation of any particular arm to a given arm joint (e.g., the elbow joint). Furthermore, or alternatively, the transition may include a step of deactivating the operation of an arm joint that was active in the second mode operation. Furthermore, or alternatively, the transition may reverse the processing of the control output from a user input device from displacement-displacement conversion to displacement-velocity conversion. In a further non-limiting example, the transition may be implemented based on user input, such as a pressed button or a rotated switch, or it may be implemented noting that the user has finished using an input device dedicated to the second mode operation and has begun using a different input device dedicated to the first mode operation.

[0103] In embodiments, particularly in embodiments where the input device employed in the second mode is avatar-like and the input arm displacement is converted to the surgical arm displacement, the transition step from the first operating mode to the second operating mode may include alignment calibration. Alignment calibration, which will be discussed in more detail with respect to Figures 12A-12B, modifies the orientation of the surgical arm, including multiple arm elements (e.g., arm joints and / or arm segments) that are "inward-facing" of each other, to match the "shape" or "curve" indicating the orientation of the corresponding input arm that takes over the operational control of the surgical arm in the transition to the second operating mode. When returning from the second operating mode to the first operating mode, there may not necessarily be a corresponding alignment calibration.

[0104] The conversion of user input to arm movement (flexion and rotation) can be achieved in various ways. For example, the displacement of an input device or the displacement (or force of displacement) of a control element of an input device can be converted to the arm's movement speed (e.g., velocity, angular velocity). In a first mode, including insertion / withdrawal and arching (or arching / non-flexion), it may be desirable to use this type of conversion. In some embodiments, it may be preferable to perform these limited, less precise movements in a simpler robotic or semi-autonomous mode rather than in a remote operation mode or avatar mode. In contrast, for movements required in a second mode, which is specialized for performing various surgical procedures, controlled displacement-to-displacement conversion may be more suitable. The displacement of an input device or the control element of an input device is suitably converted to the displacement of an arm segment, and indirectly to the rotation and flexion of the joints. For example, in the second mode, it may be desirable that the joint movement of an articulated input device corresponds to the surgical arm in an inward orientation (i.e., orientation between segments) so that the displacement-to-displacement conversion is more intuitive, ergonomic, and accurate.

[0105] In the first mode, it may be desirable to restrict the movement of the arm to the flexion and / or rotation of one given arm joint of the arm (or each arm). This can preferably be implemented by configuring the surgical system to receive inputs from the input device used in the first mode that directly address the flexion and rotation of a specific arm joint, such as the joint of one given arm that is permitted to be operated (in the first mode of operation). In other words, the user is "controlling" the arm joint itself via the input device and appropriate control circuits. In this case, the movement intended to be operated is specifically the flexion and / or rotation of the arm joint. Regardless of whether the actual arm movement is performed semi-automatically in response to the user's control input, the user is aware that they are controlling the operation of the joint. The accompanying displacement and change of direction of the end effector are presumably the intended result of the joint control.

[0106] In contrast, in the second mode, particularly in embodiments where the input device employed in the second mode is avatar-like and the displacement of the input arm is converted to the displacement of the surgical arm, it may be desirable for the surgical system to receive and process inputs that directly address the displacement of the arm segment. The flexion and rotation of the arm joints are then indirectly addressed by the surgical system by controlling the arm joints to flex and rotate to the extent necessary to achieve the required displacement and rotation of the arm segment. In other words, the user "controls" the displacement and rotation of the arm segment (or, for the purposes of this discussion, an end effector that plays a similar role to any arm segment in that its position and orientation are to be controlled by the user). The control circuit of the surgical system uses this information to determine the required flexion and rotation of each affected arm joint. In one embodiment, the user can manipulate the avatar-like input arm to a shape or configuration that predicts or drives the intended shape after the operation of the surgical arm.

[0107] In an exemplary first mode of operation, the movement of the surgical arm can be limited or restricted at least partially, eliminating certain types of movement while allowing others. For clarity, “movement” of the arm may include, for example, the displacement and / or repositioning of any part of the arm, such as one or more segment members of the arm.

[0108] As used herein, the terms “elbow joint,” “wrist joint,” and “shoulder joint” refer to specific joints of a mechanical arm in a particular implementation in which the arm has three movable joints. In such cases, the joint closest to the distal end effector is known as the “wrist joint,” the middle of the three joints is known as the “elbow joint,” and the most proximal joint is known as the “shoulder joint.” In some embodiments, the wrist joint is limited to rotation only, i.e., not configured to flex. Various joints are shown in Figure 3A and described later herein.

[0109] In the case of arm joints (i.e., multiple joints in one arm), unless otherwise specified, the term “joint” as used in this disclosure and the appended claims means any actuated member that can bend (e.g., planar bend) and / or rotate. It should also be noted that articulated / avatar-like input arms (a type of input device) can also have joints, and these refer to the “jointed members” of the input device. Typically, an arm segment is an actuated (with respect to bending / rotation) member of an arm that can be joined in series by an actuated arm joint. Here, the term “joined in series” means only that the joint is interposed between two consecutive segment members. It is possible to actuate the joint, for example, mechanically and / or electronically, to cause bending of one arm segment (and any part of the arm distal thereto) relative to a base arm segment (2181 in Figure 3A) or another (adjacent) arm segment, and / or rotation of one arm segment (and any part of the arm distal thereto) relative to the base arm segment or another arm segment. In some embodiments, the joint comprises multiple components. In some examples, a joint may include both a flexion-facing component (or subassembly) and a rotation-facing component (or subassembly). For ease of reading, in this specification, such a combination of components will be referred to as a joint or arm joint.

[0110] In embodiments, the movement of the arm may be restricted according to the type of joint movement (e.g., rotation or flexion), the speed of movement, and which parts of the surgical arm can move. During the first mode of operation, the movement of the surgical arm may be restricted to the movement of a given single arm joint (only the elbow joint) (e.g., including flexion and / or rotation of the elbow joint) and the linear movement of the surgical arm as a single unit (e.g., including linear forward and backward movement of the arm). It may be desirable to restrict the movement of the arm during the first mode of operation in order to easily introduce the surgical arm into the target surgical site with minimal volume through a narrow path.

[0111] Furthermore, it may be desirable to restrict the movement of the arm during the first mode of operation in order to bend the arm with minimal volume, so as to avoid the possibility of collision and tissue damage within the human body. Figure 3A is a simplified schematic side view of a surgical mechanical arm 102 in various configurations described herein for illustrative purposes. The dashed line 2177 represents an obstacle, such as patient tissue. It is preferable to control the movement of the arm 102 when bending so that the arm 102 (and in particular the end effector 174) does not come into contact with or collide with the obstacle 2177. Figure 3 shows three scenarios labeled A, B, and C, respectively. The arm 102 comprises a proximal segment 2181 and a distal bendable section 170. The bendable section 2179 has a shoulder joint 2101 and an elbow joint 2103. These are variously labeled as 2101a, 2101bc, 2103a, 2103b, and 2103c to indicate which of one or more scenarios (A, B, or C) the joint example relates to. For example, joint 2103a is the position of the elbow joint in scenario A. Thus, scenario A involves bending only the elbow joint 2103a (the shoulder joint 2101a is not actuated and remains unable to bend). In particular, it can be seen that no collision occurs between the end effector 174 and the obstacle 2177 when bending only the elbow joint 2103a. On the other hand, in scenario B, where only the shoulder joint 2101b is bent, a collision occurs between the end effector 174 and the obstacle 2177. The difference in collision / non-collision results between scenarios A and B is due to the fact that the length of the arm 102 from the elbow joint 2103 to the distal portion is shorter than the length of the arm from the shoulder joint 2101 to the distal portion. The wrist joint 2105 of arm 102 in Figure 3A is designed or configured to rotate but not flex, and therefore, in the non-limiting example of Figure 3A, it is not involved in any of the three scenarios. In scenario C, which is a continuation of scenario A, it is found that flexing the shoulder joint 2101c after flexing the elbow joint 2103a (here 2103c) allows for a continuous and smooth avoidance of a collision between the end effector 174 and the obstacle 2177.

[0112] Figure 3B shows examples of the elbow joint 2103 flexing from a non-flexed position to various orientations (post-flexion orientations ranging from less than 90° to more than 180°) relative to the proximal arm base segment 2181.

[0113] In some embodiments, the range of motion of the elbow joint is >90°, >120°, >140°, >160°, >180°, >190°, >200°, or approximately 210°±10°. In some embodiments, the end effector 174 can be positioned at >90°, >120°, >140°, >160°, >180°, >190°, >200°, or approximately 210°±10° relative to the base 2181 of the arm 102. In some embodiments, the end effector 174 can be parallel to the base 2181 of the arm 102 when fully flexed, or instead reach the base 2181 of the arm 102. Furthermore, the range of motion of the elbow rotation joint is at least 200°, at least 250°, at least 300°, at least 310°, at least 320°, at least 330°, at least 350°, or approximately 360°. Figure 3C shows the arm 102 rotated from the non-flexed orientation shown in Figure 3B to bring the arm 102 into a bent configuration or equivalent bent position, and the end effector 174 into a bent position, with the elbow joint 2103 in a state of over-flexion of 180°.

[0114] In some embodiments, the arching of a surgical arm can be performed automatically. That is, it can be done automatically by flexing and / or rotating one arm joint until the arm and / or end effector at the distal end of the arm reaches a pre-programmed arched position, thereby positioning the arm in response to one or a limited number of electronically controlled outputs.

[0115] Figure 4 shows a front view of the arm 102 after the elbow joint 2103 has been flexed and then rotated, similar to the elbow joint 2103a in Scenario A of Figure 3B. That is, in Figure 4, both flexion and rotation are performed on the elbow joint 2103. Rotation of any arm joint can be performed independently of flexion of the same arm joint. In some embodiments, flexion and rotation can be performed simultaneously. In other embodiments, they may be forced to be non-simultaneous, for example, due to constraints of the hardware design or the software components of the control circuit that governs the operation of the joint.

[0116] Figure 5 shows a front view of the arm 102, with the elbow joint 2103 flexed and rotated, and the shoulder joint 2101 flexed together with the elbow joint 2103 to form a complex "S" shape, similar to Figure 4. In some embodiments, such as scenario C in Figure 3B, it is preferable that the flexion of the elbow joint 2103 is activated so that the shoulder joint 2101 flexes and rotates only after the flexion of the elbow joint 2103 has "cleared" (avoided collision with) the obstacle 2177.

[0117] Next, with reference to Figure 6, a flowchart of a general method for controlling a surgical machine arm using various operating modes, according to several embodiments, is shown.

[0118] The processes described herein can be implemented for various types of surgery that involve at least partially using one or more surgical mechanical arms inserted into the patient's body, such as gynecological surgery, laparoscopic surgery, and otolaryngological surgery.

[0119] As previously stated herein, the surgical mechanical arm can operate according to multiple operating modes. Optionally, the operating mode can be selected according to the surgical step to be performed and / or according to the current stage of the surgical procedure.

[0120] Various operating modes can be characterized by various methods (movement of the input device or its control elements) that translate user input (by operating a user input device) into each movement of the surgical machine arm. Alternatively, various operating modes can be characterized by various constraints on the joint movement of the surgical arm (e.g., constraints on the joint movement (e.g., flexion) of one or more surgical arm joints, constraints on the range of motion, or constraints on the joint movement of the arm to selected degrees of freedom). Alternatively, various operating modes can be characterized by various types of feedback to the user (e.g., feedback perceived by a user controlling the surgical arm via one or more input devices).

