Relaxation tension monitoring and homing for medical devices

Abstract

The robotic system includes an end effector having one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a memory; and the memory storing computer-executable instructions that, when executed, cause a processor to determine pulley rotations that, when applied by the end effector to pulleys coupled to the elongate shaft, would be expected to articulate the elongate shaft in a desired articulation motion; drive the one or more drive outputs based at least in part on the pulley rotations; monitor tension on one or more pull wires coupled to the pulleys; and control the one or more drive outputs based at least in part on the tension.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 441,128, filed January 25, 2023, and entitled RELAXATION TENSION MONITORING AND HOMING OF MEDICAL INSTRUMENTS, the complete disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THE INVENTION The present disclosure relates to robotic medical systems. [Background technology]

[0003] Certain robotic medical procedures may involve the use of shaft-type instruments, such as endoscopes, that can be inserted into a patient through an orifice (e.g., a natural orifice) and advanced to a target anatomical site. Such medical instruments may be articulatable so that the tip and / or other portion of the shaft can be deflected in one or more dimensions using robotic control. Summary of the Invention [Means for solving the problem]

[0004] Described herein are systems, devices, and methods for facilitating instrument articulation control in connection with certain medical procedures. In particular, systems, devices, and methods according to one or more aspects of the present disclosure can facilitate monitoring of shaft articulation and / or shaft articulation pullwire tension and tensioning. For example, pullwire tensioning for purposes of articulating an instrument shaft can be relaxed at certain points in response to determined / detected articulation and / or tension conditions.

[0005] In some aspects, the technology described herein relates to a robotic system including an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and memory storing computer-executable instructions that, when executed, cause the processor to determine a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to relax the elongate shaft to a neutral position; drive the one or more drive outputs based at least in part on the pulley rotation; monitor tension on one or more pull wires coupled to the pulleys; and control the one or more drive outputs based at least in part on the tension.

[0006] In some aspects, the technology described herein relates to a robotic system in which the pulley is a dual-wire pulley and the pulley rotation is determined based on a kinematic model for a dual-wire pulley.

[0007] In some aspects, the technology described herein relates to a robotic system where the neutral position is zero degrees of joint movement, the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the tension is below a minimum tension threshold, and the controlling includes ceasing to drive one or more outputs based on the tension being below the minimum tension threshold.

[0008] In some aspects, the technology described herein relates to a robotic system where the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the magnitude of the tension is increasing and drive one or more drive outputs in an opposite direction to the pulley rotation.

[0009] In some aspects, the techniques described herein relate to a robotic system, wherein the memory further includes computer-executable instructions that, when executed, cause the processor to determine a homing offset and apply the homing offset to a kinematic model associated with the elongate shaft.

[0010] In some aspects, the technology described herein relates to a robotic system in which an elongate shaft is docked to an end effector with a non-zero articulation, and determining a homing offset includes determining the non-zero articulation.

[0011] In some aspects, the techniques described herein relate to a robotic system in which determining a homing offset includes determining a point in a kinematic model at which driving one or more drive outputs based at least in part on pulley rotation increases tension over a period of time and causes the tension at the end of the period to exceed a maximum tension threshold during relaxation.

[0012] In some aspects, the techniques described herein relate to a robotic system in which determining the homing offset includes calculating the homing offset based on a difference between a point and a pulley rotation corresponding to an edge of a central dead zone.

[0013] In some aspects, the technology described herein relates to a robotic system, wherein the memory further includes computer-executable instructions that, when executed, cause the processor to receive a relax command.

[0014] In some aspects, the technology described herein relates to a robotic system in which a relax command is received while the elongate shaft is within the patient's body.

[0015] In some aspects, the technology described herein relates to a method of robotically articulating an instrument, the method including determining a pulley rotation that, when applied by a robotic manipulator to a pulley coupled to an elongate shaft, would be expected to relax the elongate shaft to a neutral position; driving one or more drive outputs based at least in part on the pulley rotation; monitoring tension on one or more pull wires coupled to the pulleys; and controlling the driving of the one or more drive outputs based at least in part on the tension.

[0016] In some aspects, the technology described herein relates to a method wherein the pulley is a dual wire pulley and the pulley rotation is determined based on a kinematic model for a dual wire pulley.

[0017] In some aspects, the techniques described herein relate to a method further including determining when the tension is below a minimum tension threshold, the neutral position being zero degrees of articulation, and wherein controlling includes ceasing to drive one or more outputs based on the tension being below the minimum tension threshold.

[0018] In some aspects, the techniques described herein relate to a method further including determining that the magnitude of the tension is increasing and driving one or more drive outputs in an opposite direction of the pulley rotation.

[0019] In some aspects, the techniques described herein relate to a method further including determining a homing offset and applying the homing offset to a kinematic model associated with the elongate shaft.

[0020] In some aspects, the techniques described herein relate to a method in which an elongate shaft is docked to a robotic manipulator with a non-zero articulation, and determining the homing offset includes determining the non-zero articulation.

[0021] In some aspects, the techniques described herein relate to methods where determining a homing offset includes determining a point in a kinematic model where driving one or more drive outputs based at least in part on pulley rotation causes tension to increase over a period of time and causes tension at the end of the period to exceed a maximum tension threshold during relaxation.

[0022] In some aspects, the techniques described herein relate to a method in which determining a homing offset includes calculating the homing offset based on a difference between a point and a pulley rotation corresponding to an edge of a central deadband.

[0023] In some aspects, the techniques described herein relate to a method further including receiving a relax command.

[0024] In some aspects, the technology described herein relates to methods in which a relax command is received while the elongate shaft is within the patient's body.

[0025] In some aspects, the technology described herein relates to a robotic system including an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and a memory storing computer-executable instructions that, when executed, cause the processor to determine a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to articulate the elongate shaft in a desired articulation; drive the one or more drive outputs based at least in part on the pulley rotation; monitor tension on one or more pullwires coupled to the pulleys while driving the one or more drive outputs; determine that the tension is above an acceptable central deadband tension band; perform homing; and determine a homing offset.

[0026] In some aspects, the technology described herein relates to a robotic system in which the pulley is a dual-wire pulley and the pulley rotation is determined based on a kinematic model for a dual-wire pulley.

[0027] In some aspects, the techniques described herein relate to a robotic system in which performing homing includes calculating a homing offset based on a difference between a first pulley rotation associated with a tension that is greater than an allowable central deadband tension band and a second pulley rotation that corresponds to an edge of the central deadband.

[0028] In some aspects, the technology described herein relates to a robotic system in which performing homing is performed during initial articulation of an elongate shaft.

[0029] In some aspects, the technology described herein relates to a robotic system, wherein the memory further includes computer-executable instructions that, when executed, cause the processor to apply a homing offset to a kinematic model associated with the elongate shaft.

[0030] In some aspects, the techniques described herein relate to a robotic system in which monitoring tension on one or more pull wires includes sampling the monitored tension over a lookback window and calculating at least one of a mean, median, or mode of the monitored tension over the lookback window.

[0031] In some aspects, the technology described herein relates to a robotic system in which an elongate shaft is docked to an end effector with a non-zero articulation, and determining a homing offset includes determining the non-zero articulation.

[0032] In some aspects, the technology described herein relates to a robotic system wherein the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the tension is above a bypass tension threshold and to terminate homing based at least in part on determining that the tension is above the bypass tension threshold.

[0033] In some aspects, the techniques described herein relate to a robotic system wherein the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the current pulley rotation exceeds an acceptable pulley rotation and terminate homing based at least in part on determining that the current pulley rotation exceeds the acceptable pulley rotation threshold.

[0034] In some aspects, the technology described herein relates to a robotic system in which at least one of an allowable central deadband tension band, a bypass tension threshold, or an allowable pulley rotation threshold is associated with a kinematic model for the elongated shaft.

[0035] For purposes of summarizing the present disclosure, certain aspects, advantages, and novel features have been described. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, the disclosed embodiments may be performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other advantages that may be taught or suggested herein. [Brief explanation of the drawings]

[0036] Various embodiments are depicted in the accompanying drawings for illustrative purposes and should not be construed as limiting the scope of the present invention in any way. In addition, various features of different disclosed embodiments may be combined to form further embodiments that are part of this disclosure. Throughout the drawings, reference numerals may be reused to indicate correspondence between referenced elements. [Figure 1] 1 illustrates an embodiment of a robotic medical system including a shaft-type instrument coupled to a robotic end effector, according to one or more embodiments. [Figure 2] 1 illustrates a robotic system arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. [Figure 3] 1 illustrates a pedestal-based robotic system according to one or more embodiments. [Figure 4] 4 illustrates medical system components that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. [Figure 5] 1 illustrates an articulatable shaft-type instrument according to one or more embodiments. [Figure 6] FIG. 1 illustrates an exploded view of an instrument manipulator assembly associated with a robotic end effector, according to one or more embodiments. [Figure 7] 1 illustrates an instrument having one or more dual wire pulley systems for articulating the shaft of the instrument, according to one or more embodiments. [Figure 8] 10 is a graph illustrating the relationship between pulley rotation and instrument deflection for a plastic instrument shaft, in accordance with one or more embodiments. [Figure 9] 10 is a graph illustrating the relationship between pulley rotation and instrument deflection for a resilient instrument shaft, in accordance with one or more embodiments. [Figure 10] 10 is a graph illustrating the relationship between pulley rotation and instrument deflection for a hybrid plastic and elastic instrument shaft, in accordance with one or more embodiments. [Figure 11A] 1 is a kinematic model and tension response according to one or more embodiments. [Figure 11B] 1 is a kinematic model and tension response according to one or more embodiments. [Figure 12] FIG. 10 is a flow diagram of a process for controlling articulation of an instrument based on a kinematic model in accordance with one or more embodiments. [Figure 13A]10 illustrates an exemplary articulation scenario for a pre-articulated endoscope and an exemplary relaxation scenario for an articulated endoscope, according to one or more embodiments. [Figure 13B] 10 illustrates an exemplary articulation scenario for a pre-articulated endoscope and an exemplary relaxation scenario for an articulated endoscope, according to one or more embodiments. [Figure 14] 10 illustrates an exemplary articulation response plot showing the relationship between a modeled articulation response and the behavior of a physical endoscope when a pre-articulated endoscope is docked, in accordance with one or more embodiments. [Figure 15] FIG. 10 is a flow diagram of a process for relaxing and homing an endoscope based at least in part on pullwire tension monitoring, in accordance with one or more embodiments. [Figure 16] 10 is an exemplary tension-articulation response plot illustrating the relationship between pullwire tension and endoscope articulation, in accordance with one or more embodiments. [Figure 17] FIG. 10 is a flow diagram of a process for passively homing an endoscope in accordance with one or more embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0037] The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed invention. While certain preferred embodiments and examples are disclosed below, the inventive subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as modifications and equivalents thereof. Accordingly, the scope of claims that may arise from this specification is not limited by any of the specific embodiments described below. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as multiple separate operations, in a manner that may be helpful in understanding a particular embodiment; however, the order of description should not be construed to imply that these operations are order-dependent. Additionally, structures, systems, and / or devices described herein may be embodied as integrated or separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not necessarily all such aspects or advantages are achieved by any particular embodiment. Thus, for example, various embodiments may be performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0038] Certain reference numbers are reused across different figures of a set of figures of the present disclosure for convenience of devices, components, systems, features, and / or modules having characteristics that may be similar in one or more respects. However, with respect to any of the embodiments disclosed herein, the reuse of a common reference number in a figure does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, one skilled in the art may be informed by context as to the extent to which the use of a common reference number may imply similarity between the referenced subject matter. The use of a particular reference number in the context of the description of a particular figure may be understood to relate to the identified device, component, aspect, feature, module, or system in that particular figure, and not necessarily to any device, component, aspect, feature, module, or system identified by the same reference number in another figure. Furthermore, aspects of separate figures identified with a common reference number may be construed as sharing characteristics or as being entirely independent of one another. In some contexts, features associated with separate figures identified by a common reference number are unrelated and / or similar, at least with respect to certain aspects.

[0039] The present disclosure provides systems, devices, and methods for monitoring and controlling the articulation of an instrument shaft, such as a medical endoscope. Articulation of an instrument according to the present disclosure can be implemented by tensioning one or more tendons, referred to herein as "pull wires," that traverse the instrument shaft. With respect to the medical instruments described in this disclosure, the term "instrument" is used according to its broad and ordinary meaning and may refer to any type of tool, device, assembly, system, subsystem, apparatus, component, etc. In some contexts herein, the term "device" may be used substantially interchangeably with the term "instrument." Furthermore, the term "shaft" is used herein according to its broad and ordinary meaning and may refer to any type of elongated cylinder, tube, scope (e.g., endoscope), prism (e.g., rectangular, oval, elliptical, or oval prism), wire, or the like, regardless of cross-sectional shape. It should be understood that any reference herein to a "shaft" or "instrument shaft" may be understood to refer to an endoscope. The term "algorithm" is used according to its broad and ordinary meaning and may refer to any process or set of rules to be followed in a calculation or other operation to solve a problem. An "algorithmic" process or set of rules may be executable on a computing device, system, server, cloud, control circuitry, or other machine, as well as by one or more humans.

[0040] medical treatment While certain aspects of the present disclosure are described in detail herein in the context of renal, urological, and / or nephrological procedures, such as kidney stone removal / treatment procedures, it will be understood that such context is provided for convenience and clarity, and that the instrument articulation control concepts disclosed herein are applicable to any suitable medical procedure, such as robotic bronchoscopy, laparoscopy, arthroscopy, colonoscopy, laryngoscopy, neuroendscopy, rectoscopy, anoscopy, gastroscopy, sigmoidoscopy, thoracoscopy, colposcopy, esophagoscopy, or other endoscopic or elongated shaft-based procedures.

[0041] In certain medical procedures, such as ureteroscopy procedures, an elongated medical instrument accessing the treatment site through an access sheath can be used to remove debris, such as kidney stones and stone fragments or other waste or contaminants, from the treatment site. Kidney stone disease, also known as urolithiasis, is a medical condition involving the formation of solid pieces of material in the urinary tract, referred to as "kidney stones," "urinary stones," "nephrolithiasis," or "nephrolithiasis." Urinary stones can form and / or be found in the kidneys, ureters, and bladder (referred to as "bladder stones"). Such urinary stones can form as a result of the concentration of minerals in urine, and can cause significant abdominal pain if they reach a size sufficient to obstruct urine flow through the ureter or urethra. Urinary stones can be formed from calcium, magnesium, ammonia, uric acid, cystine, and / or other compounds, or combinations thereof.

[0042] Several methods may be used to treat patients with kidney stones, including observation, medical treatment (such as expulsion therapy), non-invasive treatment (such as extracorporeal shock wave lithotripsy (ESWL)), minimally invasive or surgical treatment (such as ureteroscopy and percutaneous nephrolithotomy ("PCNL")), etc. In some approaches (e.g., ureteroscopy and PCNL), a physician gains access to the stone, the stone is broken into smaller pieces or fragments, and the smaller stone fragments / particles are extracted from within the kidney using a basket device and / or suction.

[0043] In some procedures, a surgeon may insert an endoscope (e.g., a ureteroscope) through the urethra and into the urinary tract to remove urinary stones from the bladder and ureters. Typically, the ureteroscope includes a camera at its distal end configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotripsy device configured to capture or fragment ureteral stones, or allow for placement within the working channel of the ureteroscope. In some procedures, such as procedures to remove relatively large stones / fragments, a physician may use a percutaneous nephrolithotomy ("PCNL") technique, which involves inserting a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site to fragment and / or remove the stone. A percutaneous access device (e.g., a nephroscope, sheath, sheath assembly, and / or catheter) (and / or a direct entry endoscope) used to provide an access channel to a target anatomical site may include one or more fluid channels for providing irrigation fluid flow to the target site and / or for aspirating fluid from the target site (e.g., through passive outflow and / or active suction).

[0044] Robotic-assisted ureteroscopic procedures may be performed in connection with various medical procedures, such as kidney stone removal procedures, and robotic tools may enable physicians / urologists to perform endoscopic target access as well as percutaneous access / treatment. Advantageously, aspects of the present disclosure relate to systems, devices, and methods for robotically controlling the articulation of an instrument shaft (e.g., an endoscope shaft) so as to reduce the risk of injury or damage to the patient's anatomy and / or the instrument.