[0121] In some embodiments, the selection and / or switching between operating modes is controlled by a user, such as a surgeon. Optionally, the selection of operating modes can be performed via the system's user interface, for example, via a touchscreen and / or another input device, or via buttons or other input devices located on or near a control console or display screen. Alternatively, the selection of operating modes can be performed automatically, for example, by an appropriate control circuit such as a system controller or processor. In some embodiments, the selection and / or switching of operating modes is triggered and / or contingent upon (but not exhaustive) one or more of the following: Identifying the current “anatomical” position of the surgical arm or the end effector of the arm (for example, by using electromechanical instruments such as encoders or other sensors (not shown) associated with the arm's actuators and / or motors (e.g., 104 or 108), or by accessing and analyzing images of arm 102 obtained by a camera (through imaging processing or vision)). Identifying the current location of the input device. The execution of certain joint movements of a surgical arm. Receiving indications from one or more position sensors of a surgical arm. Timed display (for example, by specifying the point in time when the operating mode will change).

[0122] The flowchart in Figure 6 illustrates how a surgical machine arm operates using two operating modes, according to several embodiments.

[0123] The methods include the following:

[0124] Step S01: In the first operating mode, one or more surgical arms are inserted and guided to a predetermined position.

[0125] In the first operating mode, the surgical arm is introduced into the body and guided to a selected anatomical position and / or a selected arm position. The surgical arm may be introduced into the body through a natural body opening (e.g., vagina, anus, trachea, esophagus, external auditory canal) and / or through an incision.

[0126] In some embodiments, the joint movement of the arm is restricted in a first mode of operation. For example, the joint movement (flexion and rotation) of one or more arm joints may be restricted or eliminated. In one example, the arm has three joints: a shoulder joint, an elbow joint, and a wrist joint that rotates but does not flex, and the joint movement of one or two of these joints is restricted. In a specific example, only movement of the elbow joint (e.g., flexion, extension, and / or rotation of the elbow joint) is possible, while movement of the shoulder and wrist joints is restricted.

[0127] Furthermore, during the first operating mode, the entire arm can also be enabled to perform linear movements (including only linear movements), such as moving forward or backward in a one-dimensional manner.

[0128] In some embodiments, the constraint on the arm's movement is performed mechanically, for example, by one or more locks (e.g., solenoid locks) that affect the operation of the arm joints. Alternatively, the constraint on the arm's movement can be performed by applicable circuitry, for example, by implementing software control functions that limit the range and / or type of movement.

[0129] In some embodiments, the steps of limiting the range of motion of the arm and / or restricting certain movements are performed in accordance with the current position of the arm, such as indicated by one or more position sensors on the arm. In some embodiments, the steps of limiting the range of motion of the arm and / or restricting certain movements are performed in accordance with the current anatomical position of the arm, such as visualized by optical means (e.g., a camera optionally introduced into the body along with the surgical arm).

[0130] Step S02: In the first operating mode, one or more surgical arms are articulated to their base positions.

[0131] Furthermore, in the first operating mode, one or more surgical arms are articulated to a base position. In some embodiments, the base position includes, for example, the bent position of the arm when it is bent at at least 120 degrees, at least 150 degrees, at least 180 degrees, or an intermediate angle, a larger angle, or a smaller angle. In some embodiments, the base position positions the arm so that the user can perform the surgical procedure from a selected orientation that may be more comfortable or familiar to the user (e.g., an orientation corresponding to the abdominal orientation).

[0132] In some embodiments, the robot has control over the movement of the surgical arm in a first operating mode. Optionally, in the first operating mode, user operation of an input device includes only a limited type of user movement (e.g., limited movement of the input device along a defined axis and / or pressing a button). In one example, the step of moving the input device along a first defined axis activates rotation of a selected arm joint (e.g., elbow), the step of moving the input device along a second defined axis activates flexion of a selected arm joint (e.g., elbow), and the step of pressing one or more buttons activates linear forward or backward movement of the surgical arm.

[0133] In some embodiments, in a first operating mode, user operation of an input device is converted into the movement speed of the surgical arm. For example, when the user moves the input device relative to its stationary position, the relative movement speed of the surgical arm is set by the range by which the input device has been moved relative to its stationary position.

[0134] Step S03: The system transitions to a second operating mode and performs a surgical procedure using one or more surgical arms.

[0135] In the second operating mode, the user performs surgical actions via the surgical arm, such as grasping, dissecting, moving, and suturing tissue. In some embodiments, the second operating mode is initiated at the end of step S02 when the arm is moved to a selected base position (e.g., a bent position).

[0136] In some embodiments, the user switches input devices when transitioning from a first operating mode to a second operating mode. Alternatively, the user uses the same input device in both the first operating mode or inductive operating mode and the second operating mode or surgical operating mode.

[0137] In some embodiments, the movement of the surgical arm in the second mode of operation is not as restricted as in the first mode of operation. For example, all arm joints (shoulder, elbow, wrist) are capable of joint movement (e.g., flexion and / or rotation). In some embodiments, the range and / or speed of arm movement during the second mode of operation is limited based on safety precautions, for example, to avoid moving at speeds that are too fast or speeds that pose a risk of injury to surrounding tissues.

[0138] In some embodiments, control of the surgical arm in the second operating mode includes remote control. Optionally, each displacement of the surgical arm mimics the displacement of a user-input device. Optionally, the speed of displacement of the user-input device is reflected in the movement speed of each surgical arm.

[0139] Step S04: Transition to the first operating mode (return) and withdraw one or more surgical arms from the body.

[0140] According to some embodiments, after completing a surgical procedure, the arm is optionally retracted outward from the patient's body. In some embodiments, the retraction is performed in a first operating mode. Optionally, the arm is straightened before and / or during retraction.

[0141] Withdrawal in the first mode of operation may be advantageous because it limits the range and / or type of arm movement, thereby reducing the possibility of damage to the tissues surrounding the anatomical passage (e.g., the vagina) from which the arm is withdrawn.

[0142] Referring now to Figure 7, the control console 118 may include a display screen 407 and an input device 405 located adjacent to it, that is, in the non-limiting example of Figure 7, facing the side of the screen 407.

[0143] Each input device 405 (in the form of a "thumbstick") has a nipple-shaped controller 409 suitable for operation by the user's thumb. In embodiments, the range of movement of the nipple 409 relative to a central resting position can be converted into the movement speed of a selected surgical arm, as previously described herein. In one example, the further the nipple 409 is pushed from this central resting position, the faster the resulting movement speed of the surgical arm. In another example, the greater the force applied to the nipple 409, the faster the resulting movement speed of the surgical arm.

[0144] In some embodiments, when controlling the surgical arm via the thumbstick 405, the movement of one or more joints of the surgical arm (e.g., shoulder joint, wrist joint) is restricted, and only flexion and / or rotation of the elbow joint is enabled. In some embodiments, linear movement of the surgical arm (as a single body) is also enabled, for example, to advance or retract the arm. In some embodiments, the movement of the nipple 409 acts to flex and / or rotate the elbow joint. In some embodiments, the linear movement of the arm 102 is actuated by separate actuators. For example, in the illustrated example of Figure 7, it is actuated using another pair of input devices, such as input devices 406, 408, which are implemented as push buttons located on the body of the input device (thumbstick assembly) 405 itself. In other examples, the push buttons 406, 408 can be provided independently or on (or closer to) the display screen 407. In one example, button 406 advances the surgical arm distally (e.g., towards the abdomen), and button 408 retracts the surgical arm proximally. In this embodiment, since linear motion does not require either bending or rotation, input devices 406, 408 may be used during the first mode, which eliminates bending and rotation of arm joints other than the elbow joint.

[0145] In some embodiments, while the thumbstick 405 is in use, other input devices, such as an avatar input arm 411, provided for use in a second mode that is not restricted by any first mode, are locked in a stationary position, for example, by a solenoid lock. In some embodiments, the stationary position of the input arm 411 is selected as the bent position of the surgical arm 102, so that when the surgical arm 102 is bent (for example using the thumbstick), the user can pick up the avatar input arm 411 and continue the procedure. In some embodiments, when the avatar input arm 411 is activated during the second mode, the operation of the thumbstick is disabled.

[0146] In some embodiments, the surgical arm 102 is straight, i.e., unbent, during insertion into the patient 106's body. In some cases, it is inserted via a cannula. Simultaneously, the avatar input arm is in a stationary position, which can be a locked position and an arched position. Optionally, after arching the surgical arm using the thumbstick 405, the surgeon can release the thumbstick 405 and move their hand to the avatar input arm 411. Once the surgeon grasps the avatar input arm 411 and optionally lifts it, control over the surgical arm 102 may be automatically switched or transferred from the first user input device 405 to the second user input device 411, allowing the surgeon to continue the procedure using the avatar input arm 411.

[0147] In some embodiments, when one or more avatar input arm joints are locked by a solenoid lock, the solenoid lock is automatically released when the surgeon lifts the avatar input arm. Alternatively, manual locking of the avatar input arm joints is released, for example, via a sensor that detects the position of the avatar input arm.

[0148] In some embodiments, the system (e.g., a system processor) is configured to recognize the position of one or more input devices (e.g., the current position of a thumbstick and / or the current position of an avatar input arm) and optionally present the positions on a user interface screen. In some embodiments, position determination is assisted by the use of position sensors.

[0149] Figure 8 shows an image of an example of a thumb-operated input device 501 comprising a gripping handle 503 and optionally a textured surface that facilitates gripping, such as a surface with ridges 505. One or more control buttons 507 can be positioned along the gripping handle 503. For example, the thumbstick input device 501 in Figure 8 comprises two control buttons 507 (one for operating the distal linear advancement of the surgical arm and the other for operating the proximal linear retraction of the arm).

[0150] In some embodiments, the thumbstick 501 includes a nipple 509 extending, for example, from the proximal end of a gripping handle 503. In some embodiments, the nipple 509 is shaped and / or sized to suit the user's thumb. In some embodiments, the nipple 509 has a rounded shape. In some embodiments, the proximal surface of the nipple 509 is formed by a plurality of projections 511 arranged circumferentially. The circumferential projections help to maintain the thumb in a position on the nipple 509 and can potentially prevent or reduce the thumb sliding away from the nipple 509.

[0151] In some embodiments, the nipple 509 moves with spring-like behavior. Optionally, after pushing the nipple 509 away from this initial resting position (for example, the central position where the nipple 509 is aligned with the long axis 513 of the thumbstick), the nipple springs back to this central position.

[0152] Figure 9 is a schematic diagram showing an example of the control of the thumb-operated input 501 according to several embodiments. In some embodiments, moving ("displacing") the nipple 509 relative to a first axis activates the movement (e.g., bending) of a first type of surgical arm, and displacing the nipple 509 relative to a second axis activates the movement (e.g., rotation) of a second type of surgical arm.

[0153] In some embodiments, the thumbstick 501 is used during a first mode of operation in which at least a portion of the joints (e.g., the shoulder joint 2101 and the wrist joint 2105) are restricted. Optionally, displacing the nipple 509 along the Y-axis causes flexion of the elbow joint 2103 of the surgical arm 102, and displacing the nipple 509 along the X-axis causes rotation of the elbow joint. In some embodiments, simultaneous bending and rotation can be achieved by pressing the nipple relative to both axes (e.g., diagonally with respect to the center).

[0154] Next, referring to Figures 10 and 11, side and front views are shown of an exemplary avatar-like input arm 701, which includes multiple joints for operating the movement of each of the surgical arm joints. As shown, the joints include a shoulder joint 703, an elbow joint 705, and a wrist rotation knob 707 for controlling the wrist joint 2105 of the surgical arm 102.

[0155] In some embodiments, the avatar input arm may be equipped with additional input devices such as buttons or levers 709. These input devices can control the operation of surgical tools on the surgical arm 102 (such as end effector 174).

[0156] Other input devices positioned on the exemplary input arm 701 in Figures 10-11 include pause-resume buttons 711 and 713, 715, respectively, for activating linear forward and backward movement of the arm 102. The user can activate linear forward and / or backward movement using buttons 713, 715 on the avatar input arm and / or buttons 406, 408 positioned on the thumbstick 405. Alternatively, linear movement of the arm can be activated via a screen interface on the control console (e.g., via a touchscreen interface).