[0045] medical system FIG. 1 illustrates an example medical system 100 for performing various medical procedures in accordance with aspects of the present disclosure. The medical system 100 may be used, for example, in endoscopic (e.g., ureteroscopic) procedures. As mentioned and described above, certain ureteroscopic procedures involve the treatment / removal of kidney stones. In some implementations, kidney stone treatment may benefit from the assistance of certain robotic techniques / devices. Robotic medical solutions may provide relatively greater precision, greater control, and / or better eye-hand coordination for certain instruments compared to procedures using only human hands. For example, robotically assisted ureteroscopic access to the kidney in some procedures may advantageously allow a urologist to articulate the ureteroscope using a robotic control gear / drive coupled to the handle / base portion of the ureteroscope. While the medical system 100 of FIG. 1 is presented in the context of a ureteroscopic procedure, it should be understood that the principles disclosed herein may be implemented in any type of endoscopic procedure.

[0046] The medical system 100 includes a robotic system 10 (e.g., a mobile robotic cart) configured to engage and / or control a medical instrument 19 (e.g., an endoscope / ureteroscope) including a proximal handle / base 31 and a shaft 40 coupled at its proximal portion to the handle 31 to perform a direct entry procedure on a patient 7. In some examples, the term “medical instrument” may interchangeably refer to any portion of the medical instrument 19, including the proximal handle / base 31, the shaft 40, the scope, the scope tip, etc. The term “direct entry” is used herein according to its broad and ordinary meaning and may refer to any entry of instrumentation through a natural or artificial opening in a patient's body. For example, with reference to FIG. 1 , direct entry of the scope / shaft 40 into the urinary tract of a patient 7 may occur through the urethra 65. The term “patient” is used herein to refer to a living patient, as well as any subject to which the present disclosure may be applicable. For example, "patient" may refer to a subject, including a mannequin used in a rehearsal, a model in a computer simulation, etc., covering a non-living patient or subject.

[0047] It should be understood that the direct entry instrument 19 may be any type of shaft-based medical instrument, including an endoscope (e.g., a ureteroscope), a catheter (e.g., a steerable or non-steerable catheter), a nephroscope, a laparoscope, or other type of medical instrument. The embodiments of the present disclosure relating to a ureteroscopic procedure for removing a kidney stone through a ureteral access sheath (e.g., the ureteral access sheath 190) are also applicable to solutions for removing objects through percutaneous access, such as through a percutaneous access sheath. For example, an instrument may percutaneously access the kidney, e.g., through a percutaneous access sheath, to capture and remove a kidney stone. The term “percutaneous access” is used herein in accordance with its broad and ordinary meaning and may refer to entry, such as by puncture and / or small incision, of an instrument through a patient's skin and any other body layers necessary to reach a target anatomical location associated with the procedure (e.g., the calyceal rete of the kidney 70).

[0048] The medical system 100 includes a control system 50 configured to interface with the robotic system 10 to provide information regarding the procedure and / or perform various other operations. For example, the control system 50 may include one or more displays 56 configured to present certain information to assist the physician 5 and / or other technicians or individuals. The medical system 100 may include a table 15 configured to hold a patient 7. The medical system 100 may further include an electromagnetic (EM) field generator 18, which may be carried by one or more of the robotic arms 12 of the robotic system 10, or which may be a stand-alone device and / or may be attached to the table 15. While the various robotic arms 12 are shown in different positions and coupled to various tools / devices, it should be understood that such configurations are shown for convenience and illustrative purposes, and that such robotic arms may have different configurations over time and / or at different points during a medical procedure. Additionally, robotic arm 12 may be coupled to devices / instruments different from those shown in FIG. 1 , and in some cases or periods, one or more of the arms may not be utilized or coupled to a medical instrument. Articulation of shaft 40 may be robotically controlled, such as through movement of an end effector associated with robotic arm 12 a, and such movement may be controlled by control system 50 and / or robotic system 10. The term “end effector” is used herein according to its broad and ordinary meaning and may refer to any type of robotic manipulator device, component, and / or assembly. In implementations in which an adapter, such as a sterile adapter, is coupled to a robotic end effector or other robotic manipulator, the term “end effector” may refer to the adapter (e.g., the sterile adapter) or any other robotic manipulator device, component, or assembly associated with and / or coupled to the end effector.In some contexts, the combination of a robotic end effector and an adapter may be referred to as an instrument manipulator assembly, and such an assembly may or may not also include a medical instrument (or instrument handle / base) physically coupled to the adapter and / or end effector. The terms "robotic manipulator" and "robotic manipulator assembly" are used according to their broad and ordinary meanings and may refer collectively or individually to a robotic end effector and / or a sterile adapter or other adapter component coupled to the end effector. For example, the terms "robotic manipulator" and "robotic manipulator assembly" may refer to an instrument device manipulator (IDM) that includes one or more drive outputs, whether embodied in a robotic end effector, a sterile adapter, and / or other components. The terms "related to" and "associated with" are used herein according to their broad and ordinary meanings. For example, if a first feature, element, component, device, or member is described as being "associated" with a second feature, element, component, device, or member, such description should be understood to indicate that the first feature, element, component, device, or member is physically coupled to, attached to, connected to, integrated with, at least partially embedded within, or otherwise physically associated with, whether directly or indirectly, the second feature, element, component, device, or member.

[0049] In an exemplary use case, if patient 7 has a kidney stone (or stone fragments) 180 located in kidney 70, physician 5 may perform a procedure to remove stone 180 through the urinary tract (63, 60, 65). In some embodiments, physician 5 can interact with control system 50 and / or robotic system 10 to cause / control robotic system 10 to advance and navigate a medical instrument shaft 40 (e.g., a scope) from urethra 65, through bladder 60, up ureter 63, and into the renal pelvis 71 and / or calyceal rete of kidney 70 where stone 180 is located. Physician 5 can further interact with control system 50 and / or robotic system 10 to cause / control the advancement of a basket device or other instrument through the working channel of instrument shaft 40, configured to facilitate capture and removal of the kidney stone or stone fragments. The control system 50 may provide information associated with the medical instrument 40 and / or other instruments of the medical system 100, such as real-time endoscopic images captured therewith, via the display 56 to assist the physician 5 in navigating / controlling such instruments.

[0050] Renal anatomy is described herein for reference with respect to specific medical procedures related to aspects of the inventive concept. Kidneys 70, shown generally in a typical anatomical location in FIG. 1 , generally comprise two bean-shaped organs located on the left and right sides, respectively, within the retroperitoneal space. In an adult human, the kidneys generally measure approximately 11 cm in height / length. The kidneys receive blood from paired renal arteries 69, and blood leaves the kidneys via paired renal veins 67. Each kidney 70 is fluidly connected to a respective ureter 63, which generally comprises a tube that carries urine drained from the kidney 70 to the bladder 60.

[0051] The kidneys 70 typically lie relatively high within the abdominal cavity, in a retroperitoneal position at a slight oblique angle. Intraperitoneal asymmetry, generally caused by the position of the liver, typically causes the right kidney to be slightly lower and smaller than the left, and slightly more centrally located than the left kidney (as shown in detail in FIG. 1 ). Above each kidney is an adrenal gland (not shown). The upper portion of the kidney 70 is partially protected by the 11th and 12th ribs (not shown). Each kidney, along with its adrenal gland, is generally surrounded by two layers of fat: perirenal fat, located between the renal fascia and the renal capsule, and pararenal fat, located above the renal fascia.

[0052] The kidneys 70 help control the volume of various body fluid compartments, fluid osmolality, acid-base balance, various electrolyte concentrations, and the removal of toxins. The kidneys 70 provide a filtration function by secreting certain substances and reabsorbing others. Examples of substances secreted in urine are hydrogen, ammonium, potassium, and uric acid. In addition, the kidneys also perform various other functions, such as hormone synthesis.

[0053] The recessed area on the concave border of the kidney 70 is the renal hilum 181, where the renal artery 69 enters the kidney 70 and the renal vein 67 and ureter 63 exit. The kidney 70 is surrounded by a tough fibrous tissue, the renal capsule 74, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (back) surface is the transversalis fascia.

[0054] The functional matrix, or parenchyma, of the kidney 70 is divided into two major structures: the outer renal cortex 77 and the inner renal medulla 187. These structures each take the form of multiple roughly conical renal lobes containing a renal cortex surrounding a portion of the medulla called the renal pyramids 72. Between the renal pyramids 72 are processes of the cortex called the renal columns 73. The urine-producing functional structure of the kidney, the nephron (not shown in detail in FIG. 1 ), spans the cortex 77 and medulla 187. The initial filtering portion of the nephron is the renal corpuscle, located in the cortex, followed by renal tubules that run from the cortex deep into the medullary pyramids. The medullary ray, part of the renal cortex, is a collection of tubules that drain into a single collecting duct.

[0055] The tip / apex, or papilla 79, of each renal pyramid drains urine into a respective minor calyx 75, which drains into a major calyx 76, which drains into the renal pelvis 71, where it empties into the ureter 63. The manifold-shaped collection of minor and major calyxes may be referred to herein as the kidney's "calyx network." At the renal hilum 181, the ureter 63 and renal vein 67 exit the kidney, and the renal artery 69 enters the kidney. Hilar fat and lymphatic tissue, along with lymph nodes, surround these structures. The hilar fat is adjacent to a fat-filled cavity called the renal sinus. The renal sinus collectively contains the renal pelvis 71 and calyxes 75, 76 and separates these structures from the renal medullary tissue. The funnel-shaped / tubular anatomical structure associated with the calyx may be referred to as the infundibulum. That is, the infundibulum generally marks the end of the calyx, where the papilla is exposed within the calyx.

[0056] With further reference to the medical system 100, a medical instrument shaft 40 (e.g., a scope, direct entry instrument, etc.) may be advanced through the urinary tract and into the kidney 70. Specifically, a ureteral access sheath 190 may be disposed within the urinary tract to an area near the kidney 70. The shaft 40 may be passed through the ureteral access sheath 190 to access the internal anatomical structures of the kidney 70, as shown. A distal portion of the scope / shaft 40 deployed from the sheath 190 may be articulatable to allow the surgeon 5, using input from the control device 55, to cause the robotic system 10 to articulate the shaft 40 toward the target kidney stone. Once at the site of the kidney stone 180 (e.g., within the target calyx 75 of the kidney 70 where the stone 180 is accessible), the medical instrument 19 and / or its shaft 40 may be used to guide / direct the basket device to the target location. Once the stone 180 is captured within the distal basket portion of the basket device / assembly, the kidney stone 180 may be extracted from the patient 7 using the utilized ureteral access pathway.

[0057] Various scope / shaft-type instruments disclosed herein, such as the shaft 40 of the medical system 100, can be configured to navigate within the human anatomy, such as within natural orifices or lumens of the human anatomy. The terms “scope” and “endoscope” are used herein according to their broad and ordinary meaning and may refer to any type of elongated (e.g., shaft-type) medical instrument having imaging, viewing, and / or capturing capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space in the body. Scopes can include, for example, ureteroscopes (e.g., for accessing the urinary tract), laparoscopes, nephroscopes (e.g., for accessing the kidneys), bronchoscopes (e.g., for accessing the airways such as the bronchi), colonoscopes (e.g., for accessing the colon), arthroscopes (e.g., for accessing joints), cystoscopes (e.g., for accessing the bladder), colonoscopes (e.g., for accessing the colon and / or rectum), borescopes, etc. The scope / endoscope, in some cases, may comprise at least a portion of a rigid and / or flexible tube and may be sized to be passed through an outer sheath, catheter, introducer, or other luminal device, or may be used without such a device.

[0058] FIG. 2 illustrates a cart-based robotic system 101 arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. During bronchoscopy, the arms 12 of the robotic system 10 can be configured to drive a medical instrument shaft 40, such as a steerable endoscope, which may be a procedure-specific bronchoscope for bronchoscopy, through a natural orifice access point (e.g., the mouth of a patient 7 positioned on a table 15 in this example) to deliver diagnostic and / or therapeutic tools and / or treatments. Depending on the medical procedure being performed, the robotic arms 12 can include more or fewer arms. As shown, the robotic system 10 (e.g., a cart) can be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arms 12 can be actuated to position the bronchoscope / shaft 40 relative to the access point. The arrangement in FIG. 2 can also be utilized when a gastrointestinal (GI) procedure is performed using a gastroscope, which is an endoscope specialized for GI procedures.

[0059] Once the robotic system 10 is properly positioned, the robotic arm 12 may insert the steerable / articulatable endoscope 40 into the patient robotically, manually, or a combination thereof. The endoscope 40 may be advanced within an outer sheath 190, and each of the scope 40 and sheath 190 may be coupled and / or associated with one of a set of instrument feeders and / or instrument handles 11, each coupled to the distal end of a respective robotic arm 12. This linear arrangement of feeders / handles 11 can create a “virtual rail” 104 that can be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or positions. One or more of the instrument feeders / handles 11 may be configured to implement robotic articulation of the shaft 40 and may be configured according to one or more embodiments disclosed herein for such purpose.

[0060] After insertion, the endoscope 40 can be directed downstream of the patient's trachea and lungs using precise articulation commands from the robotic system 10 until it reaches the target surgical site. For example, the endoscope 40 can be directed to deliver a biopsy needle to a target, such as a lesion or nodule within the patient's lung. The needle can be deployed downstream of the working channel along the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the results of the pathology, additional tools can be deployed downstream of the endoscope's working channel for additional biopsies. For example, if a nodule is identified as malignant, the endoscope 40 can deliver tools endoscopically to remove potentially cancerous tissue. In some cases, diagnostic and therapeutic procedures can be delivered in separate procedures. In those situations, the endoscope 40 can also be used to deliver fiducial markers to "mark" the location of the target nodule.

[0061] In the robotic system 101, the patient introducer 102 can be attached to the patient 7 via a port (not shown, e.g., surgical tubing). The curvature of the patient introducer 102 can allow the robotic system 10 to manipulate the instruments 40 from a position that is not in direct axial alignment with the patient access port, thereby allowing greater flexibility in the placement of the robotic system 10 within a room. Furthermore, the curvature of the patient introducer 102 can allow the robotic arm 12 of the robotic system 10 to be substantially horizontally aligned with the patient introducer 102, which can facilitate manual movement of the robotic arm 12 as needed. The control system 50 and / or the robotic cart 10 can include control circuitry configured to implement scope articulation control as described herein.

[0062] For reference, FIG. 2 shows details of certain respiratory anatomical structures through which the scope 40 can be advanced and / or articulated. Generally, the respiratory system includes certain passageways, blood vessels, organs, and muscles that aid the body in gas exchange between air and blood, and between blood and body cells. The respiratory system includes the upper respiratory tract, including the nose / nasal cavity, pharynx (i.e., throat), and larynx (i.e., voice box). The respiratory system further includes the lower respiratory tract, shown in detail, including the trachea 6, lungs 4, and various segments of the bronchial tree 30, including the alveoli and alveolar ducts, which contain clusters of small air sacs responsible for gas exchange between the lungs and the pulmonary blood vessels. The bronchial tree 30 is an exemplary network of lumens through which a robotically controlled instrument can navigate and articulate in accordance with the inventive solutions presented herein. However, although aspects of the present disclosure are presented in the context of a luminal network including the bronchial network (e.g., lumens, branches) of the airways of a patient's lungs, embodiments of the present disclosure may be implemented in other types of luminal networks, such as the renal network, the cardiovascular network (e.g., arteries and veins), the gastrointestinal tract, the urinary tract, etc. The organs of the lower respiratory tract are located inside the thoracic cavity, which is bounded by the sternum (i.e., chest bone) and rib cage in front and the vertebrae (i.e., spine) in back, which collectively protect the lungs and other organs within the chest.

[0063] The trachea 6 is located just below the larynx 5 and provides the main airway to the lungs 4. l and right 4 rThe lungs are responsible for delivering oxygen to the capillaries and expelling carbon dioxide. The bronchi 7 branch from the trachea 6 to each lung 4, forming an intricate network of passages that supply air to the lungs 4. The diaphragm is the primary respiratory muscle that contracts and relaxes to move air into the lungs. The trachea 6 is the tube that carries air in and out of the lungs 4. Each lung 4 is associated with tubes 7 called bronchi that connect to the trachea. The trachea and bronchi form the bronchial tree 30. The bronchial tree 30 includes primary bronchi 81, which branch into smaller secondary bronchi 88 and tertiary bronchi 85, which terminate in even smaller tubes called bronchioles 87. Each bronchiolar tube is connected to a cluster of alveoli. During the inhalation phase of the respiratory cycle, air enters through the mouth and nose, travels down the throat into the trachea 6, passes through the left and right main bronchi 81 into the lungs 4, enters the smaller bronchial airways 88, 85, enters the smaller bronchioles 87, and enters the alveoli where oxygen and carbon dioxide exchange occurs.

[0064] Lung cancer and other cancers generally involve abnormal cell growth (e.g., in the area of ​​the lungs or other anatomical structures), which may have the potential to invade or spread to other parts of the body. For example, cancer may form in lung tissue, such as cells lining various airways. If not treated effectively and / or in a timely manner, lung cancer may spread / metastasize to lymph nodes or other organs in the body, which can seriously affect the patient's chances of recovery. In FIG. 2 , patient 7 is shown with a mass of tissue 89, called a pulmonary nodule, formed in the area of ​​lung 4. Such pulmonary nodules may be benign or cancerous. Determining whether a pulmonary nodule is cancerous may involve the use of one or more anatomical imaging modalities and / or minimally invasive lung biopsy, such as in conjunction with certain thoracoscopes, bronchoscopes, and / or robotic procedures. For example, robotically controlled instrumentation can be implemented to perform a diagnostic biopsy procedure from within the bronchial network.

[0065] In the illustrated example, the medical instrument 19 includes an endoscope 40. The scope 40 may be slidably disposed within a working channel of the sheath 190. The scope 40 may have a lumen (i.e., a "working channel") through which an instrument, such as a biopsy needle and / or syringe needle, a cytological brush, and / or tissue sampling forceps, may be passed to a target tissue site in the nodule 89. The terms "lumen" and "channel" are used herein according to their broad and ordinary meaning and may refer to a physical structure that forms a cavity, void, conduit, or other pathway, such as an at least partially rigid elongated tubular structure, or may refer to a cavity, void, pathway, or other channel itself that occupies space within an elongated structure (e.g., a tubular structure). Thus, with respect to an elongated tubular structure, such as a shaft, tube, or the like, the term "lumen" or "channel" may refer to the elongated tubular structure and / or a channel or space within the elongated tubular structure. This nested configuration of the sheath 190 and scope 40 may allow for a relatively thin design of the scope 40, which may improve the bend radius of the scope 40 while still supporting structures through the sheath 190. As shown, to reach the nodule 89, the scope shaft 40 may be navigated or guided through a lumen or branch of the lumen network 7. An operator (e.g., a surgeon) may use various advancement and articulation commands to navigate the instrument 40 to the nodule 89.

[0066] 3 illustrates a pedestal-based robotic system 103 according to one or more embodiments of the present disclosure. The system 103 incorporates the robotic components 105 into a pedestal / platform 147, thereby allowing for a reduced amount of capital equipment in the operating room compared to some cart-based robotic systems, which in some cases can allow for greater access to the patient 7. Similar to cart-based systems, the instrument device manipulator assemblies associated with one or more robotic arms 212a-212c of the system 103 may generally comprise instruments and / or instrument feeders designed to manipulate an elongated medical instrument / shaft, such as an endoscope 40, along a virtual rail / path.

[0067] As shown, the robotic platform system 103 can include a column 144 coupled to one or more carriages 141 (e.g., a ring-shaped movable structure) from which robotic arms 212a-212c can emanate. The carriage 141 can translate along a vertical column interface over at least a portion of the length of the column 144 to provide different vantage points from which the robotic arms 212a-212c can be positioned to reach the patient 7. The carriage 141, in some embodiments, can rotate about the column 144 using a mechanical motor positioned within the column 144 to allow the robotic arms 212a-212c to access multiple sides of the platform 147. The rotation and / or translation of the carriage 141 can enable the system 103 to align medical instruments, such as the endoscope 40 and sheath 190, to different access points on the patient 7. By providing vertical adjustment, the robotic arms 212a-212c can be advantageously configured to be compactly stored beneath the table / platform 147 of the table system 103 and then elevated during a procedure.

[0068] The robotic arms 212a-212c may be mounted to the carriage 141 through one or more arm mounts 145, which may comprise a series of joints that may independently rotate and / or telescopically extend to provide additional configurability for the robotic arms 212a-212c. A column 144 structurally provides support for a base / platform 147 and a path for vertical translation of the carriage 141. The column 144 may also transmit power and control signals to the carriage 141 and / or the robotic arms 212a-212c mounted thereon. The system 103 may include specific control circuitry configured to control the drive and / or articulation of the instrument shaft 40 using the end effector of one of the robotic arms 212a-212c. For visual clarity, a control tower / system is not shown in FIG. 3, but it should be understood that the system 103 may include a control tower / system, as in any embodiment disclosed herein.

[0069] FIG. 4 illustrates an exemplary embodiment of the control system of any of FIGS. 1-3. The associated control system 50 can be configured to provide various functions to assist in the performance of a medical procedure. In some embodiments, the control system 50 can be coupled to the robotic system 10 and operate in cooperation with the robotic system 10 to perform a medical procedure on a patient 7. For example, the control system 50 can communicate with the robotic system 10 via a wireless or wired connection (e.g., to control the robotic system 10). Additionally, in some embodiments, the control system 50 can communicate with the robotic system 10 to receive position data from the robotic system regarding the position of the distal end of the scope 40. Such position data regarding the position of the scope 40 can be derived using one or more electromagnetic sensors associated with the respective components, scope image processing capabilities, and / or based at least in part on robotic system data (e.g., arm position data, known parameters / dimensions of various system components, etc.).

[0070] FIG. 4 further illustrates an exemplary embodiment of the robotic system of any of FIGS. 1-3. The robotic system 10 can be configured to at least partially facilitate the performance of a medical procedure. The robotic system 10 can be arranged in various ways depending on the particular procedure. The robotic system 10 can include, for example, one or more robotic arms 12 configured to engage and / or control a scope 40 to perform one or more aspects of the procedure. As shown, each robotic arm 12 can include multiple arm segments 23 coupled to joints 24 that can provide multiple degrees of movement / freedom. Once the robotic system 10 is properly positioned, the scope 40 can be inserted into the patient 7 robotically using the robotic arms 12, manually by the physician 5, or a combination thereof. Referring to FIG. 1, a scope-driver / feeder instrument coupler 11 (i.e., an instrument device manipulator (IDM)) can be attached to the distal end effector 22 of one of the arms 12b to facilitate robotic control / advancement of the scope 40. Another of the arms 12a may be associated with an instrument base / handle 31, and the scope 40 may be physically coupled to the handle 31 at the proximal end of the scope 40. The scope 40 may include one or more working channels 44 through which additional tools, such as lithotriptors, basket devices, forceps, etc., may be introduced into the treatment site.

[0071] 1-4 , the robotic system 10 may be coupled to any component of a medical system, such as a control system 50, a stage 15, an EM field generator 18, a scope 40, and / or any type of percutaneous access instrument (e.g., needle, catheter, nephroscope, etc.). In some embodiments, the robotic system 10 is communicatively coupled to the control system 50. For example, the robotic system 10 may be configured to receive control signals from the control system 50 to perform specific actions, such as positioning one or more of the robotic arms 12 in a particular manner or manipulating (e.g., advancing, articulating) the scope 40. In response, the robotic system 10 may be controlled to perform actions using specific control circuitry 211, actuators 217, and / or other components of the robotic system 10. For example, the control circuitry 211 may control the articulation of the shaft / scope 40 by actuating a drive output of the end effector 22 coupled to the instrument handle 31. In some embodiments, the robotic system 10 and / or control system 50 are configured to receive images and / or image data from the scope 40 representing the internal anatomical structure of the patient 7 and / or portions of the access sheath or other device components.

[0072] The robotic system 10 generally includes an elongated support structure (also referred to as a "column" 14), a robotic system base 25, and a console 13 at the top of the column 14. The column 14 may include one or more arm supports 17 (also referred to as "carriages") for supporting the deployment of one or more robotic arms 12 (three are shown in FIGS. 1 and 2). The arm supports 17 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arms 12 for more desired positioning relative to the patient.

[0073] The arm support 17 can be configured to translate vertically along the column 14. In some embodiments, the arm support 17 can connect to the column 14 through slots 20 positioned on either side of the column 14 to guide the vertical translation of the arm support 17. The slots 20 accommodate vertical translation interfaces for positioning and holding the arm support 17 at various vertical heights relative to the robotic system base 25. The vertical translation of the arm support 17 allows the robotic system 10 to adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, individually configurable arm mounts on the arm support 17 can allow the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0074] The robotic arm 12 may generally include a robotic arm base 21 and end effectors 22 separated by a series of articulated arm segments 23 connected by a series of joints 24, each joint 24 including one or more independent actuators 217. Each actuator may include an independently controllable motor. Each independently controllable joint 24 may provide or represent an independent degree of freedom available to the robotic arm. In some embodiments, each of the arms 12 has seven joints, thus providing seven degrees of freedom, including "redundant" degrees of freedom. The redundant degrees of freedom allow the robotic arm 12 to position its respective end effector 22 at a specific position, orientation, and trajectory in space using different linkage positions and joint angles. This allows the system to position and orient the medical instrument from a desired point in space, while also allowing the physician 5 to move the arm joints to a clinically advantageous position away from the patient to create greater access while avoiding arm collisions.

[0075] The robotic system base 25 balances the weight of the column 14, arm support 17, and arm 12 on the floor. Thus, the robotic system base 25 can house certain relatively heavier components, such as electronics, motors, power supplies, and components that selectively enable movement or immobilize the robotic system. For example, the robotic system base 25 can include casters 28 in the form of wheels that allow the robotic system to be easily moved around the operating room before a procedure. After reaching the appropriate position, the casters 28 can be locked using wheel locks to hold the robotic system 10 in place during a procedure.

[0076] When positioned at the top of column 14, console 13 can provide both a user interface for receiving user input and a display screen 16 (or dual-purpose device, e.g., a touchscreen) for providing both pre-operative and intra-operative data to physician / user 5. Potential pre-operative data on the console / display (e.g., display screen 16 of FIGS. 1 and 2 ) or display 56 can include pre-operative planning, navigation and mapping data derived from a pre-operative computerized tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data on the display can also include optical information provided by tools, sensor information from sensors, and coordinate information, as well as vital patient statistics such as respiration, heart rate, and / or pulse. Console 13 can be positioned and tilted to allow physician 5 to access the console from the side of column 14 opposite arm support 17. From this position, physician 5 can view console 13, robotic arm 12, and the patient while operating console 13 from behind robotic system 10. As shown, the console 13 may also include a handle 27 to assist in manipulating and stabilizing the robotic system 10 .

[0077] Each end effector 22 of the robotic arm 12 may include or be configured to couple to an instrument device manipulator (IDM) (e.g., instrument base / handle) 11, which, in some cases, may be attached using a sterile adapter component. The combination of the end effector 22 and associated IDM, and any intervening articulations or couplings (e.g., sterile adapters), may be referred to as a manipulator assembly. In some embodiments, the IDM 11 may be removed and replaced with a different type of IDM; for example, a first type of IDM / instrument may be configured to manipulate the endoscope / shaft, and a second type of IDM / instrument 31 may be associated with (e.g., coupled to a proximal portion of) the shaft 40 and configured to articulate the shaft. Another type of IDM / instrument may be configured to hold the electromagnetic field generator 18. The IDM may provide a power and control interface. For example, the interface may include connectors for transmitting pneumatic pressure, power, electrical signals, and / or optical signals from the robotic arm 12 to the IDM 11. The IDM 11 may be configured to manipulate a medical instrument (e.g., a surgical tool / instrument), such as the scope 40, using techniques including, for example, direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, and the like. In some embodiments, the device manipulator 11 may be attached to a respective one of the robotic arms 12, which are configured to insert or retract each associated medical instrument into or from a treatment site.

[0078] 1-4 may include specific control circuits configured to perform specific functions described herein, including control circuitry 211 of robotic system 10 and control circuitry 251 of control system 50. That is, the control circuitry of systems 100, 101, 103, 400 may be part of robotic system 10, control system 50, or some combination thereof. Accordingly, all references to control circuits herein may refer to circuitry embodied in the robotic system, the control system, or any other component of a medical system, such as systems 100, 101, 103, and 400 shown in FIGS. 1-4, respectively. The term “control circuitry” is used herein according to its broad and ordinary meaning and may refer to any collection of processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connectivity circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any devices that manipulate signals (analog and / or digital) based on hard-coded and / or operational instructions in the circuits. Control circuitry referred to herein may further include one or more circuit boards (e.g., printed circuit boards), conductive traces and vias, and / or mounting pads, connectors, and / or components. Control circuitry referred to herein may further comprise one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuitry of a device. Such data storage devices may include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information.It should be noted that in embodiments in which the control circuitry comprises hardware and / or software state machines, analog circuits, digital circuits, and / or logic circuits, the data storage devices / registers that store any associated operational instructions may be embedded within or external to the circuitry that comprises the state machines, analog circuits, digital circuits, and / or logic circuits.

[0079] The control circuits 211, 251 may include computer-readable media configured to store and / or store hard-coded and / or operational instructions corresponding to at least some of the steps and / or functions illustrated in one or more of the present figures and / or described herein. Such computer-readable media may, in some cases, be included in an article of manufacture. The control circuits 211, 251 may be maintained / located entirely locally or may be at least partially remotely located (e.g., indirectly communicatively coupled via a local area network and / or wide area network). Either of the control circuits 211, 251 may be configured to perform any aspect of the various processes disclosed herein, including the processes shown in FIGS. 11 and 13, as described below.

[0080] With respect to robotic system 10, at least a portion of control circuitry 211 may be integrated with base 25, column 14, and / or console 13 of robotic system 10, and / or another system communicatively coupled to robotic system 10. With respect to control system 50, at least a portion of control circuitry 251 may be integrated with console base 51 and / or display unit 56 of control system 50. It should be understood that any description herein of functional control circuitry or related functionality may also be understood to be embodied at least in part in robotic system 10, control system 50, or any combination thereof, and / or in one or more other local or remote systems / devices, such as control circuitry associated with the handle / base of a shaft-type instrument (e.g., an endoscope) according to any of the disclosed embodiments.

[0081] The control circuitry 211 and / or the control circuitry 251 may be communicatively coupled to one or more torque sensors 216 configured to generate signals indicative of torque on one or more actuators of the robotic system 10. The torque sensors 216 may have any suitable or desirable configuration. For example, the torque sensors 216 may function as sensed mounting structures or load cells. In some embodiments, the torque sensors 216 are configured as reactive torque sensors that measure torque-induced strain using one or more self-contained strain gauges to create a load cell. While the torque sensors 216 of the robotic system are described herein in the context of determining tension in a pull wire / tendon of an endoscopic instrument coupled to the robotic system 10, such references may be understood to represent any type of sensor or sensing mechanism configured to generate a signal indicative of pull wire tension, such as a strain gauge. References herein to strain gauges may refer to any type of sensor configured to measure forces / loads on a robotic actuator, whether such forces are rotational or linear in nature. That is, although rotary robot output drives are disclosed in some contexts herein, it should be understood that the inventive concepts disclosed herein apply to other types of actuators, such as linear drives.