[0157] In some embodiments, a pair of avatar input arms are provided for controlling the left arm and the right arm, respectively. For example, the first avatar input arm 701 can control a first motor unit 108 associated with the first surgical arm 102 (e.g., the "right" arm), and the second avatar input arm 701 can control a second motor unit 108 associated with the second surgical arm 102 (e.g., the "left" arm). In some embodiments, any or all of the input arms 120, 411, and 701 may be the same.

[0158] Refer to Figures 12A and 12B. In the embodiment, alignment is performed between an input device, such as an avatar input arm, and the current position of the surgical machine arm. In one example, alignment is performed when the user switches between different input devices (for example, when switching from thumb-operated input to an avatar input arm). In another example, alignment of the input device with the surgical arm position is performed during system initialization, for example, at the start of surgery or before surgery. In yet another example, alignment of the input device with the current position of the surgical machine arm is performed when control is resumed after a pause. Optionally, in pause mode, movement of the input device does not actuate relative movement of the surgical machine arm. When control is resumed, it may be required to adjust the position of the input arm to match the current position of the surgical machine arm in order to continue operation smoothly and uninterrupted.

[0159] In some embodiments, control is resumed automatically or semi-automatically. For example, the user performs a selected joint movement of the input device (e.g., straightening the elbow joint of the avatar input arm) to resume control of the surgical arm.

[0160] In Figures 12A and 12B, the relative position of the input device (i.e., the input arm) is represented using a cross diagram 801. In some embodiments, there are two cross diagrams, one for the shoulder joint and one for the elbow joint. In some embodiments, the cross represents a specific joint of the surgical machine arm (e.g., the shoulder joint, the elbow joint). In some embodiments, each line in the slot represents a different type of joint movement. For example, the horizontal line 803 represents joint rotation, and the vertical line 805 represents joint flexion. During use, the user operates the input device according to the joint position indicated on the cross by two-colored dots 807. As the position of the input device approaches the position of the surgical machine arm (in response to user operation), the colored dot moves towards the center of the cross (see Figure 12B). Optionally, when sufficient alignment is achieved between the position of the input device and the position of the surgical arm, the color of the dot changes from red to green, for example, as shown in Figures 12A-B.

[0161] In embodiments, the control devices shown in Figures 12A and 12B can be used in alignment calibration as part of a transition step from a first mode using a first input device to a second mode using an avatar-like input arm. In these embodiments, the first input device can be used to adjust the position of the surgical arm to align with the fixed position of the input arm.

[0162] Figure 13 shows an example of a screen displayed to the user during alignment according to several embodiments. In the illustrated example, the first input device (corresponding to the right avatar arm) is shown to be properly aligned with the first surgical arm, as indicated by check marks 809 and / or locked locks 811 at both the elbow and shoulder joints, for example. The second input device (corresponding to the left arm) is shown to be in a position not yet aligned with the surgical arm. This joint position is represented by two cross-shaped diagrams, as described above herein, for example, and the locks are unlocked.

[0163] In some embodiments, certain joint movements and / or functions are disabled during alignment. For example, the speed of a surgical arm is limited, the function of electrosurgery is disabled, and / or other functions are disabled.

[0164] Figures 14A–E are a series of images illustrating exemplary control of a surgical machine arm using multiple different input devices according to several embodiments. In the non-limiting examples of Figures 14A–E, two arms are shown, while in other examples, there may be a single arm or two or more arms.

[0165] Figure 14A shows the control of two surgical mechanical arms 901 during the introduction of the arms into Model 903, which simulates access to the body through the vagina, according to one embodiment. In this example, the control of the surgical arms 901 during the advancement of the arms into the body (e.g., through the vaginal canal) is performed via thumb-operated inputs, including, for example, a pair of thumbsticks 905, as described herein.

[0166] Figure 14B illustrates the manipulation of the surgical arm to the bent position via the thumbstick 905. In the illustrated example, the arm is bent to the bent position (e.g., at 120, 150, 180, 210 degrees or intermediate angles, larger or smaller angles).

[0167] Figure 14C shows the surgical arm in the bent position. In some examples, after bending, the user can switch input devices by, for example, releasing the thumbstick and picking up the avatar input arm. At this point, alignment of the avatar input arm and the surgical arm with their current positions can be performed, for example, as described in Figures 12A-B and 13.

[0168] Figures 14D and 14E show the operation of a surgical arm using a pair of avatar input arms 907 according to several embodiments. It can be seen that the position of each surgical arm corresponds to the position of the input arm.

[0169] The block diagram in Figure 15 shows a multi-joint arm 102, an input device array 1500, and a detector 1520. Those skilled in the art will understand that not all elements shown in Figure 15 are required in all embodiments. The input device array 1500 shown in Figure 15 shows two user input devices 1510A (e.g., a thumbstick 501) and 1510B (e.g., a joystick 701), but those skilled in the art will understand that in different embodiments, fewer or more user input devices may be provided. In one example, the joystick 701 can be both the first user input device 1510A and the second user input device 1510B. In other words, the first user input device 1510A and the second user input device 1510B can be the same single user input device. In implementations where the first user input device 1510A and the second user input device 1510B are the same single user input device, it is typically a more versatile or flexible device, such as the joystick 701. The term "user input device" refers to a device for converting input received from a user into electronic output and / or signals. Examples of user input devices include, but are not limited to, joysticks, touchscreens, thumbsticks, mice, keyboards, and gesture detection devices (including, for example, cameras [not shown]). Unless otherwise specified, the term "array" refers to one or more items.

[0170] As shown in the example in Figure 15, the articulated arm 102 has one or more objects 1530 attached to its distal end. The one or more objects 1530 may be provided with the arm 102 or may be added or replaced separately. Examples of such objects 1530 include, but are not limited to, end effectors, such as surgical end effectors. Relevant surgical tools may include (but are not exhaustive): End-effector tools for surgical procedures, such as endoscopes for diagnostic / surgical feedback, needle holders (e.g., large needle holders, curved needle holders), monopolar and bipolar instruments (e.g., monopolar scissors, bipolar forceps), clip applicators (e.g., large clip applicators, medium clip applicators), vascular sealers, grapplers or dissecting forceps (e.g., Maryland dissecting forceps, support hook forceps, micro forceps, long-tip forceps, retractors, Fundus grapplers, Crocodile grapplers, Cadier forceps), scissors (e.g., Potts scissors, curved scissors), hooks (e.g., cauterization hooks), and spatulas (e.g., cauterization spatulas).

[0171] As discussed elsewhere, in some embodiments, the arm 102 and / or one or more objects 1530 operate in response to one or more electronic control outputs of one or more control devices. The terms “control output” and “control signal” are used synonymously. In different embodiments, the control outputs may be transmitted to the arm 102 and / or the arm’s controller via wired and / or wireless communication.

[0172] Also shown in Figure 15 is the detector 1520. As discussed elsewhere, in some embodiments, the mode transition from a first operating mode to a second operating mode of the surgical system 999 is in response to and / or dependent on the output of the detector 1520. The surgical system 999 may be functionally equivalent to the surgical system 100 shown in Figure 1. In one non-limiting example, the detector 1520 detects whether a portion of the arm 102 (e.g., the distal portion) is bent back and / or in a bent position. In one example, a camera may acquire an image of the arm 102, and the detector 1520 may detect the position by the camera and imaging processing circuitry. In another example, an encoder (not shown) or other electromechanical sensor (e.g., a sensor of 104 or 108) may be used for monitoring and detection to track, for example, the orientation of one or more joints of the arm 102. Other examples may relate to position detection based on, for example, triangulation (e.g., time of flight) using one or more magnetic detectors, or capacitive detectors, or ultrasound and / or light.

[0173] As used in this disclosure and the claims attached herein, “monitoring” and “detection” refer to actions (and / or functions, and / or potential actions and / or capabilities) that may be performed by one or more components of a surgical system, by one or more users, or by any combination of system components and human users. The descriptive language used herein with respect to automated monitoring or machine monitoring or detection is intended to be non-limiting, and in any such embodiment, user intervention may be part of the design and / or operation. In some embodiments, user intervention is required for safety reasons. In one non-limiting example, one or more sensors relay information about a surgical arm or one of its components to a display screen, and the user is trained and / or positioned to monitor and detect the curved shape of the arm, with or without automated or semi-automated visual assistance, when the arm is in a desired position and orientation (e.g., when bent back at the surgical procedure site). In another, less restrictive example, monitoring and / or detection are communicated to the user in non-visual ways (though not exhaustive, such as by audible announcements, haptic feedback, or by locking control or input devices). Of course, any of these types of communication can also be combined with visual information.

[0174] Furthermore, those skilled in the art will understand that additional elements may be provided to the surgical system 999, and that not all components of all elements shown in Figure 15 are required in all embodiments.

[0175] Refer to Figure 16 here. In step S101, the surgical system 999 operates in a first operating mode. In step S121, the surgical system 999 operates in a second operating mode. As discussed elsewhere, in different embodiments, the first operating mode and / or the second operating mode may relate to one or more specific performance and / or specific limitations of an input device. Alternatively or further, the first operating mode and / or the second operating mode may relate to one or more specific performance and / or specific limitations of an element of the arm 102 and / or object 1530. Examples of such elements include joints and articular musculoskeletons. Alternatively or further, the first operating mode and / or the second operating mode may relate to the relationship between the operation of one or more input devices 1510 and the arm 102 or this one or more component (e.g., whether the configuration of the input device 1510 or this component is translated into velocity or position of the arm 102 or this component).

[0176] While the surgical system 999 is operating in the first mode in step S101, one or more operations are performed. In one example, when the surgical system is operating in the first mode, the distal portion of the arm 102 is bent back and may start from an unbent position and / or a straight position, but this is not necessarily required. In another example, when the surgical system 999 is operating in the first mode, the distal portion of the arm 102 is brought into a position where this curved shape (e.g., a 3D curved shape or this planar projection) matches a predetermined curved shape (e.g., a bent shape or an "S" curved shape, which may be useful for initiating surgery).

[0177] Step S109 relates to monitoring and can be performed simultaneously with step S101. For example, step S109 can be performed at least partially by the detector 1520. In some embodiments, the monitoring in step S109 may include determining whether the arm is in the bent position.

[0178] Step S113 relates to a mode transition trigger event, i.e., a detectable event that causes the surgical system 999 to transition from the first mode of step S101 to the second mode of step S121. An example of step S113 is as follows: In response to, and conditioned upon, detection by, for example, detector 1520, that arm 102 is in a bent position, i.e., that arm 102 has transitioned from a non-bent position to a bent position, the surgical system 999 transitions from the first operating mode to the second operating mode. As described herein, the transition may include alignment calibration of the surgical arm 102 with the input arm 701.

[0179] The transition to step S117 may be triggered, for example, by detecting that the arm 102 has bent or that the end effector 1530 is in a bent position, and / or in response to and / or as a condition thereof.

[0180] Next, some embodiments of Figure 16 will be described. Those skilled in the art will understand that these embodiments do not need to be mutually exclusive (embodiments or combinations of these features may be used). In some embodiments, not all of the features and / or method steps are necessary.

[0181] First Embodiment as shown in Figure 16

[0182] The first embodiment relates to a method of operating a surgical system, the surgical system comprising the following: (i) An input device array of one or more user input devices. (ii) A multi-jointed mechanical arm comprising a surgical end effector at the distal end of the arm and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from the user input device. The method includes the following steps: (a) A step to initiate the operation of the surgical system in a first mode of operation S101 defined with respect to a given joint of an arm (e.g., elbow 2103). The first mode excludes the operation of any arm joint of the arm other than the given arm joint (e.g., including shoulder 2101) and allows control of the operation of the one arm joint (e.g., elbow 2103) to cause flexion and rotation of the joint of that arm (e.g., elbow 2103). (b) While the surgical system is in a first operating mode (e.g., S101), (i) in response to a control signal generated by one or more user input devices (e.g., thumbstick 501), the distal end of the arm is bent backward by flexion and rotation of one arm joint (e.g., elbow 2103) to bring the end effector 174 into a bent backward position; and (ii) the state of the mechanical arm 102 is monitored (e.g., S109) to detect whether the arm is in a bent backward position. (c) In response to and conditional upon detection that arm 102 is in the bent position (step S113), the surgical system is moved from the first mode to the second mode (e.g., a "YES" branch from S113 to S121). In the second mode, the system is able to control the flexion and rotation of at least one arm joint (e.g., elbow 2103) that was excluded in the first mode, according to the respective degrees of freedom of each arm joint. (d) A step in which the surgical system operates in a second mode (e.g., in S121) to perform a surgical procedure using an end effector.

[0183] Figure 16 shows the second embodiment.

[0184] The surgical system includes the following: (i) A first user input device 1510A (e.g., a thumbstick 501) and a second user input device 1510B (e.g., a joystick 701). (ii) A multi-jointed mechanical arm 102 having multiple arm joints (e.g., elbow 2103 and shoulder 2101), and a surgical end effector 174 at the distal end of the arm. The operation of the surgical system includes the following steps: (a) A step to initiate the operation of the surgical system in a bend-over mode (e.g., the first mode of S101). With respect to flexion and rotation of the arm joint, (i) a first user input device 1510A (e.g., a thumbstick 501) is active to instruct flexion and rotation of only a given joint of the arm joint, and (ii) a second user input device 1510B (e.g., a joystick 701) is disabled. (b) While in the arching mode, the distal portion of the articulated mechanical arm is arched in response to an electronically controlled output from a first user input device 1510A by flexing and rotating a predetermined joint of the arm joint (e.g., the elbow 2013) to bring the end effector to the arching position. (c) Step of transitioning the surgical system from the arching mode to the surgical operation mode in order to enable a second user input device 1510B with respect to the flexion and rotation of at least one of the arm joints of the arm other than a given joint of the arm (e.g., elbow 2103) (e.g., shoulder 2101). (d) While in surgical operation mode, in response to an electronically controlled output from a second user input device 1510B, flex and rotate at least two of the arm joints (e.g., the shoulder and elbow) according to the respective degrees of freedom of each arm joint. This moves the surgical end effector and performs one or more surgical operations.

[0185] Third Embodiment as shown in Figure 16

[0186] The surgical system includes the following: (i) An input device array 1500 of one or more user input devices. (ii) A multi-jointed mechanical arm 102 including multiple arm joints (e.g., shoulder 2101 and elbow 2103), and a surgical end effector 1764 at the distal end of the arm. The operation method of the surgical system includes the following: (a) Steps to initiate operation of the surgical system in the arching mode (e.g., S101). With respect to flexion and rotation of the arm joint, the input device array is activated to instruct flexion and rotation of only a given joint of the arm joint (e.g., elbow 2103). (b) While in the arching mode, the distal portion of the articulated mechanical arm is arched by flexion and rotation of a given joint of the arm joint in response to an electronically controlled output from an input device array, so as to bring the end effector to the arching position. (c) A step of transitioning the surgical system from the arching mode to the surgical operation mode in order to enable the input device array with respect to the flexion and rotation of the arm joints other than the given joint among the arm joints. (d) During the surgical operation mode, in response to an electronically controlled output from the input device array, the step of effectively flexing and rotating at least two of the arm joints (e.g., at least both the elbow 2013 and the shoulder 2101) according to the respective degrees of freedom of each arm joint. This moves the surgical end effector to perform one or more surgical actions.

[0187] Figure 16 shows the fourth embodiment.

[0188] The surgical system includes the following: (i) User input device (e.g., joystick 701). (ii) A multi-jointed mechanical arm 102 having multiple arm joints, and a surgical end effector located at the distal end of the arm. The operation of the surgical system includes the following steps: (a) Steps to initiate the operation of the surgical system in the arching mode (e.g., S101). With respect to the flexion and rotation of the arm joints, a user input device is activated to instruct only the flexion and rotation of a given joint of the arm (e.g., the elbow). (b) While in the arched mode, the distal portion of the articulated mechanical arm is arched by flexion and rotation of a given joint of the arm joint in response to an electronically controlled output from a user input device, so as to bring the end effector to the arched position. (c) A step of transitioning the surgical system from the arching mode to the surgical operation mode (e.g., 121) in order to enable a user input device with respect to flexing and rotating at least one of the arm joints of the arm other than a given joint of the arm joint. (d) During the surgical operation mode, in response to an electronically controlled output from a user input device, the step of effectively flexing and rotating at least two of the arm joints according to the respective degrees of freedom of each arm joint, thereby moving the surgical end effector to perform one or more surgical operations.

[0189] Fifth embodiment shown in Figure 16

[0190] A method using a surgical system, the method comprising the following steps: (a) Providing a multi-joint mechanical arm capable of displacing a surgical end effector 174 at the distal end of the arm. The arm comprises multiple arm segments connected (e.g., in series) by a plurality of corresponding arm joints (e.g., elbow and shoulder). The arm joints are configured to flex and rotate in response to electronically controlled outputs from a user input device. (b) The step of maneuvering the end effector to the bent position while operating in the first input mode. In the first input mode, the displacement of the input device (e.g., a thumbstick, etc.) or the displaceable part thereof is converted into the flexion speed and / or rotation speed of the arm joint. (c) In response to and conditioned upon detection that the end effector is in a bent-over position, the step of transitioning from operation in a first input mode to operation in a second input mode. In the second input mode, the displacement of an input device (e.g., 1510B such as a joystick) or a displaceable portion thereof is converted into a corresponding displacement of at least one arm segment. (d) After the transition step, the step of performing a surgical procedure using the end effector while operating in the second input mode.

[0191] A specific embodiment of Figure 16 relating to Figures 22A-C.

[0192] (A) The surgical system includes (i) a given user input device (e.g., a multi-joint user input arm and / or a flexible user input arm, e.g., a joystick 701), and (ii) A multi-joint mechanical arm 102 comprising a surgical end effector 174 at the distal end of the arm and a plurality of arm joints (e.g., shoulder 2101 and elbow 2103). The plurality of arm joints are configured to flex and rotate (e.g., in at least one operating mode of the surgical system) in response to electronically controlled output from a given user input device 1510B (e.g., joystick 701) (e.g., multi-joint and / or flexible) (e.g., and optionally, also in response to output from an additional user input device 1510A (e.g., thumbstick 501) which is another user input device other than the given user input device). The operating method of the surgical system is: a. Steps for initiating the operation of the surgical system in a first operating mode (for example, the movement of the arm is not controlled by and / or is insensitive to the output of a given user input device 1510b), b. While the surgical system is in a first operating mode (e.g., step S101), (i) modify the curve shape of the articulated mechanical arm by mechanized bending and / or rotation of one or more arm joints of the articulated mechanical arm (e.g., starting from 2830 in Figure 22B), and (ii) monitor the shape state of the mechanical arm to detect whether part or all of the arm has a curve shape that matches (e.g., the curves match or their two-dimensional projections match) the currently dominant curve shape (e.g., shape 2810) and / or the stationary curve (e.g., shape 2810) defined by a given (articulated and / or flexible) user input device 1510B. c. A step of transitioning the operation of the surgical system from a first mode (e.g., step S101) to a second mode (e.g., step S121) in response to and conditional on the detection of a positive match (i.e., a "positive" detection means the detection that the curve shape defined by the arm matches the curve shape defined by a given user input device) [i.e., in Figure 22B, 2830 and 2810 do not match, but in Figure 22C they do], and d. The step of operating the surgical system in a second mode (for example, the (e.g., control) output of a given user input device (e.g., 1510B - e.g., joystick) to perform a surgical operation using an end effector in response to the output of a given user input device (e.g., multi-joint and / or flexible), including the step of modifying the configuration of an arm or a section of an arm (e.g., a non-distal section) or an element of an arm (e.g., any joint thereof).

[0193] (B) The surgical system comprises a multi-joint mechanical arm having (i) a user input device (e.g., a multi-joint and / or flexible user input device) (e.g., controlled by a user input device having position control), and (ii) a surgical end effector at the distal end of the arm, and a plurality of arm joints. The plurality of arm joints are configured to bend and rotate (e.g., in at least one operating mode of the surgical system) in response to an electronically controlled output from a given input device (e.g., multi-joint and / or flexible) (e.g., also in response to an output from an additional user input device, which is optionally another input device other than the given user input device). The operating method of the surgical system is: a. Steps for initiating the operation of a surgical system in a first operating mode (for example, the movement of the arm is not controlled by the output of a given user input device and / or is insensitive to the output of a given user input device), b. While the surgical system is in a first operating mode, (i) modify the curved shape of the arm by mechanized bending and / or rotation of one or more arm joints of the articulated mechanical arm; (ii) monitor the shape state of the mechanical arm to detect whether part or all of the arm has a curved shape that matches a predetermined curved shape (e.g., a shape having one or more local minimums or local maximums, a shape having one or more inflection points - e.g., an S-shaped curve) (e.g., the curves match or their two-dimensional projections match). c. A step of transitioning the operation of the surgical system from a first mode to a second mode in response to and conditional on the detection of a positive match, and d. The step of operating a surgical system in a second mode (for example, the output (e.g., control) of a given user input device modifies the configuration of an arm or a section of an arm (e.g., a non-distal section) or an element of an arm (e.g., any joint thereof)) in response to the output of a given user input device (e.g., multi-joint and / or flexible) to perform a surgical operation using an end effector.

[0194] Additional features related to a specific embodiment shown in Figure 16.

[0195] You can provide one or more of the following (for example, any combination):

[0196] (1) The transition step of step c includes the step of handing off user control of the arm configuration from a different user input device (e.g., 1510A - e.g., a thumbstick device) other than the given user input device (e.g., 1510B - e.g., a joystick) to the given user input device (e.g., 1510B - e.g., a joystick).

[0197] (2) The method further comprises the step of controlling the configuration of arm 102 by the output of a user control device (e.g., 1510A - e.g., a thumbstick device) so that, while the surgical system is in a second mode (e.g., step S121), simultaneously with or following thereafter, the magnitude of the displacement of a given input device or the displaceable part thereof is converted into a corresponding displacement of at least a portion of the arm and / or at least one arm segment of the arm.

[0198] (3) The method further includes, simultaneously with or following step (d) (e.g., S121), controlling the configuration of the arm by the output of a user control device (e.g., 1510B - e.g., joystick 701) such that the magnitude of displacement of a given input device or displaceable part specifies (e.g., fully specifies, e.g., commands) a target position of the arm element (i.e., a position different from the currently dominant position) and / or a target configuration of the arm (e.g., a configuration different from the currently dominant configuration).

[0199] (4) The first mode is defined with respect to (i) a suitable subset of multiple arm joints (e.g., only the elbow 2103), (ii) excluding the operation of one or more arm joints of an arm that is not a member of the suitable subset of joints (e.g., the shoulder 2101) by control signals from the multi-joint user input device, and (iii) allowing control of the operation of one or more arm joints belonging to the suitable subset (e.g., the elbow 2103) causing flexion and / or rotation of each arm joint of the suitable subset.

[0200] (5) During the transition step from the first mode to the second mode, the articulated user input device (e.g., 1510B - e.g., joystick 701) is enabled to control the flexion and rotation of at least one arm joint that was excluded in the first mode (e.g., joystick 703 of joystick 701).

[0201] (6) The step of modifying the shape of the arm 102 is performed in response to an electronic control signal provided by a given user input device (e.g., 1510B - e.g., a joystick).

[0202] (7) The step of modifying the shape of the arm is performed in response to an electronic control signal from a user input device other than the given user input device.

[0203] (8) The step of correcting the shape of the arm is performed automatically (e.g., automatic bending).

[0204] (9)(i) In a first mode, the arm shape is controlled by a multi-joint input device or another input device that operates to convert the displacement of the input device or this displaceable part into the flexion and rotational speeds of the arm joints; (ii) In a second mode, the arm shape is controlled by a multi-joint input device that operates to convert the displacement of the multi-joint input device or this displaceable part into the corresponding displacement of at least one arm segment.