[0082] 1-4 , the control system 50 can include various I / O components 258 configured to assist the physician 5 or others in performing a medical procedure. For example, the input / output (I / O) components 258 can be configured to allow user input to control / navigate the scope 40 and / or other robotically controlled instruments (e.g., a basket system) within the patient 7. In some embodiments, for example, the physician 5 can use one or more input controls 255 to provide input to the control system 50 and / or the robotic system 10, and in response to such input, can send control signals to the robotic system 10 to operate the scope 40. The control system 50 can include one or more display devices 56 to provide various information regarding the procedure. For example, the display 56 can provide information regarding the scope 40. For example, the control system 50 can receive real-time images captured by the scope 40 and display the real-time images via the display 56. Additionally or alternatively, the control system 50 can receive signals (e.g., analog, digital, electrical, acoustic / sonic, pneumatic, tactile, hydraulic, etc.) from medical monitors and / or sensors associated with the patient 7, and the display 56 can present information regarding the health or environment of the patient 7. Such information may include, for example, information displayed via the medical monitor, such as heart rate (e.g., ECG, HRV, etc.), blood pressure / blood velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, brain waves (e.g., EEG), environmental and / or local or core body temperature information. Similarly, the robotic system 10 can include various I / O components 218 integrated on the console 13 and configured to assist the physician 5 or others in setting up the robotic system 10.

[0083] The various components of the systems of FIGS. 1-4 can be communicatively coupled to one another over a network, which can include a wireless network and / or a wired network. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), cellular networks, the Internet, personal area networks (PANs), body area networks (BANs), etc. For example, the various communication interfaces 214, 254 of the systems of FIGS. 1-4 can be configured to communicate with one or more devices / sensors / systems, such as over wireless and / or wired network connections. In some embodiments, the various communication interfaces 214, 254 can implement wireless technologies such as Bluetooth, Wi-Fi, near field communication (NFC), etc. Furthermore, in some embodiments, the various components of the systems can be connected for data communication, fluid exchange, power exchange, etc. via one or more supporting cables, conduits, etc.

[0084] The control system 50 and / or the robotic system 10 may include specific user controls (e.g., controls 55), which may comprise any type of user input (and / or output) device or device interface, such as one or more buttons, keys, joysticks, handheld controllers (e.g., video game-type controllers), computer mice, trackpads, trackballs, control pads, and / or sensors (e.g., motion sensors or cameras) that capture hand and finger gestures, touchscreens, and / or interfaces / connectors therefor. Such user controls are communicatively and / or physically coupled to respective control circuits. In some embodiments, a user may engage the user controls 55 to command robot shaft articulation, as described herein. Additionally, the control system 50 and / or the robotic system 10 may include one or more power interfaces 219, 259 configured to provide electrical power.

[0085] FIG. 4 shows further details of an exemplary articulatable scope assembly / instrument 19 that may be implemented in connection with any of the embodiments of the present disclosure. In some embodiments, the scope assembly 19 includes a handle or base 31 coupled to an endoscope / shaft 40. For example, the endoscope (i.e., “scope” or “shaft”) may include an elongated shaft that includes one or more lights 49 and one or more cameras or other imaging devices, such as an imaging device 48. In some implementations, the imaging device may be a separate tool outside of the scope assembly 19 or a tool releasably attachable to or slidable within the scope 40. The scope 40 may further include one or more working channels 44 that may span the length of the scope 40. The scope assembly 19 may be powered through a power interface 39 and / or controlled through a control interface 38, each or both of which may interface with a robotic arm / component of the robotic system 10. The scope assembly 19 may further include one or more sensors 32, such as pressure sensors and / or other force-reading sensors, which may be configured to generate signals indicative of forces experienced at / by one or more components of the scope assembly 19.

[0086] The scope assembly 19 includes certain mechanisms for articulating / deflecting the shaft 40 relative to its axis. For example, the shaft 40 may have associated with it a proximal portion, and one or more drive inputs 34 may be associated with and / or integrated with one or more pulleys / spools 33 configured to tension / release pull wires 45 of the scope shaft 40 to cause articulation of the shaft 40. The terms "strain relief" and "strain relief" are used herein according to their broad and ordinary meaning and may refer to a reduction in tension in a wire, cable, line, or the like, and such terms may be used interchangeably.

[0087] Figure 5 illustrates a robotic articulatable endoscope 40 coupled to a robotic end effector, according to one or more embodiments. Figure 6 shows an exploded view of an instrument device manipulator assembly 150 associated with a robotic arm 12, according to one or more embodiments. Robotic endoscope control can provide relatively greater precision, control, and / or coordination compared to strictly manual procedures. The following description may be understood in the context of Figures 5 and 6 and other embodiments presented herein.

[0088] The scope / shaft (e.g., endoscope / ureteroscope) 40 may comprise a tubular and flexible medical shaft / instrument configured to be inserted into a patient's anatomy to capture images of the anatomy and to perform a specific task using its one or more working channels. In some embodiments, the scope 40 may house wires and / or fiber optics for transmitting signals to / from an optical assembly at the distal end 42 of the scope 40, which may include one or more imaging devices 48, such as optical cameras. The scope 40 may further include one or more light sources 49, such as LEDs or fiber optic light sources / lenses.

[0089] The scope 40 may be articulatable relative to at least a distal portion 42 of the scope 40 so that the scope 40 can be maneuvered within the human anatomy. In some embodiments, the scope 40 is configured to be articulated with six degrees of freedom, including, for example, XYZ coordinate translation as well as pitch, yaw, and roll. Certain position sensors (e.g., electromagnetic sensors) of the scope 40, if implemented, may have similar degrees of freedom with respect to the position information they generate / provide.

[0090] In a robotic implementation, the robotic arm / rail 12 of the robotic system may be configured / configurable to manipulate the scope 40. For example, an instrument device manipulator (e.g., a scope handle) 31 may be coupled to the end effector 22 of the robotic arm / rail 12 and may manipulate the scope 40 using an elongated movement member. The elongated movement member may include one or more pull wires (e.g., pull or push wires), cables, tendons, fibers, and / or flexible shafts. For example, the end effector may be configured to actuate multiple pull wires (not shown) coupled to the scope 40 to deflect the tip 42 of the scope 40. The pull wires may include any suitable or desirable material, such as metallic and non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, and the like. In some embodiments, the scope 40 is configured to exhibit nonlinear behavior in response to forces applied by the elongated movement members. The nonlinear behavior may be based on the stiffness and compressibility of the scope and the slack or stiffness variability between different elongated movement members. The robotic arm 12 may include one or more hinges 382 and / or joints configured to allow the distal portion 384 of the robotic arm 12 to extend in various directions and / or at various angles.

[0091] Scope 40 may further be configured to house an optical fiber for carrying light from a proximally located light source, such as a light emitting diode, to the distal end 42 of the scope. In some embodiments, scope 40 is configured to be controlled by a robotic system similar in one or more respects to systems 100, 101, 103, and 400 shown in Figures 1-4, respectively.

[0092] In some embodiments, the shaft (e.g., scope) 40 includes a sensor configured to generate and / or transmit sensor position data to another device, or to generate a detectable distortion or signature in an electromagnetic field. The sensor position data can indicate the position and / or orientation of the medical instrument 40 (e.g., its distal end 42) and / or can be used to determine / estimate the position / orientation of the medical instrument. For example, the sensor (sometimes referred to as a “position sensor”) can include an electromagnetic (EM) sensor having a coil of conductive material or other form / embodiment of an antenna.

[0093] The instrument base / handle 31 may be configured to be attached, mounted, or otherwise connected or coupled to the robotic end effector 22. For example, a robotic arm may include an instrument drive mechanism / assembly 150 comprising the end effector 22 and / or sterile adapter 8 and the instrument base / handle 31 attached to the end effector 22 and / or adapter 8. The instrument drive mechanism may include drive outputs 302, 309 configured to engage and actuate corresponding drive inputs 602 on the instrument base / handle 31 to manipulate the medical instrument 19. For example, one or more drive outputs 302 of the robotic end effector 22 may be configured to control shaft articulation, as described in detail herein. The drive output 302 of the end effector 22 may be coupled to one or more drive couplings of an adapter (e.g., a sterile adapter) configured to transfer drive torque from the drive output 302 of the end effector 22 to the drive output 309 of the adapter 8. References herein to a robot end effector and / or drive output or other features may be understood to refer to an adapter (e.g., a sterile adapter) coupled to the end effector and / or the adapter's drive output. For example, a description of docking an instrument onto an end effector should be understood to refer to docking the instrument onto the adapter when the adapter is coupled to the end effector.

[0094] In some configurations, the elongated shaft 40 of the medical instrument 19 is arranged to form a service loop 43 between the instrument handle 31 and the instrument feeder 11 and / or an associated robotic arm. The service loop 43 can include the length of the shaft 40 between the instrument base / handle 31 and the feeder device 11. The service loop 43 can provide slack in the shaft 40 that can be used to allow for faster insertion and / or retraction of the shaft 40. For example, during insertion, slack in the service loop 49 can be addressed (shortening or contracting the service loop 49). During retraction, the service loop 49 can be created (increasing or expanding in length).

[0095] The scope 40 is located in the first / primary plane P p The scope 40 may also be deflectable in one or two directions within the primary plane P p A second / secondary plane P that can be perpendicular to s For example, it may be desirable for at least the distal portion 42 of the scope 40 to be deflectable in two or more planes to reach a desired area. p and secondary deflection surface P s is shown in a particular configuration, the illustrated quadratic plane P s is the first order plane P p It should be understood that it may be the case that

[0096] In some embodiments, one or more cables, tendons, pull wires, or pull wire segments can run along the length of the shaft 40. Manipulation / tensioning of the one or more pull wires results in actuation or deflection of the distal portion 42 of the scope 40. Manipulation / tensioning of the one or more pull wires can be controlled via one or more instrument drivers / pulleys positioned within or connected to the instrument base / handle 31.

[0097] The instrument base / handle 31 may generally include a mounting interface having one or more mechanical drive inputs 602 (e.g., receptacles, pulleys, spools, female inputs, etc.) designed to reciprocate with one or more torque couplers on a mounting surface of the instrument driver. The instrument handle 31 may include multiple drive inputs 602, each associated with a respective pull wire articulation pulley. Multiple pull wires may be coupled to the multiple drive inputs 602 (and corresponding pulleys) and extend along the flexible shaft 40. The multiple drive inputs 602 may be configured to control or apply tension to the multiple pull wires in response to rotation of the drive output 302 from a coupled robotic system.

[0098] To navigate the scope 40 through the anatomy, the articulating portion of the scope 40 is aligned in a primary plane P. p The distal portion of the articulating portion can be deflectable in a secondary plane P s The articulating distal portion 42 of the scope 40 may be further deflectable in two directions within the secondary plane P. Thus, the articulating distal portion 42 of the scope 40 may be deflectable in two planes and four directions (e.g., left / right and up / down). The bending radius of the scope 40 may be deflectable in the secondary plane P. s (e.g., less than 180° in either direction) than in the primary plane P p (e.g., up to 270° or more in either direction).

[0099] In embodiments in which the instrument device manipulator assembly 150 (see FIG. 6 ) includes an adapter component 8, the adapter 8 may be attachable to the end effector 22 and configured to provide a driver interface between the end effector 22 and the instrument handle 31. The adapter 8 and / or the instrument handle 31 may be removable or detachable from the robotic arm 12 and, in some embodiments, may lack any electromechanical components, such as motors. This dichotomy may be caused by the need to sterilize medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to the medical instrument's complex mechanical assemblies and sensitive electronics. Therefore, the instrument handle 31 and / or the adapter 8 may be designed to be detached, removed, and replaced from the end effector 22 (and thus the system) for individual sterilization or disposal. In contrast, the end effector 22, in some cases, does not need to be replaced or sterilized and may be covered (e.g., using a drape 301) for protection. The drape 301 may be coupled to the adapter 8 in such a manner to allow transmission of mechanical torque from the end effector 22 to the adapter 8. The adapter 8 may generally be configured to maintain a seal around its working components such that the adapter 8 itself provides a sterile barrier. With the arm 12 covered in plastic, a physician and / or other technician may interact with the arm 12 and / or other components of the robotic cart (e.g., a screen) during a procedure. The draping may further protect against biohazard contamination of equipment and / or minimize post-procedure cleanup.

[0100] In some embodiments, the adapter 8 can include connectors for transmitting air pressure, power, electrical signals, and / or optical signals from the robotic arm 12 and / or end effector 22 to the instrument handle 31. The robotic arm 12 can advance / insert or retract the coupled instrument handle 31 into and out of a treatment site. In some embodiments, the instrument handle 31 can be removed and replaced with a different type of instrument. The end effector 22 of the robotic arm 12 can include various components / elements configured to connect to and / or align with components of the adapter 8, the instrument handle 31, and / or the shaft 40. For example, the end effector 22 may include a drive output 302 (e.g., a drive spline, gear, or rotatable disk with mating features) for controlling / articulating the medical instrument 31, a reader 304 for reading data from the medical instrument 31 (e.g., a radio-frequency identification (RFID) reader for reading a serial number from the medical instrument), one or more fasteners 306 for attaching the instrument handle 31 and / or adapter 8 to the end effector 22, and markers 308 for assisting in instrument alignment and / or defining the front face of the device manipulator assembly 150. In some embodiments, a portion (e.g., a plate) 315 of the adapter 8, when coupled to the end effector 22, may be configured to rotate / spin independently of one or more other components of the adapter 8 and / or end effector 22. The adapter 8 may be configured to release from the end effector 22 via a release tab 303 and / or similar mechanism.

[0101] The instrument handle 31 can include multiple drive inputs 602 on the surface 336 of the housing 80 of the instrument handle 31. In the illustrated embodiment, the instrument handle 31 includes two drive inputs 602, although other embodiments can include a different number of drive inputs. The drive inputs can be at spaced, fixed positions along the mating surface 336 of the instrument handle 31, facilitating coupling of the drive inputs 602 to corresponding drive outputs 302 of the end effector 22, which can be at spaced, fixed positions along the mating surface, designed for modular use to attach a variety of other instruments. The handle 31 can include latch clips or other latching features / means for physically coupling to corresponding structures on the adapter 8 and / or end effector 22.

[0102] A mechanical assembly within the instrument handle 31 can enable the drive inputs 602 to be used to drive articulation of the shaft 40. Each of the drive inputs 602 can be configured to engage a corresponding drive output 302 on the end effector 22. For example, each drive input can include a receptacle configured to mate with a drive output configured as a spline. The drive input and drive output can be configured to engage to transfer motion therebetween. Thus, rotation of the drive output can cause a corresponding rotation of the drive input to control various functions of the instrument handle 31.

[0103] References herein to an "instrument device manipulator assembly," "instrument manipulator assembly," "manipulator," "manipulator assembly," and other variations thereof, can refer to any subset of the components of assembly 150 shown in FIG. 6 , including a robotic arm, an end effector of a robotic arm, an adapter configured to couple to a robotic end effector, an instrument base / handle configured to couple to an end effector and / or adapter, and / or other actuator components, means, and / or mechanisms associated with the instrument base / handle. Furthermore, it should be understood that references herein to an "actuator" can refer to any component of assembly 150 shown in FIG. 6 that directly or indirectly affects or causes movement of an instrument / component engaged with, coupled to, or otherwise actuable by a component of assembly 150. For example, according to embodiments disclosed herein, an "actuator" may comprise any set or subset of the following devices or components: feed rollers, shaft actuation wheels / rollers, feed roller channels, instrument feeder drive inputs, adapter drive outputs, adapter drive inputs, pulleys, belts, gears, pegs, pins, end effector drive outputs, and / or structures and / or control circuits configured to cause their actuation. For example, an actuator may be any component, device, or structure configured to cause a corresponding movement in another component, device, or structure, whether that movement is integrated with or separate from the actuator.

[0104] Dual Wire Pulley FIG. 7 shows an exemplary instrument having one or more dual-wire pulley systems for articulating the instrument's shaft 40, according to one or more embodiments. As illustrated, the instrument 700 can include a shaft 40 and a handle 31. The handle 31 can include one or more dual-wire pulleys, such as a first dual-wire pulley 701 and a second dual-wire pulley 702. Each dual-wire pulley 701, 702 can be robotically controlled / rotated with a received drive output (e.g., drive output 309 of FIG. 6). In other words, the drive output can provide torque that rotates each dual-wire pulley 701, 702 a certain amount of rotation. The dual-wire pulleys 701, 702 can be rotated in either a clockwise or counterclockwise direction.