[0205] Explanation of Figures 17-21

[0206] In one example, both the first and second modes use the same input device, an avatar-like input arm. As described herein, the input arm is used in a limited mode for bending the arm backward, and at this point (bending point), it transitions to full-fledged use in the second mode. However, at this point, the input arm, or at least the handle member (e.g., the handle member 702 in Figure 10), may be inverted by about 180° or more, depending on the angle of bending used for bending. This means that (a) the handle 702 is in an "upside-down" position, making it difficult for the surgeon to handle, and (b) the coordinate system used in the surgical system is "upside-down". The surgeon's viewpoint switches from looking "distal" to bend the arm backward to looking "proximal" to perform surgery with the arm in the bent position. As a result, the displacement vectors or reversal arcs of the segment members are not translated into corresponding (e.g., parallel) displacement vectors or reversal arcs in the same xyz space.

[0207] Exemplary designs of the input device 701 and handle member 702 are provided for illustrative purposes only, and it should be noted that in other examples and embodiments, the input device and handle member can be designed and implemented in different ways. For example, in some embodiments, the handle member can be physically detached from an input device that is functionally a single component. As another example, in some embodiments, an avatar-like or joystick-like input device consists entirely, almost entirely, or largely of a handle member that is operable and / or grippable by hand. As yet another example, in some embodiments, the handle member can incorporate multiple operating functions into its design by including buttons, switches, toggles, wheels, knobs, and / or small sticks such as thumbsticks (not exhaustive). Multiple input devices and the functions of each of these can be “combined” into something that visually appears as a single input device. The input device 701 and handle member 702 of Figure 10 are shown repeatedly herein for convenience and ease of understanding, and should be understood as not limiting the design of the input device and handle member.

[0208] Here, it is disclosed that when transitioning from the first mode to the second mode, the step of transitioning from a first input device of an array of one or more input devices to a second input device of the array can overcome the aforementioned drawbacks. The handle member 702 of the second input device (avatar-like input arm 701) can be pre-positioned in an orientation that is not "upside down" from the surgeon's perspective. The bending can be performed using an input device (e.g., input devices 501 / 405). The use of an input device does not involve, or requires, moving the handle member 702 of the second input device, or if it is moved, it does not move beyond 90° which could become a "turning point" that would be "upside down" from the surgeon's perspective. Furthermore, the control circuit that controls the second input device (input arm 701) can be set (e.g., programmed) to use a "direct" coordinate transformation matrix. The "direct" coordinate transformation matrix transforms the displacement vector of the input arm segment member into the corresponding displacement vector of the corresponding surgical arm segment (for example, parallel, or at least maintaining the same sign in each x, y, and z direction or at least two of the three directions), and / or transforms the turning arc of the input arm segment member into the corresponding turning arc of the corresponding surgical arm segment.

[0209] Therefore, in some embodiments, it may be desirable to ensure a handoff (transition) from the first mode to the second mode. In the second mode, control of arm movement is transferred from the first input device (such as the “thumbstick” detailed herein) to an avatar-like input arm. The avatar-like input arm ensures ergonomic comfort and convenience based on a handle member oriented to an optimal orientation and a directly translatable coordinate translation sequence (from the input arm to the surgical arm).

[0210] Referring here to Figure 17, the user input device 701 is oriented in the xyz space corresponding to the same xyz space in which the arm 102, or at least the distal portion of the arm, is facing in Figure 18. In Figure 18, the end effector 174 is connected to the distal end of the arm 102. The arm 102 in Figure 18 is shown as not bent, indicating the orientation of the arm at the start of surgery or before surgery. Controlling the arm 102 and positioning the end effector 174 in Figures 17-18 is straightforward. A leftward displacement of the input device 701 is translated into a leftward displacement of the arm 102 (e.g., along the x-axis), a forward displacement is translated into a forward displacement (e.g., along the y-axis), a rightward displacement is translated into a rightward displacement (again, along the x-axis), and a backward displacement is translated into a backward displacement (again, along the y-axis). An upward displacement of the input device 701 is translated into an upward displacement of the arm 102 (e.g., along the z-axis), and a downward displacement is translated into a downward displacement.

[0211] In Figures 19 and 20, the distal portion of arm 102 is curved, and the arm (and the attached surgical end effector 174) is positioned in the curved position. The handle member 702 of the user input device 701 is rotated to cause the curved movement of arm 102. If the user were to transition to surgical operation mode at this point, the user input device 701 would be oriented to the rotated xyz coordinate system in Figure 19. This does not coincide with the xyz coordinate system of the end effector 174 in Figure 20 (which has rotated according to the curve of arm 102 and now coincides with the curved orientation / position of the end effector 174). Note: The xyz coordinate system of the curved arm 102 is "inverted" to match the surgeon's viewpoint in a typical surgical system. For example, if the camera (e.g., an endoscope camera at the end of the arm) was not "inverted," the surgeon would not be able to see the surgical procedure space or see what they need to see. However, the inverted handle 702 and the "inverted" (curved) end effector are no longer in a common oriented three-dimensional xyz space. As described above, there are two options available at this point: to grasp the device 701 from a different viewpoint in a way different from how it is normally used, or to perform surgery in such a way that the movement of the input device 701 (specifically, the handle member 702) is not ergonomically easily translated to the surgical arm 102 in the same xyz coordinate system. For example, a leftward displacement of the device 701 (according to this xyz coordinate system) in Figure 19 would result in a rightward displacement of the end effector 174 according to the end effector's xyz coordinate system, and similarly, upward means downward.

[0212] As discussed earlier, the first solution to the "inverted handle" is to use a different user input device for the arm's bending. As a result, in the subsequent surgical operation mode envisioned later, the arm and end effector shown in Figure 20 will be controlled by a non-inverted handle as shown in Figure 17. Although the xyz coordinate systems appear to be inverted, those skilled in the art will understand that the input device 701 and the arm 102 are actually aligned such that a leftward displacement (e.g., of device 701 in the surgeon's hand) translates to a leftward displacement of the end effector 174 (from the surgeon's viewpoint). This is similar in all directions of the common xyz coordinate system (except, for example, when the surgeon can grasp the handle member from the opposite direction).

[0213] A second solution to the "inverted handle" is shown in Figure 21. As previously explained, the handle member 702 in Figure 19 is inverted, i.e., rotated, so that the xyz coordinate system of the input device 701 rotates. According to the embodiment, an exemplary surgical system of the second solution is configured to change the orientation of the xyz coordinate system of the input device 701. In other words, the same input device 701 is used in the first bend mode in the xyz space shown in Figure 17. This xyz space is rotated in Figure 19 (due to the "inverted handle"), making it difficult to use the input device 701 in a second surgical mode (e.g., left is right, up is down, etc.). Therefore, the surgical system replaces the original, but inverted, xyz coordinate system of Figure 19 with the new xyz coordinate system of Figure 21. This appears to coincide with the original xyz coordinate system of Figure 17, but is induced by an inverted handle input device oriented as shown in Figure 21, rather than an input device oriented as shown in Figure 17.

[0214] Here, we refer to Figures 22A-C, which have already been described herein with respect to a specific embodiment of Figure 16. Figure 22A shows an input device 701 having a curved shape 2810. At a first time T1, the corresponding arm 102 has a non-bent shape as shown in Figure 22B. The arm 102 has a curved shape 2830, which clearly does not match the curved shape 2810 of the input device 701 at time T1. After manipulating the arm 102 with a different user input device (not shown in Figures 22A-C), the arm 102 bends before time T2, as shown in Figure 22C. At this point, the curved shape 2830 of the arm 102 matches the curved shape 2810 of the input device 701. Once this match is detected, as described above in the explanation of Figure 16, the surgical system can transition from the first (bending) mode to the second (surgical operation) mode, with the xyz coordinate systems of the device 701 and the end effector 174 facing the same direction, as shown in Figures 20-21, for example.

[0215] Figures 22A–C show a curved arm as a non-limiting example of a curved shape that matches the surgical arm and the user input device. In other examples, the corresponding curved shape can include any useful curved shape of the surgical arm. Two exemplary examples of useful arm shape curves can be seen in Figures 4 and 5 described herein.

[0216] First additional explanation

[0217] Now, refer to Figures 23A-C.

[0218] In some embodiments, control of one or more surgical arms can be achieved via one or more input arms, joysticks, control handles, and / or other means suitable for operation by a user (e.g., a surgeon), which are then translated into corresponding joint movements of one or more surgical arms.

[0219] As referenced in the flowchart of Figure 23A, some embodiments of the examples described herein include dual control of the surgical arm. In some embodiments, a first user input (in this example, a thumbstick 4005 in Figure 23B) is used to introduce the surgical arm into the patient's body, for example, through the vagina, and then to bend the surgical arm (4001). In some embodiments, the bending of the surgical arm within the patient's body (e.g., bending backward) is done to reduce the area in which the surgical arm is located. Optionally, bending is done during surgery to avoid obstacles, such as certain organs or parts thereof, such as the inner wall of the abdomen. Optionally, bending is done to position the surgical arm in an orientation familiar to the laparoscopic surgeon for performing surgery.

[0220] Next, in some embodiments, a second user input is used, in this example in the form of an input arm 4011 (e.g., an avatar joystick), to perform the remaining surgical procedure (4003).

[0221] In some embodiments, the thumbstick 4005 is positioned adjacent to the control console screen 4007 (e.g., on the opposite side of the screen). In some embodiments, each thumbstick 4005 is equipped with a nipple-shaped controller 4009 that is shaped and sized appropriately for the user's thumb. In some embodiments, the nipple of the thumbstick is configured to have a resting position when centered and to spring back to the resting position when the thumb is released. In some embodiments, the degree to which the nipple moves relative to the resting position of the center determines the resulting movement speed of the surgical arm. For example, the further the nipple is pushed away from this resting position, the greater the movement speed of the surgical arm (and conversely, the closer the nipple is to this resting position, the less the arm moves).

[0222] In some embodiments, when controlling a surgical arm via a thumbstick, the movement of one or more joints of the surgical arm (e.g., shoulder joint, wrist joint) is restricted. In some embodiments, the movement of all surgical arm joints except the elbow joint is blocked, and only flexion and / or rotation of the elbow joint is enabled. In some embodiments, linear movement of the surgical arm (as a single unit) is also enabled, for example, to advance or retract the arm. In some embodiments, the movement of the nipple acts to flexion and / or rotation of the elbow joint. In some embodiments, linear movement of the arm is actuated by separate actuators using push buttons such as 4006, 4008 configured along the body of the thumbstick 4005, for example. In one example, button 4006 advances the surgical arm distally (e.g., into the abdomen), and button 4008 retracts the surgical arm proximally.

[0223] In some embodiments, while using the thumbstick, the input arm 4011 is locked in a stationary position, for example, by a solenoid lock. In some embodiments, the stationary position of the input arm is selected as the bent position. Optionally, this position allows the surgeon to use the thumbstick to continue the procedure directly following the bend. In some embodiments, when operating the input arm, the operation of the thumbstick is disabled.

[0224] A potential benefit of using a thumbstick for guiding and arching the surgical arm to the body while a selected arm joint, such as the shoulder joint, remains stationary is that it may reduce the bending radius of the surgical arm, thereby reducing the likelihood of collision with surrounding obstacles such as the internal abdominal wall. Another potential benefit of using a thumbstick during guidance and / or arching processes is that it may improve control over the surgical arm compared to guiding and arching with an input arm, for example, where the ergonomics of the handle may not be well-suited to supporting the rotational movement that the surgeon needs to make while holding the handle in order to arch.