[0105] As illustrated, the first dual wire pulley 701 can be configured to have a common axis of rotation with the drive output. In some embodiments, the first dual wire pulley 701 is aligned with the first / primary plane P of FIG. p As illustrated, the second dual wire pulley 702 can be configured to have an axis of rotation that is perpendicular to both the axis of rotation of the drive output and the axis formed along the shaft 40 and handle 31. In some embodiments, the second dual wire pulley 702 can be configured to rotate in a second / secondary plane P s Can rotate on 。 The handle 31 may employ any known mechanism for converting and transmitting torque / force received from the rotational axis of the drive output to the rotational axis of the second dual wire pulley 702.

[0106] A first set of pull wires 91 can be attached to a first dual-wire pulley 701. In some embodiments, the first set of pull wires 91 can include a first pull wire 91a and a second pull wire 91b, which can be referred to as an agonist pull wire and an antagonist pull wire, respectively. The first set of pull wires 91 can be coupled to the first dual-wire pulley 701 on either side of the first dual-wire pulley 701, thereby allowing the tension of the first pull wire 91a to be increased through rotation of the first dual-wire pulley 701 without increasing the tension of the second pull wire 91b, or vice versa. For example, as illustrated, the first pull wire 91a can be coupled to the “left” side of the first dual-wire pulley 701, and the second pull wire 91b can be coupled to the “right” side of the first dual-wire pulley 701. Continuing with the illustrated example, counterclockwise rotation of the first dual-wire pulley 701 can pull (e.g., increase tension) the first pull wire 91a while potentially releasing tension in the second pull wire 91b, and vice versa.

[0107] Similarly, the second set of pull wires 92 can be attached to the second dual-wire pulley 702. In some embodiments, the second set of pull wires 92 can include a third pull wire 92a and a fourth pull wire 92b, which can be referred to as an agonist pull wire and an antagonist pull wire, respectively. The second set of pull wires 92 can be coupled to the second dual-wire pulley 701 on either side of the second dual-wire pulley 702, thereby allowing the tension of the third pull wire 92a to be increased through rotation of the second dual-wire pulley 702 without increasing the tension of the fourth pull wire 92b, or vice versa. For example, as illustrated, the third pull wire 92a can be coupled to the “rear” side of the second dual-wire pulley 702, and the fourth pull wire 92b can be coupled to the “front” side of the second dual-wire pulley 702. Continuing with the illustrated example, the illustrated counterclockwise rotation of the second dual-wire pulley 702 can pull (e.g., increase tension) the third pull wire 92a while potentially releasing tension in the fourth pull wire 92b, and vice versa.

[0108] The distal end of the shaft 40 can be coupled to the other ends of the pull wires 91a, 91b, 92a, and 92b. More specifically, the first pull wire 91a and the second pull wire 91b of the first set of pull wires 91 are aligned in a primary plane P P Similarly, the third pull wire 92a and the fourth pull wire 92b of the second set of pull wires 92 may be coupled to opposing ends of the upper tip of the second set of pull wires 92 in a secondary plane P S An enlarged view of shaft 40 and handle 31 illustrates the corresponding attachment of pull wires 91a, 91b, 92a, 92b.

[0109] Continuing with the exemplary instrument 700, the tip can be articulated based on pulley rotation of the dual-wire pulleys 701, 702. For example, to articulate the tip of the shaft 40 to the left, the first dual-wire pulley 701 can be rotated counterclockwise. The rotational force of the first dual-wire pulley 701 pulls on the attached first pullwire 91a, thereby transmitting the rotational force as tension on the first pullwire 91a. The first pullwire 91a applies tension to the other end of the first pullwire 91a attached to the tip. Simultaneously, the rotational force releases the attached second pullwire 91b, thereby allowing the tip to tilt more freely toward the side attached to the first pullwire 91a. In combination with the increased tension in the first pullwire 91a, the tip can tilt to the left with the counterclockwise rotation of the first dual-wire pulley 701. Conversely, clockwise rotation of the dual wire pulley 701 can tilt the tip to the right. Thus, rotation of the first dual wire pulley 701 causes P P Similarly, counterclockwise and clockwise rotation of the second dual wire pulley 702 translates into tension on the second set of pull wires 92, P S The inclination of the tip at each point can be changed toward the rear and out of the paper.

[0110] Each plane P P and P S The movements of the dual wire pulleys 701, 702, which each result in a change in the tilt of the tip at 701, 702, can be considered independent of the other. Thus, the combined movements of the dual wire pulleys 701, 702 can allow articulation of the tip in any direction.

[0111] The use of dual-wire pulleys 701, 702 offers many advantages over single-wire pulleys (not shown). For example, a single-wire pulley with only a pull wire attached to its tip can only articulate the tip in one direction. To articulate the tip in the opposite direction requires a different single-wire pulley and another pull wire attached to the tip. Thus, a bidirectional implementation based on a single-wire pulley requires the overhead of an additional single-wire pulley and corresponding drive output. The overhead can be costly not only in terms of the additional pulley and drive output components required, but also in terms of the use of limited physical space within the handle 31. Furthermore, in single-wire pulley implementations, the single-wire pulleys must be synchronized in the application of tension (e.g., pulling on one pull wire must be accompanied by the release of the other pull wire), or the single-wire pulleys can apply undesirably high tension that may be unsafe for the instrument. In contrast, the exemplary instrument 700 based on dual wire pulleys 701, 702 can reduce the total number of drive outputs and greatly simplify the synchronization of the sets of pull wires 91, 92.

[0112] Dual wire pulley articulation response 8-10 are graphs 800, 900, and 1000 illustrating the relationship between pulley rotation and instrument deflection / articulation. Each of the graphs 800, 900, and 1000 is plotted on a plane having an X-axis representing pulley rotation (e.g., amount of rotation) and a Y-axis representing deflection / articulation (e.g., tilt). A centerline on the X-axis can indicate zero rotation of the dual-wire pulley, which is neither clockwise nor counterclockwise rotation. Moving toward the right of the centerline along the X-axis can indicate increasing clockwise rotation, and moving toward the left can indicate increasing counterclockwise rotation. A centerline on the Y-axis can indicate zero tip tilt, which is neither to the left (e.g., negative tilt) nor to the right (e.g., positive tilt). Moving toward the top of the centerline along the Y-axis can indicate increasing rightward tilt, and moving toward the bottom can indicate increasing leftward tilt. With this understanding, each relationship is described in terms of a counterclockwise traverse of the relationship. It should be understood that the starting coordinates and counterclockwise traversal have been selected for ease of explanation below and may be considered arbitrary. Additionally, some aspects of the graphs 800, 900, 1000 may be exaggerated for ease of explanation.

[0113] 8 is a graph 800 illustrating the relationship between pulley rotation and instrument tilt for the tip of a plastic (e.g., malleable, soft, flexible, pliable, bendable, etc.) instrument shaft, according to one or more embodiments. A plastic instrument shaft may be one that exhibits a tendency to remain tilted when positioned in a tilted position. An example of a plastic instrument shaft may be one that is flexible and does not return to a neutral position (e.g., zero tilt) on its own.

[0114] This relationship is described in a counterclockwise manner, going from the first configuration 802 to the second configuration 804 to the third configuration 806 to the fourth configuration 808 to the fifth configuration 810 to the sixth configuration 812 and back to the first configuration 802.

[0115] A first configuration 802 is plotted with clockwise (e.g., positive) pulley rotation and zero tilt. In the first configuration 802, the left pull wire (e.g., first pull wire 91a in FIG. 7) has zero or a small amount of tension, while the right pull wire (e.g., second pull wire 91b in FIG. 7) is taut due to the clockwise pulley rotation. Now, the traverse is about to begin toward the second configuration 804, i.e., the tip is about to tilt to the right.

[0116] The second configuration 804 is plotted with increasing clockwise pulley rotation and a slope to the right. Between the first configuration 802 and the second configuration 804, an increase in tension in the right pull wire causes a linear increase in the right slope. The right pull wire has increased tension compared to the first configuration 802, while the left pull wire remains at zero or a small amount of tension.

[0117] The third configuration 806 is plotted with zero pulley rotation and a rightward tilt. Between the second configuration 804 and the third configuration 806, counterclockwise pulley rotation steers the pulley rotation toward zero and correspondingly reduces the tension on the right pull wire. However, counterclockwise pulley rotation does not change the rightward tilt previously articulated in the second configuration 804. As illustrated, a flat (e.g., parallel to the X-axis) response between the second configuration 804 and the third configuration 806 indicates a constant tilt of the tip. The lack of tilt response during traversal between the second configuration 804 and the third configuration 806 can be observed when both the left and right pull wires are slack (e.g., no significant tension) and therefore the tilt cannot be adjusted. Because the plastic instrument shaft is flexible and does not return to its neutral position on its own, no change in tilt is observed during this traversal.

[0118] As the traverse reaches the third configuration 806, the left pull wire becomes taut based on the counterclockwise pulley rotation. The traverse is now beginning to move towards the fourth configuration 808, i.e., the tip begins to tilt leftward from its rightward tilt.

[0119] A fourth configuration 808 is plotted with counterclockwise (e.g., negative) pulley rotation and zero slope. In the fourth configuration 808, the left pull wire is taut, while the right pull wire has zero or a small amount of tension based on the counterclockwise pulley rotation.

[0120] The fifth configuration 810 is plotted with increasing counterclockwise pulley rotation and a slope to the left. Between the third configuration 806 and the fifth configuration 810, increasing tension in the left pull wire causes a linear increase in the slope to the left. The right pull wire maintains zero or a small amount of tension.

[0121] The sixth configuration 812 is plotted with zero pulley rotation and a leftward tilt. Between the fifth configuration 810 and the sixth configuration 812, clockwise pulley rotation steers the pulley rotation toward zero and correspondingly reduces the tension on the left pull wire. However, clockwise pulley rotation does not change the leftward tilt previously articulated in the fifth configuration 810. As illustrated, a flat (e.g., parallel to the X-axis) response between the fifth configuration 810 and the sixth configuration 812 indicates a constant tilt of the tip. The lack of tilt response during the traverse between the fifth configuration 810 and the sixth configuration 812 can be observed when both the left and right pull wires are slack (e.g., no significant tension) and therefore the tilt cannot be adjusted. Because the plastic instrument shaft is flexible and does not return to its neutral position on its own, no change in tilt is observed during this traverse.

[0122] As the traverse reaches the sixth configuration 812, the right pull wire becomes taut based on the clockwise pulley rotation. The traverse is now attempting to move back toward the first configuration 802. That is, the tip begins to tilt from left to right.

[0123] As shown, the plastic instrument shaft may exhibit at least two traverse zones / regions that exhibit invariant slope even when subjected to changes in pulley rotation: between the second configuration 804 and the third configuration 806, and between the fifth configuration 810 and the sixth configuration 812. The zones are flat (or nearly flat) in graph 800 due to the lack of change in the Y-axis in response to changes in the X-axis. These flat zones may be considered "dead zones" where the plastic instrument shaft may remain insensitive to some degree of pulley rotation.

[0124] 9 is a graph 900 illustrating the relationship between pulley rotation and instrument tilt for the tip of a resilient (e.g., stiff, springy, rigid, etc.) instrument shaft, in accordance with one or more embodiments. A resilient instrument shaft may be a shaft that, when tilted, exhibits a tendency to return to its pre-tilt position. An example of a resilient instrument shaft may be a shaft that is rigid and returns to a neutral position (e.g., zero degrees tilt) on its own.

[0125] This relationship is described in a counterclockwise manner, going from the first configuration 902 to the second configuration 904 to the third configuration 906 to the fourth configuration 908 to the fifth configuration 910 to the sixth configuration 912 to the seventh configuration 914 and back to the first configuration 902.

[0126] A first configuration 902 is plotted with clockwise (e.g., positive) pulley rotation and zero tilt. In the first configuration 902, the left pull wire (e.g., first pull wire 91a in FIG. 7) has zero or a small amount of tension, while the right pull wire (e.g., second pull wire 91b in FIG. 7) is taut due to the clockwise pulley rotation. Now, traverse is about to begin toward the second configuration 904, i.e., the tip is about to tilt to the right.

[0127] The second configuration 904 is plotted with increasing clockwise pulley rotation and a slope to the right. Between the first configuration 902 and the second configuration 904, an increase in tension in the right pull wire causes a linear increase in the right slope. The right pull wire has increased tension compared to the first configuration 902, while the left pull wire remains at zero or a small amount of tension.

[0128] A third configuration 906 is plotted after applying some counterclockwise pulley rotation during a rightward tilt. Now, the shaft is stiff and tends to return to the neutral position, so the right pull wire is taut, opposing the tendency of the tip. The rightward tilt remains proportional to the sum of the clockwise pulley rotations (e.g., the pulley rotation is a rotation to the right of the X-axis centerline) and the tension in the right pull wire. The left pull wire has zero or little tension.

[0129] The fourth configuration 908 and the fifth configuration 910 are plotted over a range of pulley rotations that provide a neutral position. Between the fourth configuration 906 and the fifth configuration 908, the shaft's elastic tendency overcomes clockwise or counterclockwise pulley rotation, and the shaft remains in the neutral position. In some embodiments, pulley rotations within the range may not provide the threshold tension level needed to tilt the tip. In some embodiments, the left and right pull wires may provide zero or some slight tension so that the elastic tendency fully controls the tip back to the neutral position. In either case, the tip tilts only leftward when a counterclockwise pulley rotation to the left of the fifth configuration 910 is provided, and only rightward when a clockwise pulley rotation to the right of the first configuration 902 is provided. Referring back to the counterclockwise traverse of the graph 900, in the fifth configuration 910, the counterclockwise pulley rotation has not yet caused a leftward tilt.

[0130] The sixth configuration 912 is plotted with increasing counterclockwise pulley rotation and a leftward tilt that is a mirror image of the second configuration 904. Between the fifth configuration 910 and the sixth configuration 912, increasing tension in the left pull wire causes a linear increase in the leftward tilt. The right pull wire maintains zero or a small amount of tension.

[0131] From the sixth configuration 912 to the seventh configuration 914, a clockwise pulley rotation is applied. Now, the shaft is stiff and tends to return to the neutral position, so the left pull wire is taut, opposing the tendency of the tip. The leftward tilt continues to be proportional to the sum of the counterclockwise pulley rotations (e.g., the pulley rotation is to the left of the X-axis centerline) and the tension in the left pull wire, while the right pull wire has zero or little tension.

[0132] In the seventh configuration 914, the tip again reaches its neutral position due to its resilient tendency. Until the first configuration 902, the resilient tendency of the shaft overcomes clockwise or counterclockwise pulley rotation and the shaft remains in the neutral position. Now the resilient instrument shaft behaves similarly to its behavior between the fourth configuration 908 and the fifth configuration 910.

[0133] As shown, the elastic instrument shaft may exhibit at least two traverse zones / regions that exhibit invariant slope even given changes in pulley rotation: between the fourth configuration 908 and the fifth configuration 910, and between the seventh configuration 914 and the first configuration 902. The zones are flat (or nearly flat) in graph 900 due to the lack of change in the Y-axis in response to changes in the X-axis. These flat zones may be considered "dead zones" where the elastic instrument shaft may remain unresponsive to some degree of pulley rotation.

[0134] FIG. 10 is a graph 1000 illustrating the relationship between pulley rotation and instrument deflection for a hybrid (both plastic and elastic) instrument shaft, according to one or more embodiments. The hybrid instrument shaft may desirably be both plastic and elastic. In other words, the tip of a hybrid instrument shaft may have a tendency to return to its neutral position on its own, unlike a plastic instrument shaft, but less than an elastic instrument shaft. Thus, a hybrid instrument shaft can combine or take into account the response profiles exhibited by a variety of different materials to provide a response profile that is more desirable or optimal for a particular application. Furthermore, a hybrid instrument shaft may better model the articulation behavior of real instrument shafts.

[0135] In contrast to previous relationships for plastic and elastic instrument shafts, the relationship for a hybrid instrument shaft has a linear region 1002 and a non-linear region 1004. The linear region 1002 can include a clockwise linear region 1002a and a counterclockwise linear region 1002b. Within the linear region 1002, pulley rotation can induce a proportional tilt related to the slope of the respective line.