[0225] In some embodiments, during the introduction of the surgical arm into the body, the surgical arm is straight (optionally for insertion via a cannula), while the input arm is in a stationary, locked, or bent position. Optionally, after bending the surgical arm using a thumbstick, the surgeon releases the thumbstick and moves their hand to the input arm. Once the surgeon grasps the input arm and optionally lifts it, the surgical arm is automatically controlled, allowing the surgeon to continue the procedure using the input arm. In some embodiments, when one or more input arm joints are locked by a solenoid lock, the solenoid lock is automatically released when the surgeon lifts the input arm. Alternatively, manual locking of the input arm joints is released, for example, via a sensor that detects the input arm position.

[0226] In some embodiments, the system (e.g., a system processor) is configured to recognize one or more positions of an input arm, for example, when the input arm is in this stationary position, and optionally display the current position to the user.

[0227] Refer to Figure 24 here. In some embodiments, a tactile handle that provides force feedback to the user (a preferred example being the tactile device "omega.7" available from Force Dimension in Nyon, Switzerland) is used throughout the operation to control the movement and joint movement of the surgical arm. In some embodiments, the tactile handle is configured to have counterresistance to prevent the user from moving the surgical arm in a direction that it does not support (e.g., bending the elbow joint of the surgical arm backward, touching a joint (e.g., the elbow joint) with a different segment of the same arm, and / or other). In some embodiments, the handle is configured to have counterresistance that changes depending on the current anatomical position and / or orientation of the surgical arm. As an example, the resistance may be greater if the user attempts to move to an anatomical area that is not permitted, such as an organ to be avoided.

[0228] In some embodiments, the tactile handle is programmed to operate according to various control modes. Optionally, the control mode is selected according to the current stage in the surgical procedure. In some embodiments, switching between different modes is performed via one or more buttons on a screen interface, control console or handle, foot pedals, and / or other means.

[0229] In some embodiments, the tactile handle is used in “speed control” mode during the first stage of a procedure in which a surgical arm is introduced into the patient’s body and optionally bent back (5001). Optionally, in speed control mode, the speed at which the surgical arm is moved is set by the relative movement of the handle to a stationary position. As the user moves the handle further away from the stationary position, the speed increases, and vice versa. For example, moving the handle to the right of this stationary position can cause the arm joints (e.g., elbow joints) to rotate to the right at a speed determined by the distance of the handle from this stationary position. In some embodiments, in speed control mode, the tactile handle is configured to have elastic (spring-like) counterresistance to the user’s movement. In some embodiments, in speed control mode, a control algorithm is applied to translate the current configuration of the tactile handle into speed commands issued to the actuators (e.g., motors) of the surgical arm (e.g., increasing the rotational speed of one or more motor gears).

[0230] A potential advantage of introducing a surgical arm inside the body and using a speed control mode while selectively bending it is that although the direction reverses during bending (e.g., upward / downward), the movement of the surgical arm is restricted, and only the movement speed changes, so this change can be ignored and the movement can continue naturally.

[0231] In some embodiments, during the second stage of the surgical procedure, and optionally for the remainder of the procedure, the tactile handle is set to “position control” mode (5003). Optionally, in position control mode, the spatial position of the handle sets the position of each surgical arm. In position control mode, the user's displacement of the tactile handle is translated into displacement commands relative to the surgical arm. In some embodiments, the step of translating the displacement of the tactile handle is controlled according to an algorithm. In some embodiments, the control is performed according to a known algorithm (e.g., the inverse Jacobian algorithm). Furthermore, or alternatively, in some embodiments, the control is performed by a custom algorithm. In one example, the custom algorithm is set to scale the user's movement, such as increasing the precision of the movement. Such scaling may include a step of amplifying the movement required on the user's side by a selected ratio to produce a similar, unamplified movement of the surgical arm. For example, for the arm to move a distance X, the user needs to move the handle by A*X (A>1). In another example, an algorithm is selected to filter the signal, for instance using a low-pass filter to reduce the user's hand tremors.

[0232] In some embodiments, a clutch mechanism is provided in position control mode. This allows the user to temporarily disconnect control from the surgical arm (so that movement of the input tactile handle no longer controls the surgical arm). Optionally, when disconnected, the user can freely reposition the tactile handle. In one example, the user repositions the tactile handle to a position and / or orientation that is more comfortable for the user to perform and control the next movement.

[0233] In some embodiments, the degree of resistance perceived by the user in response to the movement of the handle can be selected and controlled. In one example, a floating mode can be set, in which the user is virtually unaffected by resistance and can move the handle freely in any direction. Furthermore, or alternatively, the level of resistance felt by the user can be adjusted (for example, the user may feel high resistance in response to one movement and low resistance or no resistance at all in response to another movement).

[0234] In some embodiments, the amount of resistance is controlled based on the anatomical position of the surgical arm. For example, if an obstacle (e.g., the abdominal wall) is found near the surgical arm, the resistance may be set higher. In a specific example, if an obstacle is found to the right of the surgical arm, the user may experience high resistance when moving the handle to the right. If no obstacle is found to the left of the arm, the user may experience low resistance or no resistance when moving the handle to the left. Optionally, the degree of resistance is defined by system-defined settings that produce wall-type resistance, rubber-like resistance, sand-type resistance, and / or other types of resistance.

[0235] Second additional explanation

[0236] According to one embodiment, a method for operating a surgical system is disclosed, comprising (i) a multi-jointed mechanical arm having a plurality of arm joints, (ii) a first user input device and a second user input device for controlling the arm, and (iii) a surgical end effector located at the distal end of the arm. The method is, (a) Steps for initiating the operation of the surgical system in the arched mode (with respect to the flexion and rotation of the arm joint, (i) the first user input device is active to instruct the flexion and rotation of only a given joint of the arm joint, and (ii) the second user input device is disabled), (b) While in the bend mode, the distal portion of the articulated mechanical arm is bent back by bending and rotating the given joints of the arm joint in response to an electronically controlled output from the first user input device, so as to bring the end effector to the bend position. (c) Steps to enable the second user input device with respect to bending and rotating at least one of the arm joints of the arm other than the given joint of the arm joint, to transition the surgical system from the arching mode to the surgical operation mode, (d) While in the surgical operation mode, the step of effectively flexing and rotating at least two of the arm joints in accordance with the respective degrees of freedom of each arm joint in response to an electronically controlled output from the second user input device (thereby moving the surgical end effector to perform one or more surgical actions).

[0237] In some embodiments, the surgical system may further include a control circuit effective for restricting the movement of arm joints other than the one arm joint while the surgical system is in the arching mode.

[0238] In some embodiments, the transition step may include calibrating the input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0239] In some embodiments, the first input device may be configured to control the operation of one arm joint and / or not to control the operation of any other arm joints.

[0240] In some embodiments, the step of transitioning to the surgical operation mode may be in response to and conditional on the detection that the arm is in a bent position.

[0241] A surgical system according to an embodiment comprises: (a) an articulated mechanical arm including a plurality of arm joints, and a surgical end effector at a distal end of said arm, and (b) a first user input device and a second user input device for controlling said arm. The surgical system comprises: (i) a retraction mode in which a distal portion of the articulated mechanical arm operates to retract, in response to an electronic control output from the first user input device, to bring said end effector to a retracted operating position, and (ii) a surgical operation mode in which at least two of said arm joints operate to bend and rotate in response to an electronic control output from the second user input device, thereby moving said surgical end effector to perform one or more surgical procedures, wherein the modes are configured to operate asynchronously, (A) while in said retraction mode, with respect to bending and rotation of said arm joints, said first user input device is active to instruct bending and rotation of only a given joint of said arm joints, and said second user input device is disabled, and (B) while in said surgical operation mode, said second user input device is active for bending and rotation of at least one of said arm joints of said arm other than the given joint of said arm joints, in accordance with the respective degrees of freedom of each arm joint.

[0242] In some embodiments, the surgical system may further comprise a control circuit effective to restrict the actuation of arm joints other than said one arm joint while the surgical system is in said retraction mode.

[0243] In some embodiments, the surgical system can be configured such that the transition step includes the step of calibrating the input device with respect to at least one of the position and orientation of the end effector or a distal portion of the arm.

[0244] In some embodiments, the first input device may be configured to control actuation of the one arm joint and / or may be configured not to control actuation of arm joints other than the one arm joint.

[0245] In some embodiments, the surgical system may be configured such that the step of transitioning to the surgical operation mode is responsive to and conditioned on detection that the arm is in a bent-back position.

[0246] According to an embodiment, a method of operating a surgical system is disclosed. According to the method, the surgical system comprises (i) a user input device, and (ii) an articulated mechanical arm comprising a plurality of arm joints, and a surgical end effector at a distal end of the arm. The method comprises: (a) starting operation of the surgical system in a bent-back mode, wherein with respect to flexion and rotation of the arm joints, the user input device is active to instruct flexion and rotation of only a given one of the arm joints, (b) while in the bent-back mode, bending back a distal portion of the articulated mechanical arm by flexion and rotation of the given joint of the arm joints in response to an electronic control output from the user input device to bring the end effector to a bent-back operative position, (c) transitioning the surgical system from the bent-back mode to a surgical operation mode to enable the user input device with respect to flexing and rotating at least one of the arm joints of the arm other than the given joint of the arm joints, (d) while in the surgical operation mode, effectively flexing and rotating at least two of the arm joints according to the respective degree of freedom of each arm joint in response to an electronic control output from the user input device, thereby moving the surgical end effector to perform one or more surgical procedures.

[0247] In some embodiments of the present method, the surgical system may further include a control circuit effective for restricting the operation of arm joints other than a given joint while the surgical system is in the arching mode. In some such embodiments, the restricting step can be performed by disabling the operation of the arm joints other than the given joint.

[0248] In some embodiments, the user input device can control the operation of the multiple arm joints in both the arching mode and the surgical operation mode.

[0249] In some embodiments, the user input device may be prevented from generating or transmitting control outputs that control the operation of the arm joints of the arm other than the given joint.

[0250] In some embodiments, the transition step to the surgical mode may be in response to the detection that the arm is in a bent position, and the detection condition may be.

[0251] In some embodiments, the transition step may include calibrating the user input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0252] In some embodiments, the method may further include the step of unbending the distal end of the arm so as to bring the arm to an unbent position, following the operation in the second mode.

[0253] According to the embodiments, a surgical system is disclosed. The surgical system comprises a multi-joint mechanical arm having (a) a user input device, and (b) (i) a plurality of arm joints, and (ii) a surgical end effector at the distal end of the arm. The aforementioned surgical system is (A) A bend mode in which the distal portion of the articulated mechanical arm bends in response to an electronically controlled output from the user input device so as to bring the end effector to the bend position, and (B) A surgical operation mode is configured to operate asynchronously, in which at least two of the arm joints flex and rotate in response to an electronically controlled output from the user input device, thereby moving the surgical end effector to perform one or more surgical actions. (A) While in the arched mode, with respect to the flexion and rotation of the arm joint, the user input device is active to instruct only the flexion and rotation of a given joint of the arm joint, and (B) While in surgical operation mode, the user input device is active with respect to the flexion and rotation of at least one of the arm joints of the arm other than a given joint of the arm, according to the respective degrees of freedom of each arm joint.

[0254] In some embodiments, the surgical system may further include a control circuit effective for restricting the operation of the arm joints other than a given joint while the surgical system is in the arching mode. In some such embodiments, the restricting step can be performed by disabling the operation of the arm joints other than the given joint.

[0255] In some embodiments, the user input device may be effective in controlling the operation of the plurality of arm joints in both the arching mode and the surgical operation mode.

[0256] In some embodiments, the surgical system may be configured such that the user input device is prevented from generating or transmitting control outputs that control the operation of the arm joints of the arm other than the given joint.

[0257] In some embodiments, the surgical system can be configured such that the transition step to the surgical mode responds to and / or is a detection condition that the arm is in a bent position.

[0258] In some embodiments, the surgical system may be configured such that the transition step includes a step of calibrating the user input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0259] In some embodiments, the surgical system can be further configured to effectively unbend the distal end of the arm so as to bring the arm to an unbent position following operation in a second mode.