[0136] The nonlinear region 1004 can include a first nonlinear region 1004a and a second nonlinear region 1004b. As illustrated, the nonlinear region 1004 connects the clockwise linear region 1002a and the counterclockwise linear region 1002b. In other words, the tip of the hybrid instrument shaft can traverse the first nonlinear region 1004a when its dual-wire pulley rotation direction is reversed from clockwise to counterclockwise. Similarly, the tip of the hybrid instrument shaft can traverse the second nonlinear region 1004b when its dual-wire pulley rotation direction is reversed from counterclockwise to clockwise.

[0137] The curves for the first nonlinear region 1004a and the second nonlinear region 1004b illustrate little or no dead zone. Thus, the tip of the hybrid instrument shaft remains responsive to any changes in pulley rotation. Furthermore, the hybrid instrument shaft is neither too wobbly nor too stiff, which can reduce operator frustration and, in some cases, improve instrument durability.

[0138] Kinematic Model The hybrid instrument shaft and its articulation response to pulley rotation can be represented based on a kinematic model. The kinematic model can estimate the relationship between pulley rotation and the corresponding endoscope articulation motion (e.g., deflection / tilt) in a plane. Based on this relationship, the kinematic model can enable the determination of the resulting articulation motion for a given pulley rotation. Conversely, the kinematic model can enable the determination of the predicted pulley rotation for a desired articulation motion. When a kinematic model is involved, the determination of articulation motion, pulley rotation, articulation response, or any region thereof, can be described synonymously as estimating, calculating, computing, or identifying.

[0139] In some embodiments, the kinematic model may be a mathematical model that represents the joint motion response in terms of an equation. Such a mathematical kinematic model may advantageously allow for the calculation of the resulting joint motion or predicted pulley rotation. The equation may rely on the following example parameters and variables to represent the joint motion response:

[0140] [Table 1]

[0141] Depending on the equation used to represent the joint motion response, there may be additional or fewer parameters and variables than those shown in Table 1.

[0142] 11A is a kinematic model 1100 of a hybrid instrument shaft illustrating the relationship between pulley rotation and instrument deflection, in accordance with one or more embodiments. The kinematic model 1100 calculates the relationship between the commanded pulley rotation (j cmd The X axis represents the deflection (denoted by φ) and the Y axis represents the angle (denoted by φ).

[0143] The kinematic model 1100 can be formulated using a combination of linear and nonlinear piecewise continuous functions. Specifically, the kinematic model can include eight joint motion response regions: four linear regions (e.g., a first linear region 1101, a second linear region 1103, a third linear region 1104, and a fourth linear region 1106) and four nonlinear regions (e.g., a first nonlinear region 1102, a second nonlinear region 1105, a third nonlinear region 1107, and a fourth nonlinear region 1108). The kinematic model 1100 plots the linear regions and the nonlinear regions can be defined (e.g., determined) based at least in part on the pulley rotations, as shown on the X-axis, and the associated joint motions, as shown on the Y-axis. When either pull wire is under tension, the articulation response can be linear; therefore, a linear function can model the endoscope response during articulation in the first linear region 1101 or the third linear region 1104, and during de-articulation in the second linear region 1103 or the fourth linear region 1106. Articulation in the first linear region 1101 or the third linear region 1104 is when the endoscope deflects and continues to deflect toward a direction from a neutral position. De-articulation in the second linear region 1103 or the fourth linear region 1106 is when the endoscope returns to its neutral position from its previous deflection. The response is nonlinear during a transition of tension from one pull wire to another (e.g., from an agonist wire to an antagonist wire). A transition of tension can occur during a direction reversal. The nonlinear function can model the endoscope response during reversals (e.g., when changing from articulation to de-articulation or vice versa) in the first nonlinear region 1102, the second nonlinear region 1105, the third nonlinear region 1107, or the fourth nonlinear region 1108. Reversals of articulation in the first nonlinear region 1102 or the second nonlinear region 1105 can occur at any instant during articulation in the first linear region 1101 or the third linear region 1104, and reversals of de-articulation in the third nonlinear region 1107 or the fourth nonlinear region 1108 can occur at any instant during de-articulation in the second linear region 1103 or the fourth linear region 1106.In some embodiments, a sigmoid function may be used to model the joint motion response during inversion in the first nonlinear region 1102, the second nonlinear region 1105, the third nonlinear region 1107, or the fourth nonlinear region 1108. More specifically, a generalized logistic function may be used to model the joint motion response.

[0144] The kinematic model 1100 includes one or more "dead zones" where pulley rotation does not readily result in articulation of the endoscope. Dead zones can arise due to various instrument characteristics, such as friction in the endoscope mechanism, endoscope anatomy, material properties, pulley characteristics, and component wear. An exemplary dead zone is the amount of force that must be applied to a positive threshold level (+j) before a neutrally positioned endoscope will be deflected. dz ) or a negative threshold level (-j dz 1109, which must be met for pulley rotations below 1104 (denoted by 1105). That is, pulley rotations within the central deadband 1109 will not deflect a neutrally positioned endoscope.

[0145] 11B is a tension response 1150 of a hybrid instrument shaft showing the relationship between pulley rotation and applied tension, in accordance with one or more embodiments. The tension response 1150 is a function of the pulley rotation (j cmd The force is plotted on a plane having an X-axis representing the net tension on the pair of pull wires (denoted by ).

[0146] Similar to the kinematic model, the tension response exhibits a combination of linear and nonlinear regions. Specifically, the tension response exhibits six regions: two linear tension regions 1151 and 1152 and four nonlinear tension regions 1153a, 1153b, 1154a, and 1154b. When any pull wire is under tension, the tension response is linear. For example, a positive net tension (e.g., the first pull wire causes tension) within the first linear tension region 1151 results in endoscope articulation in a first direction. A positive net tension can cause articulation in the first linear region 1101 and de-articulation in the fourth linear region 1106 of the kinematic model 1100 of FIG. 11A . Similarly, a negative net tension (e.g., the second pull wire causes tension) within the second linear tension region 1152 results in endoscope articulation in a second direction opposite to the first direction. A negative net tension can cause articulation release in the second linear region 1103 and articulation in the third linear region 1104 of the kinematic model 1100 .

[0147] During the reversals associated with the nonlinear tension regions 1153a, 1153b, 1154a, and 1154b, the tension is nonlinear. For example, the first reversal associated with the first nonlinear tension region 1153a may occur at the moment the dual-wire pulley begins to rotate counterclockwise from maximum clockwise pulley rotation. The moment of the first reversal associated with the first nonlinear tension region 1153a may correspond to the apex of articulation in the first linear region 1101 of the kinematic model 1100. As the pulley continues to rotate counterclockwise, the first pull wire loses tension, resulting in a decrease in absolute net tension, as illustrated during the reversal associated with the first nonlinear tension region 1153a. Eventually, the second pull wire begins to provide a negative net tension throughout the second linear tension region 1152 due to articulation release in the second linear region 1103 and articulation in the third linear region 1104 of the kinematic model 1100. Conversely, a second reversal associated with the second nonlinear tension region 1153b may occur at the moment the dual-wire pulley begins to rotate clockwise from maximum counterclockwise pulley rotation. The moment of the second reversal associated with the first nonlinear tension region 1153b may correspond to the bottom of articulation in the third linear region 1104 of the kinematic model 1100. As the pulley continues to rotate clockwise, the second pull wire loses tension, resulting in a decrease in absolute net tension, as illustrated during the reversal associated with the second nonlinear tension region 1153b. Eventually, the first pull wire begins to provide a positive net tension throughout the first linear tension region 1151 due to articulation release in the fourth linear region 1106 of the kinematic model 1100 and articulation in the first linear region 1101.

[0148] In some instances, a reversal may occur before maximum pulley rotation. For example, a third reversal associated with the third nonlinear tension region 1154a may occur before the dual-wire pulley is at maximum clockwise pulley rotation. Similarly, a fourth reversal associated with the fourth nonlinear tension region 1154b may occur before the dual-wire pulley is at maximum counterclockwise pulley rotation. The tension responses of the third reversal associated with the third nonlinear tension region 1154a and the fourth reversal associated with the fourth nonlinear tension region 1154b are illustrated.

[0149] The tension response 1150 provides some insight into the operation of dead zones, such as the central dead zone 1109 of the kinematic model 1100. During the transfer of tension from one pull wire to another during reversal, the range of pulley rotation 1155 may provide the minimum tension (or minimum net tension) on the pull wire. Furthermore, there may be little or no change in tension (or net tension) during the range of pulley rotation 1155. Thus, when within the range of pulley rotation 1155, clockwise or counterclockwise rotation of the dual-wire pulley is unlikely to cause endoscope deflection and contribute to the formation of the dead zone.

[0150] It should be noted that some aspects of the kinematic model 1100 and tension response 1150 may be exaggerated for ease of explanation. For simplicity, the relationships in the kinematic model 1100 and tension response 1150 are limited to a single dual-wire pulley setup. However, it will be appreciated that modeling multiple dual-wire pulley setups is not difficult, and the relationships in the kinematic model 1100 and tension response 1150 can be extended using additional dimensions for each additional dual-wire pulley.

[0151] The kinematic model 1100 and tension response 1150 described above can be mathematically modeled using the parameters and variables in Table 1. First, the joint motion in the first linear region 1101 or the third linear region 1104 can be modeled as follows:

[0152]

number

[0153] Second, articulation release in the second linear region 1103 or the fourth linear region 1106 can be modeled as follows:

[0154]

number

[0155] Articulation Equation 1 and Articulation Release Equation 2 are linear in nature and therefore easily invertible.

[0156] Finally, the inversion of the first nonlinear region 1102, the second nonlinear region 1105, the third nonlinear region 1107, or the fourth nonlinear region 1108 can be modeled as follows:

[0157]

number

[0158] The inversion equation of FIG. 3 is inherently nonlinear. While it is possible to model the inversion of the first nonlinear region 1102, the second nonlinear region 1105, the third nonlinear region 1107, or the fourth nonlinear region 1108 with various nonlinear functions, the example inversion equation of FIG. 3 is chosen to be sigmoidal, using a generalized logistic function that has advantageous properties. In general, nonlinear equations are not very easy to invert. In contrast, the inversion equation of FIG. 3 is invertible, and furthermore, the inverted inversion equation has a unique solution. As will be explained in more detail, due to its easy invertibility, the inversion equation of FIG. 3 is often preferable to other nonlinear equations that are invertible or have closed-form solutions.

[0159] Based on Equations 1, 2, and 3, all linear and nonlinear regions in the kinematic model 1100 can be mathematically described. However, the kinematic model 1100 may need to be adapted for each individual endoscope (e.g., each endoscope may need to be calibrated to the kinematic model 1100). The parameters, for example, k flex , j dz0 , Q, B, and nu, which may depend on manufacturing tolerances and may vary for each endoscope.

[0160] This variation results from many factors, including component and assembly tolerances unique to each endoscope, which can cause the endoscope to respond differently to articulation commands (e.g., pull wire commands). Endoscopes are flexible, soft, and compliant mechanisms driven by cables (e.g., pull wire cables), and mechanical characterization of an endoscope can be essential to understanding the motion of the endoscope, modeling the endoscope's behavior, developing control algorithms, making mechanical design decisions, and / or testing the endoscope's durability. Without characterizing the effects of these differences on the endoscope's response, accurately and responsively controlling the endoscope can be difficult, especially when attempting to do so robotically.

[0161] Calibration can help characterize the differences between each endoscope. A method for characterizing and calibrating an endoscope is described below. This method can characterize the input-to-output behavior of each endoscope by using the measured endoscope tip position as the basis for controlling the endoscope's articulation.

[0162] The method may include a setup that may consist of a fixture for mounting and holding the endoscope, mechanisms / sensors for rotating and measuring the position of individual pulley shafts of the endoscope, mechanisms / sensors for measuring the displacement and tension of the pull wires, and / or mechanisms / sensors for measuring the articulation of the endoscope (e.g., tip position / orientation). In some embodiments, the tip of the endoscope may be controlled by one or more pulleys attached to one or more pulley shafts. For example, the tip may be controlled by four pulleys attached to either two or four pulley shafts.

[0163] With this setup, some or all of the following steps can be performed to characterize the endoscopic response: 1. The endoscope can be mounted in a setup and coupled to various input mechanisms. 2. Several sensors may be used to measure the starting / reference position of one or more pulley shafts, and the position / orientation of the endoscope tip in two-dimensional / three-dimensional space may be recorded using other sensors (e.g., EM sensors, image sensors, and / or any other sensors). 3. Starting from a start / reference position, the tip can be articulated by rotating the pulley shaft while continuously measuring / sampling pulley rotation, pullwire tension, and endoscope articulation. In some embodiments, for single-wire movement characterization, a single pulley shaft can be rotated to articulate the tip while measuring tip position / orientation using a tip position / orientation measurement sensor. In some embodiments, for two-wire movement characterization, two pulley shafts can be rotated simultaneously by a fixed amount or a predetermined ratio between the two pulley shafts. This step can be repeated until the endoscope has reached all of the predetermined articulation targets and all of the desired input combinations. 4. After the above input-output (e.g., joint motion) data collection process, visualizations can be generated from the collected data. Joint motion responses (e.g., V plots, I plots, etc.) can be generated by plotting pulley rotation and endoscope tip joint motion on a plane such as the X-axis and Y-axis, or vice versa. Force / tension responses (e.g., V plots, I plots, etc.) can be generated by plotting pull wire tension and endoscope tip joint motion on a plane such as the X-axis and Y-axis, or vice versa. Figures 11A-11B illustrate exemplary joint motion and tension responses, respectively.

[0164] The plotted response can allow for the measurement of several endoscope-specific mechanical characteristics, including the central dead zone, articulation and de-articulation gradients, direction reversal transition region, and direction reversal dead zone. These characteristics are described in connection with Figures 11A-11B. Based on the measurements and equations, the endoscope can be calibrated; i.e., adjusting / fitting a kinematic model for the endoscope. flex , j dz0 , Q, B, and nu can be determined.

[0165] Through calibration, endoscope-specific parameters can be determined for each endoscope. In some embodiments, the calibration parameters can be encoded on a scannable medium and affixed to the endoscope. For example, the parameters can be programmed into an RFID tag inserted into the endoscope or printed on a QR code attached to the endoscope. A reader (e.g., reader 304 in FIG. 6) can scan the parameters and adapt the kinematic model 1100 to the endoscope accordingly. Once calibrated, the endoscope can be robotically controlled, such as by determining predicted pulley rotations to achieve desired joint motions based on the adapted kinematic model.

[0166] In addition to parameters, Equation 1, Equation 2, and Equation 3 may also depend on variables, such as k φ , k j , φoffset , φ @EoS , φ @Reversal、 j @EoS、 j @Reversal、 j c , and j cmd It can contain inverted variables (e.g., (.) @Reversal Some of the variables, such as the (.) variable, may be determined at a moment specific to the flip. For example, the flip variable may capture the articulation and pulley rotation specific to the moment of flip. The flip variable may indicate the state of the endoscope at that moment, including what linear region the endoscope was traversing before the flip. The end of the sigmoid end variable (e.g., (.) @EoS Several other variables can be calculated, such as the deflection of the ends of the sigmoid (φ @EoS ) and pulley rotation (j @EoS ) can be calculated based on:

[0167]

number

[0168] Based on the parameters and variables, a kinematic model 1100 can be fitted to any endoscope and its current state can be described by Equations 1, 2, and 3. Because all equations are invertible and provide a unique solution given the endoscope state, the predicted pulley rotation to achieve a desired or commanded deflection can be easily calculated by solving the inverse equations. Such kinematic models can be received, calculated, or otherwise obtained by the robotic cart / system and / or control tower / system of the present disclosure.

[0169] FIG. 12 is a flow diagram 1200 of a process for controlling instrument articulation based on a kinematic model, according to one or more embodiments. This process can be used to calculate predicted pulley rotations (or required tensions) to achieve desired articulation of the endoscope. This process can be implemented in connection with endoscope articulation via robotic control of pullwire tensioning pulleys / mechanisms associated with the endoscope (e.g., integrated into the handle of the endoscope). The process can be implemented at least in part by control circuitry in any of the system components disclosed herein, such as a robotic cart / system and / or a control tower / system. For ease of explanation, the endoscope is initially assumed to be in a neutral (e.g., straightened) position with pulley rotation reset. However, this process can be applied to an endoscope at any position and any pulley rotation, so long as the endoscope's position is accurately identified on its kinematic model.

[0170] In block 1202, a desired joint movement may be received. The desired joint movement may be a commanded joint movement received from an operator. The desired joint movement may be expressed in various ways as an angle within an allowable range of articulation defined around some reference. For example, some possible allowable range definitions of articulation may include [-90°, 90°], [0°, 180°], [-π / 2, π / 2], [0, π], etc.

[0171] Block 1204 may check whether the desired joint movement causes a direction reversal. In some embodiments, checking for a direction reversal may include comparing the currently commanded pulley rotation direction for the desired joint movement with the previously commanded pulley rotation direction. For example, assume the last pulley rotation included a clockwise rotation. If the commanded pulley rotation direction is also clockwise, the commanded pulley rotation does not cause a direction reversal. Otherwise, if the commanded pulley rotation is counterclockwise, the commanded pulley rotation causes a direction reversal.

[0172] In some embodiments, checking for a direction reversal can include comparing the desired joint movement to a previous actual joint movement. For example, the previous direction of change in joint movement can be determined by sampling the previous actual joint movement. If the desired joint movement continues in the same direction as the previous direction, the desired joint movement does not cause a direction reversal. On the other hand, if the desired joint movement does not continue in the same direction as the previous direction, the desired joint movement causes a direction reversal.

[0173] If a direction reversal is not detected, blocks 1206, 1208, 1210, 1212 may be optional and the process may jump to block 1214. If a direction reversal is detected, the process proceeds to block 1206.

[0174] In block 1206, the parameters and variables of the sigmoid can be set. As explained, the parameters are k, which fit the kinematic model to the endoscope. flex , j dz0 , Q, B, and nu. φ , k j , φ offset , φ @Reversal , j @Reversal、 and j c Specifically, the observed reversal joint motion (φ @Reversal ) and counter pulley rotation (j @Reversal ) can indicate at which joint movements and pulley rotations direction reversals occur. Furthermore, reversing joint movements and reversing pulley rotations can help identify regions of the kinematic model where the robotic control of the endoscope is located.

[0175] At block 1208, the articulation of the end of the sigmoid (φ @EoS ) and the sigmoid end pulley rotation (j @EoS) can be calculated. When the commanded joint motion for direction reversal occurs at a point corresponding to the first linear region 1101, the third linear region 1104, the third nonlinear region 1107, or the fourth nonlinear region 1108 joint motion response region, the sigmoid end joint motion and the sigmoid end pulley rotation can be calculated based on Equation 4 and Equation 5, respectively. However, if the direction reversal is toward one of the linear responses of the joint motion within the first linear region 1101 or the third linear region 1104 (i.e., when the commanded joint motion for the direction reversal occurs at a point corresponding to the joint motion response region of the first nonlinear region 1102, the second linear region 1103, the second nonlinear region 1105, or the fourth linear region 1106), the sigmoid's end joint motion can be calculated based on Equation 4, while the calculation of the sigmoid's end pulley rotation can be simplified by using the inverse form of Equation 1 (instead of using Equation 5) for the sigmoid's end joint motion because the sigmoid's end pulley rotation is in one of the linear responses. The calculated variables of the sigmoid's end joint motion and sigmoid's end pulley rotation, along with the parameters and observed variables from block 1206, can define the sigmoid for the direction reversal.

[0176] At block 1210, a post-sigmoid linear response may be determined. When a commanded joint motion for a direction reversal occurs at a point corresponding to a joint motion response region of the first linear region 1101, the third linear region 1104, the third nonlinear region 1107, or the fourth nonlinear region 1108, the post-sigmoid linear response may be calculated by multiplying the calculated sigmoid end joint motions and sigmoid end pulley rotations by the end of the central deadband 1109 (e.g., −j dz or +j dz) However, when the direction reversal is toward one of the linear responses of the joint motion within the first linear region 1101 or the third linear region 1104 (i.e., when the commanded joint motion for the direction reversal occurs at a point corresponding to the joint motion response region of the first nonlinear region 1102, the second linear region 1103, the second nonlinear region 1105, or the fourth linear region 1106), the determination of the post-sigmoid linear response can be simplified by considering the post-sigmoid linear response to be equivalent to the linear response within the first linear region 1101 or the third linear region 1104 (because the post-sigmoid linear response aligns with the joint motion within the linear region).

[0177] In block 1212, a target region of desired joint motion can be identified. Specifically, the desired joint motion can be determined to be a target region of inverse joint motion (φ ) on a post-sigmoidal linear response (e.g., first linear region 1101, second linear region 1103, third linear region 1104, or fourth linear region 1106) or on a nonlinear region (e.g., first nonlinear region 1102, second nonlinear region 1105, third nonlinear region 1107, or fourth nonlinear region 1108). @Reversal ) and the sigmoid end joint motion (φ @EoS ) and determines whether it is on the sigmoid of the direction reversal.

[0178] In block 1214, a predicted pulley rotation for the desired joint motion is calculated. The predicted pulley rotation is calculated based on the identified target region. If the target region is a post-sigmoid linear response determined in block 1210, the predicted pulley rotation is calculated using Equation 1 if the post-sigmoid linear response is consistent with the joint motion (e.g., in the first linear region 1101 or the third linear region 1104), or using Equation 2 if the post-sigmoid linear response is consistent with the joint motion release (e.g., in the second linear region 1103 or the fourth linear region 1106). Alternatively, in block 1212, if the target zone is on a direction-reversing sigmoid, the predicted pulley rotation is calculated using Equation 3.

[0179] In block 1216, the IDM is driven to achieve the desired joint motion based on the predicted pulley rotation calculated in block 1214. Providing the predicted pulley rotation should result in the desired joint motion.

[0180] Relaxation Tension Monitoring and Homing Algorithm As described, robotic control of an endoscope may involve pulling one or more pull wires attached to a dual-wire pulley to articulate the tip of the endoscope. As illustrated with respect to FIG. 12 , a kinematic model may be used to calculate the required pulley rotation to achieve the desired articulation. The required pulley rotation may then be applied to the pulley rotation corresponding to the desired articulation by driving the IDM. The required pulley rotation is calculated based on a reference position, also referred to as a home position or home. For simplicity, the robotic system may assign the pulley rotation that causes zero tilt as the home position. Homing may refer to the process of finding the home position (e.g., determining the homing offset that causes zero tilt) and, in some cases, may further include adjusting the indexing of the pulley rotation (e.g., indexing the homing offset to be at zero pulley rotation) so that the home position is located at zero pulley rotation.

[0181] In general, the above descriptions of kinematic models assume that the endoscope is initialized with zero pulley rotation and zero tilt (e.g., neutral articulation, reference articulation, relaxed articulation, etc.). For example, the kinematic model 1100 illustrated in FIG. 11A is centered at zero pulley rotation with no offset in either the clockwise or counterclockwise direction, and zero tilt with no pre-articulation to the left or right. However, this assumption may not always be correct.

[0182] The initialization assumption of zero tilt with zero pulley rotation may deviate when a pre-articulated endoscope (e.g., an endoscope with non-zero articulation) is docked. Deviation from the assumption may result in misalignment between the predicted endoscope behavior based on the kinematic model and the behavior of the physical endoscope. For example, a robotic system may rely on a kinematic model to predict joint motion given pulley rotation. If the endoscope is pre-articulated, the pulley rotation may cause additional joint motion on top of the pre-articulation motion, resulting in unpredicted physical endoscope behavior.

[0183] In part, the misalignment may be the result of information asymmetry between the robotic system sending the articulation command and the endoscope receiving the articulation command and articulating its elongate shaft. Prior to docking, the robotic system may be aware of its state, such as the current pulley rotation of the drive output, but may not be aware of the state of the detached endoscope, such as the pre-articulation and / or actual tension on the pull wires. That is, prior to docking, the robotic system may initialize its pulley rotation to zero or some other reference value, but that initialization of the pulley rotation may not center the uncoupled, pre-articulated endoscope.

[0184] If the assumption of a straight endoscope docked is invalid, it can affect multiple aspects of robotic endoscope control, including articulation and relaxation. Here, relaxation can refer to the process of reducing the magnitude of endoscope tilt to straighten the endoscope (e.g., zero tilt). Figures 13A-13B illustrate an example scenario in which the assumption can lead to undesirable results.

[0185] 13A illustrates an exemplary articulation scenario 1300 of a pre-articulated endoscope in accordance with one or more embodiments. Articulation scenario 1300 shows endoscope 40a having a distal end attached to the end of pull wires 91, including first pull wire 91a and second pull wire 91b. Opposite ends of pull wires 91 are attached to dual wire pulley 701. As shown, when endoscope 40a is docked to the end effector, first pull wire 91a may be slack and second pull wire 91b may be tight, causing endoscope 40a to pre-articulate to the right in pre-articulated state A.

[0186] Unless further articulation takes pre-articulation state A into account, further articulation may result in undesired articulation that could cause harm to the endoscope and / or the patient's anatomy. In articulation scenario 1300, assume that rightward articulation is desired. The robotic system, unaware of the rightward pre-articulation, may command a clockwise pulley rotation to cause further rightward articulation. When the clockwise pulley rotation is applied, the endoscope 40a articulates from its pre-articulated state A to articulated state B. Application of the clockwise pulley rotation may increase tension on the already taut second pull wire 91b beyond its acceptable tolerance, causing irreparable harm to the second pull wire 91b and endoscope function. Furthermore, articulated state B may potentially cause harm to the patient's anatomy because it may result in unintended articulation that proceeds further to the right than the desired articulation that would result from a zero-tilt initialized endoscope.

[0187] 13B illustrates an exemplary relaxation scenario 1350 of an articulated endoscope, according to one or more embodiments. Similar to endoscope 40a of articulation scenario 1300, endoscope 40b can include a first pull wire 91a, a second pull wire 91b, and a dual-wire pulley 701. As shown, first pull wire 91a can be tightened and second pull wire 91b can be slackened, causing endoscope 40b to articulate leftward from pre-articulated state A to articulated state C.

[0188] Unless the relaxation takes into account the condition of the pull wire 91 in the articulated state C, the relaxation can result in undesired articulation that could cause harm to the patient's anatomy. In the relaxation scenario 1350, the endoscope 40b is assumed to be docked in the pre-articulated state A at its initialization. When relaxation is commanded, a robotic system that assumes zero tilt at initialization may apply a pulley rotation at initialization to return the endoscope 40b to the zero tilt. However, that pulley rotation instead returns the endoscope 40b to the pre-articulated state A, which is not relaxed at zero tilt. An unintentional return to the pre-articulated state A during relaxation can cause harm to the patient's anatomy.

[0189] 14 illustrates an exemplary articulation response plot 1400 showing the relationship between a modeled response 1410 and physical endoscope behavior 1430 when a pre-articulated endoscope is docked, in accordance with one or more embodiments. The articulation response plot 1400 plots the modeled response 1410 and physical endoscope behavior 1430 on an XY plane, with the X-axis representing pulley rotation (e.g., amount of rotation) and the Y-axis representing deflection / articulation (e.g., tilt).

[0190] Modeled response 1410 represents the expected endoscope articulation response based on a kinematic model of the endoscope. Modeled response 1410 is plotted from the perspective of a robotic system controlling the endoscope. The robotic system may center modeled response 1410 in the XY plane with zero tilt and zero pulley rotation at model origin 1412. That is, modeled response 1410 uses model origin 1412 as its reference point (e.g., home position).

[0191] Physical endoscope behavior 1430 represents the actual endoscope articulation response from the perspective of a pre-articulated endoscope. Physical endoscope behavior 1430 has an endoscope origin 1432 that is shifted / translated compared to model origin 1412 of modeled response 1410. As explained above, misalignment between modeled response 1410 and physical endoscope behavior 1430 can be caused by pre-articulation during docking. For example, pre-articulation point 1434 on physical endoscope behavior 1430 indicates that the endoscope is pre-articulated with a slight rightward tilt (e.g., pre-articulation point 1434 is above endoscope origin 1432). However, a robotic system controlling the endoscope based on modeled response 1410 is unaware of the slight rightward pre-articulation and assumes the endoscope is at zero tilt. In some cases, the misalignment can be caused by component variations, tolerances, or degradation.

[0192] Misalignment can cause some of the undesirable results during articulation and relaxation described above in connection with Figures 13A and 13B. For example, assume a robotic system desires to articulate a straight endoscope to the right. Based on the modeled response 1410, the robotic system will effect a clockwise change in pulley rotation from the model origin 1412 through a first model point 1416 to a second model point 1418. The robotic system expects that the change in pulley rotation will articulate the endoscope from a straight articulation at the model origin 1412 and the first model point 1416 to a rightward articulation at the second model point 1418. However, as shown in physical endoscope behavior 1430, the commanded change causes the endoscope to articulate from a slight rightward articulation at pre-articulation point 1434, to a moderate rightward articulation at a first endoscope point 1436, to an unattainable rightward articulation at a second endoscope point 1438 that is outside the range of physical endoscope behavior 1430.

[0193] 13A provides visual assistance for articulating the endoscope upon receiving a commanded change. At pre-articulation point 1434, the endoscope may be in pre-articulated state A of exemplary articulation scenario 1300. At first endoscope point 1436, the endoscope articulates toward articulated state B. However, the endoscope cannot articulate significantly further beyond articulated state B, even when provided with pulley rotation at second endoscope point 1438. In fact, pulley rotation at second endoscope point 1438 could apply excessive tension to the endoscope's pull wires 91, potentially damaging the endoscope. Additionally, from model origin 1412 to first model point 1416, the robotic system does not expect any articulation when providing a pulley rotation change because modeled response 1410 shows no change in its Y-axis. However, as shown by the corresponding physical endoscope behavior 1430, the change in pulley rotation causes significant articulation from the pre-articulation point 1434 to the first endoscope point 1436. Unintended articulation can cause harm to the patient's anatomy.

[0194] As another example, assume that the robotic system desires to relax an endoscope that is articulated to the left. Based on the modeled response 1410, the robotic system will initiate a clockwise change in pulley rotation from the third model point 1420 to the first model point 1416. The robotic system expects that the change in pulley rotation will change the endoscope from leftward articulation at the third model point 1420 to linear articulation at the first model point 1416. However, as shown in physical endoscope behavior 1430, the commanded change articulates the endoscope from leftward articulation at the third endoscope point 1440, through linear articulation at the fourth endoscope point 1442 and pre-articulation at the pre-articulation point 1434, to rightward articulation at the first endoscope point 1436.

[0195] Figure 13B provides visual assistance for articulating the endoscope to receive the commanded change. At the third endoscope point 1440, the endoscope may be in articulated state C of the example relaxed scenario 1350 with articulation to the left. At the pre-articulation point 1434, corresponding to the zero-tilt model origin 1412, the endoscope has already articulated past zero tilt toward pre-articulated state A. At the first endoscope point 1436, the endoscope articulates further to the right. That is, while the robotic system drives the commanded change to straighten the endoscope, the commanded change over-articulates the endoscope past zero tilt. Unintended articulation can cause harm to the patient's anatomy.

[0196] Nonlinearities and central deadbands can amplify / attenuate discrepancies between predicted and actual joint motion. For example, during a traverse between the third model point 1420 and the first model point 1416, the modeled response 1410 exhibits a smaller change in joint motion compared to the physical endoscope behavior 1430 due to nonlinearities. As another example, during a traverse between the model origin 1412 and the first model point 1416, the modeled response 1410 exhibits no change in joint motion, while the physical endoscope behavior 1430 exhibits significant joint motion. Thus, nonlinearities and central deadbands can further complicate delivery of desired joint motion.