[0260] According to the embodiments, a method of operating a surgical system is disclosed. The surgical system comprises (i) a multi-joint mechanical arm having a surgical end effector and a plurality of arm joints at the distal end of the multi-joint mechanical arm, and (ii) an input device array of one or more user input devices, wherein the arm joints are configured to bend and rotate in response to electronically controlled outputs from one or more user input devices of the input device array. The aforementioned method, (a) A step of initiating the operation of the surgical system in a first operating mode defined with respect to a given joint of the arm (the first operating mode excludes the operation of any arm joint of the arm other than the given arm joint and allows control of the operation of the one arm joint to cause flexion and rotation of the one arm joint), (b) While the surgical system is in the first operating mode, (i) bending and rotating the distal end of the arm by bending the one arm joint in response to a control signal generated by one or more of the user input devices of the input device array to bring the end effector to a bent position; (ii) monitoring the state of the mechanical arm to detect whether the arm is in a bent position. The method is (c) In response to detection that the arm is in a bent position, and conditionally thereof, the operation of the surgical system is transitioned from the first operating mode to a second operating mode (in which the system is able to control the flexion and rotation of at least one arm joint that was excluded in the first mode according to the respective degrees of freedom of each arm joint), (d) Further includes the step of operating the surgical system in the second operating mode so as to perform a surgical procedure using the end effector.

[0261] In some embodiments, the surgical system may further comprise a control circuit effective to restrict actuation of arm joints other than said one arm joint while said surgical system is in said first mode of operation. In some such methods, said limiting step may be performed by disabling actuation of arm joints of said arm other than said one arm joint. In some such embodiments, said input device may be prevented from generating or transmitting a control output that controls actuation of arm joints of said arm other than said one arm joint. In some such embodiments, said limiting step may comprise disabling the capability of said first input device. In some such embodiments, (i) a first input device of said array of input devices controls actuation of said one arm joint while said surgical system is in said first mode of operation, a second input device controls actuation of said plurality of arm joints while said surgical system is in said second mode of operation, and / or (ii) said limiting step is performed by providing a first input device, wherein said first input device is configured to control actuation of said one arm joint and can be configured to not control actuation of arm joints other than said one arm joint.

[0262] In some embodiments, said transitioning step may comprise calibrating said input device with respect to at least one of the position and orientation of the end effector or a distal portion of the arm.

[0263] In some embodiments, a first input device of said array of input devices controls actuation of said one arm joint while said surgical system is in said first mode of operation, and / or a second input device of said array of input devices can control actuation of said plurality of arm joints while said surgical system is in said second mode of operation.

[0264] In some embodiments, the transition step may include calibrating the second input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0265] In some embodiments, a single user input device can control the operation of the multiple arm joints in both the first and second operating modes.

[0266] In some embodiments of the present method, the surgical system may further comprise a control console having a display screen, and at least one user input device of the input device array is located on or adjacent to the display screen.

[0267] In some embodiments, an additional user input device for operating the linear forward and backward movement of the arm may be located on, at the same location as, or adjacent to the user input devices in the input device array.

[0268] In some embodiments, the bending position can be located at or near the surgical procedure site.

[0269] In some embodiments, the operation step in the second mode can be such that the arm is in the bent position.

[0270] In some embodiments, following the operating step in the second mode, the further step may be to unbend the distal end of the arm so that the arm is brought to an unbent position.

[0271] According to the embodiment, the first operating mode and the second operating mode are configured to operate asynchronously, and the surgical system for use with a surgical end effector includes (a) an input device array of one or more user input devices, and (b) The articulated mechanical arm may include a surgical end effector at the distal end of the articulated mechanical arm, and a plurality of arm joints configured to bend and rotate in response to control signals generated by one or more input devices of the input device array. (i) The first mode of operation is defined with respect to a given joint of the arm joint, and the first mode of operation is capable of controlling the operation of the given arm joint, thereby causing flexion and rotation of the given arm joint, excluding the operation of any arm joint of the arm other than the given arm joint. (ii) The system is configured to bend the distal end of the arm by activating one arm joint in response to an electronically controlled output from one or more of the user input devices of the input device array, thereby causing flexion and rotation of the one arm joint, so as to bring the surgical end effector to the bent position during the first operating mode, (iii) The second operating mode is defined with respect to the plurality of arm joints, and the second operating mode enables control of the operation of at least one of the arm joints that were excluded in the first mode, according to the respective degrees of freedom of each arm joint. (iv) The system is configured to transition from the first operating mode to the second operating mode in response to and condition of detection that the arm is in a bent position, and during the second operating mode, the end effector is used to perform a surgical procedure.

[0272] In some embodiments, the surgical system may further include a control circuit effective for restricting the operation of arm joints other than the one arm joint while the surgical system is in the first operating mode. In some such embodiments, the restricting step can be performed by disabling the operation of the arm joints of the arm other than the one arm joint. In some such embodiments, the input device may be prevented from generating or transmitting a control output that controls the operation of the arm joints of the arm other than the one arm joint. In some such embodiments, the restricting step can include disabling the capability of the first input device. In some such embodiments, (i) a first input device of the input device array controls the operation of the one arm joint while the surgical system is in the first operating mode, a second input device controls the operation of the plurality of arm joints while the surgical system is in the second operating mode, and / or (ii) the restricting step can be performed by providing the first input device, wherein the first input device is configured to control the operation of the one arm joint and not to control the operation of the arm joints other than the one arm joint.

[0273] In some embodiments, the system may be configured such that the transition step includes a step of calibrating the input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0274] In some embodiments, a first input device of the input device array may be effective in controlling the operation of one arm joint while the surgical system is in the first operating mode, and / or a second input device of the input device array may be effective in controlling the operation of multiple arm joints while the surgical system is in the second operating mode.

[0275] In some embodiments, the system may be configured such that the transition step includes a step of calibrating the second input device with respect to at least one of the position and orientation of the end effector or the distal portion of the arm.

[0276] In some embodiments, a single user input device may be effective in controlling the operation of the multiple arm joints in both the first and second operating modes.

[0277] In some embodiments, the surgical system may further include a control console having a display screen, and at least one user input device of the input device array is located on or adjacent to the display screen.

[0278] In some embodiments, an additional user input device for operating the linear forward and backward movement of the arm may be located on, at the same location as, or adjacent to the user input devices in the input device array.

[0279] In some embodiments, the bending position can be located at or near the surgical procedure site.

[0280] In some embodiments, the operation step in the second mode can be such that the arm is in the bent position.

[0281] In some embodiments, the distal end of the arm may be further configured to effectively unbend the arm so as to bring the arm to an unbent position, following the operating step in the second mode. According to the embodiment, a method of operating a surgical system is disclosed, comprising (i) a multi-jointed mechanical arm having a plurality of arm joints, and a surgical end effector at the distal end of the arm, and (ii) an input device array of one or more user input devices for controlling the arm. The aforementioned method, (a) The step of bending and rotating the given joint of the arm joint in response to an electronically controlled output from the input device array, so as to bring the end effector to the bent position without bending or rotating any arm joint other than the given joint of the arm joint, and (b) The bending and rotation step includes, in response to detection that the arm is in a bent position, and, conditional on such detection, in response to an electronically controlled output from the input device array, a step of effectively bending and rotating at least two of the arm joints according to the respective degrees of freedom of each arm joint (thereby moving the surgical end effector to perform one or more surgical actions).

[0282] In some embodiments of the above method, the surgical system may further include a control circuit effective for restricting the movement of the arm joints other than a given joint during the bending step.

[0283] In some embodiments, the step of unbending the distal end of the arm to bring it to an unbent position after the performance of one or more surgical procedures may further be included.

[0284] According to the embodiment, the surgical system is (a)(i) a multi-jointed mechanical arm comprising a plurality of arm joints, and (ii) a surgical end effector at the distal end of the arm, and (b) comprising an input device array of one or more user input devices for controlling the arm. The aforementioned surgical system is (i) The distal portion of the articulated mechanical arm is configured to bend backward by bending and rotating the given joint of the arm in response to an electronically controlled output from the input device array, so as to bring the end effector to the bent-back position without bending or rotating any of the arm joints other than a given joint of the arm, and (ii) In response to detection that the arm is in a bent position, and conditional on such detection, and in response to an electronically controlled output from the input device array, the system is configured to effectively flex and rotate at least two of the arm joints according to the respective degrees of freedom of each arm joint, thereby moving the surgical end effector to perform one or more surgical actions.

[0285] In some embodiments, the surgical system may further include a control circuit effective for restricting the movement of the arm joints other than a given joint during the bending step.

[0286] In some embodiments of the above method, the surgical system may further include a control circuit effective for restricting the movement of the arm joints other than a given joint during the bending step.

[0287] In some embodiments, the step of unbending the distal end of the arm to bring it to an unbent position after the performance of one or more surgical procedures may further be included.

[0288] According to the embodiment, a method for using a surgical system is disclosed. The method is (a) A step of providing a multi-joint mechanical arm having a surgical end effector at the distal end of the multi-joint mechanical arm (the arm comprises a plurality of arm segments connected in series by a plurality of corresponding arm joints configured to bend and rotate in response to an electronically controlled output from a user input device, and the step of providing is provided such that the end effector is displaced), (b) While operating in the first input mode, the step of maneuvering the end effector to the bent position (the first input mode converts the displacement of the input device or a displaceable portion of the input device into the velocity of at least one of (i) flexion of the arm joint and (ii) rotation of the arm joint), (c) In response to and conditional upon detection that the end effector is in the bend position, the step of transitioning from operation in the first input mode to operation in the second input mode (in which the displacement of the input device or a displaceable portion of the input device is converted into a corresponding displacement of at least one arm segment), and d. The step of performing a surgical procedure using the end effector after the transition step and while operating in the second input mode.

[0289] In some embodiments, a single user input device can be used in both the first and second input modes.

[0290] In some embodiments, a first input device may be used in the first input mode, and / or a second input device may be used in the second input mode.

[0291] In some embodiments, additional user input devices can be used to operate the linear forward and backward movement of the arm.

[0292] In some embodiments, the bending position can be located at or near the surgical procedure site.

[0293] According to one embodiment, a surgical system for use with a surgical end effector is provided. (a) The articulated mechanical arm having a surgical end effector at the distal end of the articulated mechanical arm (the arm comprises a plurality of arm segments connected in series by a plurality of corresponding arm joints configured to bend and rotate in response to an electronically controlled output from a user input device), and (b) comprising an array of one or more input devices for controlling the arm. The aforementioned surgical system is (i) (A) a first input mode that converts the displacement of an input device or a displaceable part of the input device into the flexion and rotation speed of an arm joint, and (B) a second input mode that converts the displacement of an input device or a displaceable part of the input device into the corresponding displacement of at least one arm segment, are configured to operate asynchronously. (ii) While operating in the first input mode, the end effector is configured to be steer the end effector to a bent position during the first stage in which the end effector is displaced, and (iii) The end effector is configured to perform surgical procedures while operating in the second input mode.

[0294] In some embodiments, the system can be configured to use a single user input device in both the first and second input modes.

[0295] In some embodiments, the system can be configured to use a first input device in the first input mode and / or a second input device in the second input mode.

[0296] In some embodiments, the system may be configured to use an additional user input device to actuate the linear forward and backward movement of the arm.

[0297] In some embodiments, the bending position can be located at or near the surgical procedure site.

[0298] The present invention has been described using embodiments for carrying out the invention, but these are provided as examples and are not intended to limit the scope of the invention. The described embodiments have different features, and not all of them are required in all embodiments of the invention. Some embodiments of the invention utilize only some of the features or possible combinations of features. Those skilled in the art to which the invention belongs will be able to imagine variations of the described embodiments of the invention and embodiments of the invention having various combinations of the features indicated in the described embodiments.

[0299] Any feature or combination of features described herein may be combined with any features and combinations described herein, which are all incorporated herein by reference as if to describe this whole in complete terms.

[0300] In the specification and claims of this disclosure, the verbs “to have,” “to include,” and “to possess,” and their conjugations, are used to indicate that one or more objects of a verb are not necessarily a complete list of components, structures, elements, or parts of one or more subjects of a verb. Where used herein, the singular “a,” “an,” and “the” include plural references unless the context clearly indicates otherwise. For example, the terms “marking” or “at least one marking” may include multiple markings.

Claims

1. A method of operating a surgical system, The aforementioned system, (i) Articulated mechanical arms, and (ii) Equipped with first and second input devices, The aforementioned method, a. Back-bending step, b. Transition steps, and c. Includes a surgical procedure step, The arm has a surgical end effector at its distal end and comprises multiple arm segments, each of which is connected in series by multiple arm joints configured to have degrees of freedom and to bend and rotate. The second input device includes a handle member configured to be oriented in any one of a plurality of selectable orientations in x-y-z space, The handle member comprises a segment member and a joint member corresponding to the arm segment and the arm joint of the arm, respectively. Each of the arm joints is operable by the corresponding joint member and has the same degree of freedom as the joint member. In the aforementioned bending step, the arm is bent in response to the electronically controlled output from the first input device. The electronically controlled output is effective in adjusting the flexion and rotation of the arm joint to bring the end effector to the bent-back position. In the transition step, following the arm bending step, control of the arm is transferred from the first input device to the second input device. The surgical procedure step, after the transition step, involves changing the orientation of the handle member, displacing and changing the orientation of the segment member and the joint member, respectively, thereby causing the corresponding arm segment and arm joint of the curved arm to be displaced and changed in orientation, and performing the surgical procedure using the end effector, wherein the orientation of the handle member is such that the displacement vector or turning arc of the handle member in the x-y-z space is converted to the corresponding displacement vector or corresponding turning arc of the end effector in the same x-y-z space.

2. The method according to claim 1, A method for performing the bending step using the first input device, wherein the handle member is not rotated from a selected orientation in the x-y-z space.

3. A method according to claim 1 or 2, A method for performing the bending step using the first input device, wherein it is not necessary to change the orientation of the handle member from the selected orientation in the x-y-z space.

4. A method according to any one of claims 1 to 3, A method for performing the bending step using the first input device, wherein it is not necessary to change the direction of the handle member by more than 90° from the selected orientation in the x-y-z space.

5. A method according to any one of the above claims, A method wherein the surgical system further comprises a control circuit effective for causing the transition step.

6. A method according to any one of the above claims, A method for deactivating the first input device after the transition step.

7. A method according to any one of the above claims, A method wherein, after the transition step, the first device is disconnected from the arm.

8. A method according to any one of the above claims, A method comprising a surgical system having a user input device for operating the linear forward and backward movement of the arm.

9. A surgical system for use with surgical end effectors, The aforementioned system, a. Multi-jointed mechanical arm, b. A first input device configured to provide electronically controlled outputs for controlling the bending speed and rotational speed of each of the arm joints in response to a change in position, such as causing the distal end of the arm and the end effector to bend to a bent position, and c. A second input device comprising a handle member configured to be directed in any one of a plurality of selectable orientations in x-y-z space, The arm has a surgical end effector at its distal end and comprises a plurality of arm segments, each of which is connected in series by a plurality of arm joints configured to have degrees of freedom and to bend and rotate. The handle member comprises a segment member and a joint member corresponding to the arm segment and the arm joint of the arm, respectively. Each of the arm joints is operable by the corresponding joint member and has the same degree of freedom as the joint member. i. The surgical system is configured such that, after the arm bends backward, the control of the arm transitions from the first input device to the second input device. ii. A system in which, following the transition step, the step of reorienting the handle member to displace and reorient the segment member and the joint member, respectively, is effective in causing the corresponding arm segment and arm joint of the curved arm to displace and reorient the respective, and the orientation of the handle member is converted to the corresponding displacement vector or reorientation arc of the handle member in the x-y-z space to the corresponding displacement vector or corresponding reorientation arc of the end effector in the same x-y-z space.

10. A method of operating a surgical system, The aforementioned system, (i) Articulated mechanical arms, and (ii) comprising an input device array of one or more user input devices configured to control the flexion and rotation of an arm joint, The aforementioned method, a. Back-bending step, b. Transition steps, and c. Includes a surgical procedure step, The arm has a surgical end effector at its distal end and is equipped with multiple arm joints, each having a degree of freedom. In the aforementioned bending step, in response to the electronically controlled output from the first user input device, the first coordinate transformation matrix is ​​used to convert the user input into flexion and rotation of each arm joint, and the distal end of the arm is bent back to bring the end effector to the bent position. In the transition step, in response to and conditional upon detection that the end effector is in the bent position, the system transitions to a second coordinate transformation matrix based on the bent position of the end effector. The surgical procedure execution step involves, after the transition step and in response to an electronically controlled output from a second user input device, using the second coordinate transformation matrix to convert the user input into flexion and rotation of each arm joint, and performing the surgical procedure using the end effector.

11. The method according to claim 10, The first and second input devices are the same input device. The first and second coordinate transformation matrices are not the same three-dimensional coordinate transformation matrices.

12. The method according to claim 10, The first and second input devices are not the same input device. The first and second coordinate transformation matrices are not the same three-dimensional coordinate transformation matrices.

13. A method according to any one of claims 10 to 12, Before the transition step and during the bending step, the proximal displacement of the first user input device or a part thereof is converted into the proximal displacement of the end effector. A method in which, while the end effector is in the bent position after the transition step, the proximal displacement of the second user input device or a part thereof is converted into a distal displacement of the end effector.

14. A method according to any one of claims 10 to 13, The surgical system further comprises a control circuit effective for causing the transition step, in a method.

15. A method according to any one of claims 10 to 14, A method wherein the first input device is deactivated after the transition step.

16. A surgical system for use with surgical end effectors, a. An array of one or more input devices, and b. Equipped with a multi-jointed mechanical arm, The arm has a surgical end effector at its distal end and comprises a plurality of arm segments, the plurality of arm segments being connected by a plurality of arm joints configured to bend and rotate in response to control signals generated by an input device. The aforementioned surgical system is i. In response to an electronically controlled output from a first user input device, the system is configured to convert the user input into flexion and rotation of each arm joint using a first coordinate transformation matrix, and to bend the distal end of the arm so that the end effector is in a bent-back position. ii. The system is configured to transition to a second coordinate transformation matrix based on the current orientation of the end effector in response to and conditional on the detection that the current orientation of the end effector corresponds to the current orientation of the second user input device. iii. A system configured to, after a transition step and in response to an electronically controlled output from the second user input device, use the second coordinate transformation matrix to convert the user input into flexion and rotation of the respective arm joints, and to perform a surgical operation using the end effector.

17. A method of operating a surgical system, The aforementioned system, (i) A given user input device, and (ii) A multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from a given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm, The aforementioned method, a. A start step in which the surgical system is started to operate in a first operating mode, b. While the surgical system is in the first operating mode, i. modification step and ii. monitoring step, c. Transition steps, and d. Including operational steps, In the modification step, the curved shape of the arm is modified by at least one of one of the mechanized bending and mechanized rotation of one or more of the arm joints of the articulated mechanical arm. In the monitoring step, the shape state of the machine arm is monitored, and it is detected whether at least a portion of it has a curved shape that matches the currently dominant curved shape defined by the given user input device. In the transition step, in response to the detection that the curved shape of the mechanical arm matches the curved shape of the given user input device, and on the condition of such detection, the operation of the surgical system is transitioned from the first mode to the second mode. A method for operating the surgical system in the second mode such that the output of the given user input device modifies the configuration of the arm or a section or element of the arm, in order to perform a surgical procedure using the end effector.

18. The method according to claim 17, The transition step includes a step of handing off user control of the arm configuration from a user input device other than the given user input device to the given user input device.

19. The method according to claim 17 or 18, The first mode is defined with respect to a suitable subset of the plurality of arm joints; (ii) by a control signal from a given user input device, the operation of any arm joint of the arm that is not a member of the suitable subset of the arm joints is excluded; and (iii) the control of the operation of one or more arm joints belonging to the suitable subset causes flexion and / or rotation of one or more arm joints of the suitable subset.

20. The method according to claim 19, A method wherein, during the transition step from the first mode to the second mode, the given user input device enables control of flexion and rotation of an arm joint that was excluded in at least one of the first modes.

21. A method according to any one of claims 17 to 20, The method for performing the modification step of the shape of the arm is performed in response to an electronic control signal provided by a given user input device.

22. A method according to any one of claims 17 to 21, A method wherein the step of modifying the shape of the arm is performed in response to an electronic control signal provided by a user input device other than the given user input device.

23. A method according to any one of claims 17 to 22, The method is such that the step of modifying the curved shape of the arm is performed automatically.

24. A method of operating a surgical system, The aforementioned system, (i) A given user input device, and (ii) A multi-joint mechanical arm having a surgical end effector and a plurality of arm joints configured to bend and rotate in response to an electronically controlled output from a given user input device, wherein the surgical end effector is located at the distal end of the multi-joint mechanical arm, The aforementioned method, a. A start step in which the surgical system is started to operate in a first operating mode, b. While the surgical system is in the first operating mode, i. modification step, and ii. monitoring step, c. Transition steps, and d. Equipped with operating steps, In the modification step, the curved shape of the arm is modified by at least one of the mechanized bending and mechanized rotation of one or more of the arm joints of the articulated mechanical arm. In the monitoring step, the shape state of the machine arm is monitored, and it is detected whether at least a part of the machine arm has a curved shape that matches a predetermined curved shape. In the transition step, in response to the detection that the curved shape of the mechanical arm matches the predetermined curved shape, and on the condition of the detection, the operation of the surgical system is transitioned from the first mode to the second mode. A method for operating the surgical system in the second mode such that the output of the given user input device modifies the configuration of the arm or a section or element of the arm in order to perform a surgical procedure using the end effector.

25. The method according to claim 24, The step of detecting whether the curved shape of the machine arm or a part thereof matches the predetermined curved shape is: (i) A step of detecting whether the curved shape of the machine arm or a part thereof matches the two-dimensional projection of the predetermined curved shape, (ii) A step of detecting whether the two-dimensional projection of the curved shape of the mechanical arm or a part thereof matches the predetermined curved shape, (iii) A step of detecting whether the two-dimensional projection of the curved shape of the machine arm or a part thereof matches the two-dimensional projection of the predetermined curved shape. A method that includes at least one of the following.

26. The method according to claim 24 or 25, A method wherein the predetermined curve shape has one or more local minimums or local maximums.

27. A method according to any one of claims 24 to 26, A method wherein the predetermined curve shape has one or more inflection points.

28. The method according to claim 27, A method wherein the predetermined curve shape or the two-dimensional projection thereof is an "S" curve shape.

29. A method according to any one of claims 24 to 28, The transition step includes a step of handing off user control of the configuration of the arm from a user input device other than the given user input device to the given user input device.

30. A method according to any one of claims 24 to 29, The first mode is, (i) With respect to a suitable subset of the plurality of arm joints, (ii) The operation of any arm joint of the arm that is not a member of the appropriate subset of the arm joints is excluded by a control signal from the given user input device, (iii) A method for allowing control of the operation of one or more arm joints belonging to the appropriate subset, and causing flexion and / or rotation of the one or more arm joints of the appropriate subset.

31. The method according to claim 30, A method wherein, during the transition step from the first mode to the second mode, the given user input device enables control of flexion and rotation of an arm joint that was excluded in at least one of the first modes.

32. A method according to any one of claims 24 to 31, The step of modifying the shape of the arm is performed in response to an electronic control signal provided by the given user input device.

33. A method according to any one of claims 24 to 32, A method in which the step of modifying the shape of the arm is performed in response to an electronic control signal provided by a user input device other than the given user input device.

34. A method according to any one of claims 24 to 33, The step of modifying the curved shape of the arm is performed automatically by the method.

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