[0197] The problem can be avoided / mitigated if the modeled response 1410 and the physical endoscope behavior 1430 can be aligned (e.g., homed) to share a common reference. That is, if the robotic system can determine the pulley rotation offset 1452, the robotic system can use the pulley rotation offset 1452 to shift / translate the modeled response 1410 to the physical endoscope behavior 1430, or vice versa.

[0198] The homing algorithm may determine a homing offset (e.g., pulley rotation offset 1452) and provide alignment. The homing algorithm may be run at any time, either manually or automatically. In one embodiment, the homing algorithm may be run once the endoscope is docked to account for pre-articulation motion that existed before docking and avoid potential harm to the patient's anatomy. The homing algorithm may determine whether one or more homing conditions are met and, if so, align the modeled response 1410 with the physical endoscope behavior 1430.

[0199] The relaxation algorithm can provide reliable relaxation of the endoscope (e.g., return to zero tilt). The ability to reliably relax the endoscope can further mitigate potential articulation problems. For example, if the endoscope can be reliably returned to the relaxed position, an operator who notices any unwanted articulation can correct the unwanted articulation by articulating the endoscope to the relaxed position. That is, the robotic system can minimize discrepancies between expected and actual endoscope behavior by resetting the endoscope to a relaxed position, e.g., zero tilt. The endoscope can then be articulated from the known articulation (e.g., zero tilt) before advancing into or retracting from the patient's anatomy. Relaxation can be commanded at any desired time.

[0200] In some embodiments, the relaxation algorithm may monitor tension on one or more pullwires during relaxation. Generally, a decrease in the net magnitude of tension and joint movement is expected during relaxation. Therefore, the robotic system may complete relaxation by continuing to drive pulley rotation toward lower tension until zero joint movement or some minimum tension (e.g., below a minimum tension threshold) is achieved.

[0201] In some embodiments, it may be advantageous to run a homing algorithm in parallel with or as part of the relaxation (e.g., execution of the relaxation algorithm). As described, relaxation attempts to return the endoscope to a known tilt (e.g., zero tilt), which may be a home position. Thus, determining the pulley rotation associated with zero tilt may involve determining the pulley rotation offset 1452. A relaxation tension monitoring and homing algorithm that implements both relaxation and homing is described in connection with FIG. 15.

[0202] FIG. 15 is a flow diagram for a process 1500 for relaxing and homing an endoscope based at least in part on pullwire tension monitoring, according to one or more embodiments. Process 1500 may determine whether a misalignment exists between a modeled endoscope response and an actual endoscope response during execution of a commanded relaxation. If process 1500 identifies such a misalignment, process 1500 may implement tension-based relaxation and homing to correct the misalignment. Process 1500 may be implemented in conjunction with articulation of an endoscope shaft via robotic control of a pullwire tensioning pulley / mechanism associated with the endoscope (e.g., integrated into the handle of the endoscope). Process 1500 may be implemented, at least in part, by control circuitry of any of the system components disclosed herein, such as a robotic cart / system and / or a control tower / system. For ease of description below, a robotic system is selected.

[0203] At block 1502, process 1500 involves setting, receiving, accessing, or otherwise determining one or more tension threshold levels / values ​​associated with each relaxation and / or homing algorithm. Such threshold parameters may include a maximum tension during relaxation, which may be set during endoscope adjustment / calibration based on safety requirements to avoid any damage to the endoscope and the patient's anatomy. Such parameters may be maintained as global values ​​associated with one or more endoscopic devices, or may be determined / set by the robotic system as processor- and / or instrument-specific values. In some implementations, process 1500 may involve identifying the particular instrument / endoscope used in process 1500, such as by a unique identifier or other identification that may be manually identified and / or entered, or automatically read / queried (e.g., using radio frequency identification (RFID) or other technology) when the endoscope is docked to the robotic system. The system may maintain / store specifications / parameters associated with various instrument identifiers, and process 1500 may involve accessing such parameters for the particular instrument / endoscope utilized.

[0204] At block 1504, process 1500 involves receiving a relaxation command. Different types of “relaxation” may exist. For example, a first type of relaxation may be a simple relaxation, involving rotation of one or more pulleys to a relaxation pulley rotation estimated to articulate the endoscope to a reference articulation (e.g., de-articulate the endoscope to zero tilt). The relaxation pulley rotation may be calculated at least in part based on a kinematic model (e.g., modeled response 1410 of FIG. 14 ). If the first type of relaxation is based on a kinematic model, monitoring tension on one or more pull wires may be optional. If misalignment exists (e.g., if the endoscope is docked pre-articulated), the first type of relaxation may not return the endoscope to the reference articulation. In this application, the first type of relaxation will be referred to as “relaxation.”

[0205] The second type of relaxation may be tension-based relaxation, which relies on monitored tension to relax the endoscope. The second type of relaxation may rotate the pulley to reduce tension on the pullwire until the monitored tension falls below a threshold, zero, or substantially zero, thereby ensuring that the endoscope is relaxed at a desired tilt, such as a tilt near zero. In other words, the second type of relaxation is relaxation based on the actual endoscope response (e.g., physical endoscope behavior 1430 in FIG. 14 ). The second type of relaxation does not need to reference a preset or supplied pulley rotation when relaxing the endoscope, but rather can actively determine the relaxation pulley rotation. In this application, the second type of relaxation will be referred to as “tension-based relaxation” to distinguish it from the first type of relaxation.

[0206] The relax command may be received automatically, such as upon docking of the endoscope, or may be manually commanded. With regard to manual commands, a robotic system utilized to implement process 1500, which may comprise any of the features of any robotic system disclosed herein, may include means for receiving a relax command from a user. Such user input may be received via a controller or other user input device, where manual (or other) engagement with one or more input mechanisms (e.g., buttons, joysticks, sliders, levers, knobs, etc.) can generate a relax command that is received by the robotic system (e.g., robotic control tower / cart).

[0207] At block 1506, process 1500 involves performing the commanded relaxation. When the user commands the scope to relax, the robotic system may attempt to dearticulate the endoscope with a relaxation pulley rotation, which should likely return the endoscope to zero tilt. In some implementations, the robotic system may select a direction of pulley rotation (e.g., clockwise, counterclockwise, or toward a particular direction in a plane) that will reduce the difference between the current and relaxation pulley rotations. By rotating the pulley in this direction, the pulley displacement between the current and relaxation pulley rotations may be reduced toward zero.

[0208] At block 1508, process 1500 involves monitoring and / or determining tension / force (f) and / or direction of pulley rotation associated with one or more pull wires of a surgical instrument coupled to the robotic system (e.g., an endoscope coupled to an end effector of a robotic cart). In some implementations, the tension may be a net tension on one or more pull wires. In other implementations, the tension may be of an individual pull wire. The robotic system may be configured to control articulation of the coupled instrument in a direction, dimension, and / or plane associated with an articulation input. The monitored tension / force may be associated with a pull wire coupled to a pulley or other actuator configured to cause tensioning / untensioning of the pull wire, and / or the tension / force may be associated with the pulley / actuator itself. That is, tension monitoring associated with block 1508 may involve directly monitoring tension on the pull wire (e.g., through strain gauge coupling / measurement) and / or monitoring tension / torque on a component / actuator mechanically coupled to the pull wire, such as a tension actuator (e.g., pulley) or an output drive / gear of a robotic end effector coupled to the instrument base. In some embodiments, one or more torque sensors may be used to generate a signal indicative of pull wire tension, and such torque sensors may be associated with any component, device, and / or system of a robotic system. For example, a torque sensor may be associated with a robotic end effector coupled to an instrument and configured to drive articulation of the instrument. A torque sensor may be utilized to monitor torque on a robotic output drive (e.g., gear, spline) coupled to an instrument tension pulley (e.g., associated with the instrument base / handle).

[0209] The tension monitoring associated with block 1508 may be performed using a lookback window configured to store monitored tension and / or pulley rotation direction over time, e.g., as samples over time. The lookback window may provide a mechanism by which stored samples of tension and pulley input direction may be compared to one another to provide a measure of changes in tension and, if any, changes in the direction of pulley rotation. The changes in tension and / or the direction of pulley rotation may provide, among other things, an indication of whether one or more pullwires are experiencing an increase (e.g., pulled) or decrease (e.g., released) in tension during successive pulley rotations in a particular direction.

[0210] At block 1510, process 1500 involves determining whether a relaxation tension monitoring and homing (RTMH) condition is met. The determination may be based on the monitored tension and the change in direction of pulley rotation at block 1508. The conditions may include (i) whether the robotic system is rotating the pulley in a direction in which tension should be released, (ii) whether the monitored tension has increased in magnitude during one or more recent time samples, and (iii) whether the monitored tension during the most recent time sample is greater than the maximum tension during relaxation, which may have been set / determined at block 1502.

[0211] The conditions are explained with reference to tension response plot 1550, which depicts a portion having a shape similar to tension response 1150 in FIG. 11B. Tension response plot 1550 shows two linear regions 1552, 1554 and two nonlinear regions 1556, 1558. As illustrated, the monitored tension should decrease in magnitude while the robotic system dearticulates the endoscope toward zero tilt during traverse over nonlinear regions 1556, 1558, likely during execution of a commanded relaxation, satisfying the first condition (i). The tension then begins to increase in magnitude after the traverse crosses zero tilt and continues to increase, thereby satisfying the second condition (ii). Eventually, further traverses increase the tension magnitude beyond maximum tension during relaxation 1562, thereby satisfying the third condition (iii). In tension response plot 1550, the three conditions are satisfied at point 1560.

[0212] Satisfaction of the three conditions may trigger the RTMH algorithm. Satisfaction of the three conditions may result in a pre-articulated endoscope. As described above in connection with FIG. 14 , a pre-articulated endoscope may cause misalignment between the kinematic model (e.g., modeled response 1410 in FIG. 14 ) and the actual endoscope response (e.g., physical endoscope behavior 1430 in FIG. 14 ). For example, upon receiving a relax command in block 1504, the robotic system calculates or otherwise obtains a relax pulley rotation that is expected to return the endoscope to zero tilt. Applying a relax pulley rotation typically only involves a decrease in tension during execution of the command. When the calculated pulley rotation instead causes an increase in the magnitude of tension, the endoscope is likely to have unaccounted articulation (e.g., an undesired deviation from the pre-articulation or commanded relax).

[0213] Referring to the articulation response plot 1400, a relaxation commanded by the robotic system (e.g., a first type of relaxation) may be visually represented as a traverse from the third model point 1420 to the first model point 1416, where the robotic system applies a relaxation pulley rotation that is expected to bring the endoscope to zero tilt. However, as the robotic system drives the relaxation pulley rotation, the relaxation pulley rotation actually articulates the physical endoscope behavior 1430 from a leftward articulation at the third endoscope point 1440, through zero tilt at the fourth endoscope point 1442, to a rightward articulation at the first endoscope point 1436. The endoscope articulation may satisfy three conditions at or near the fourth endoscope point 1442 before a complete traverse with the relaxation pulley rotation. Thus, satisfaction of the three conditions before a complete traverse can indicate a failure of the commanded relaxation.

[0214] The failure of the commanded relaxation may be caused by misalignment. To correct the misalignment, process 1500 may proceed to block 1510 and implement a RTMH algorithm, which may involve tension-based relaxation (e.g., a second type of relaxation) and endoscope homing.

[0215] At block 1512, process 1500 includes performing tension-based relaxation. Tension-based relaxation uses the monitored tension to relax the endoscope to zero tilt. That is, the pulleys are rotated in a direction that reduces tension depending on the monitored tension. The robotic system may continue to drive the pulley rotation toward lower tension until zero or some minimum tension is achieved. If the robotic system is able to achieve zero or minimum tension, the endoscope may be assumed to be relaxed to zero tilt. In some implementations, whether minimum tension has been achieved may be determined based on a comparison of the monitored tension with a minimum tension threshold. After tension-based relaxation is complete, process 1500 may proceed to the homing portion of the RMTH algorithm.

[0216] At block 1514, process 1500 involves performing homing. After completion of block 1512, the endoscope should be de-articulated at zero tilt. At this block 1514, the robotic system may determine the current pulley rotation that resulted in zero tilt and set the pulley rotation as the relax pulley rotation that is predicted to relax the endoscope. That is, homing may enable a first type of relax that uses the relax pulley rotation to relax the endoscope in the future without relying on tension monitoring.

[0217] Homing can resolve misalignments between the modeled and actual responses. As described in connection with the example articulation response plot 1400 of FIG. 14 , homing associated with block 1514 can be implemented with adjustments / shifts / translations that align the modeled response 1410 with the physical endoscope behavior 1430. Homing can include various steps.

[0218] As a step, block 1514 may involve setting / resetting the current joint motion to zero tilt, where the robotic system can reset its joint motion from the current joint motion to zero tilt. The reset can prepare the robotic system for application of the homing offset 1454.

[0219] As another step, block 1514 may include calculating a homing offset 1454. The homing offset 1454 may be calculated based on the current pulley rotation that provided zero tilt and a central deadband. For example, the pulley rotation at the fourth model point 1414 in the modeled response 1410 may correspond to the current pulley rotation that actually provided zero tilt, as indicated by the fourth endoscope point 1442 in the physical endoscope behavior 1430.

[0220] The homing offset 1454 may be determined based on a relationship between a pulley rotation predicted to provide a particular joint motion based on a kinematic model and a pulley rotation that actually provides the particular joint motion. For example, the modeled response 1410 predicts a zero slope for the pulley rotation at the first model point 1416. However, it was the pulley rotation corresponding to the fourth model point 1414 (e.g., the fourth endoscope point 1442) that actually provided the zero slope. The homing offset 1454 may be calculated as the difference between (e.g., subtraction between) the predicted pulley rotation and the actual pulley rotation, such as between the pulley rotation at the fourth model point 1414 and the pulley rotation at the first model point 1416. The predicted pulley rotation is at the first model point 1416, which is observed at the edge (e.g., the right edge) of the central deadband. The predicted pulley rotation may have a value that is half the central deadband range. In joint motion response plot 1400, when the predicted pulley rotation is subtracted by the actual pulley rotation at the fourth model point 1414, the subtraction adds the magnitude of the actual pulley rotation to the predicted pulley rotation because the actual pulley rotation is a negative value. This results in a homing offset 1454, which may be the same or substantially the same as pulley rotation offset 1452.

[0221] In some embodiments, the homing offset 1454 can be applied to adjust the pulley rotation. That is, all subsequent pulley rotations as controlled by the robotic system can be adjusted by the homing offset 1454. For example, after homing, the pulley rotation at the first model point 1416 can be subtracted by the homing offset 1454, and the robotic system can use the result to command articulation of the endoscope. Conversely, when determining the pulley rotation that will result in a particular articulation, the robotic system can determine the pulley rotation based on the modeled response 1410 (e.g., a kinematic model of the endoscope) and adjust the pulley rotation by the homing offset 1454. For example, if articulation at the third model point 1420 is desired, the robotic system can calculate the pulley rotation for the third model point 1420 based on the modeled response 1410. The robotic system can then adjust the pulley rotation by applying the homing offset 1454 and control the endoscope with the resulting pulley rotation to articulate the endoscope to the desired articulation.

[0222] In some embodiments, the homing offset 1454 may be applied to permanently shift / translate the modeled response 1410 to more closely match the physical endoscope behavior 1430. The shift / translation may involve resetting the old X-axis used to count / index the pulley rotations based on the homing offset 1454 to provide a new X-axis for subsequent counting / assignment of pulley rotations. The new X-axis becomes the new frame of reference from which the robotic system counts / indexes pulley rotations. After the reset, the robotic system may count / index zero pulley rotations on the new X-axis if the old X-axis had a negative value of the homing offset 1454. Similarly, the robotic system may count / index the homing offset 1454 on the new X-axis if the old X-axis had zero pulley rotation. As a visual example, in the joint motion response plot 1400, a reset can shift the modeled response 1410 leftward by a homing offset 1454, so that the pulley rotation provided by the robotic system based on the shifted modeled response (not shown) aligns with the physical endoscope behavior 1430.

[0223] As yet another step, homing may involve resetting the current tilt zone to the post-transition relaxation zone. Subsequent pulley rotation and expected joint motion are affected by application of the homing offset 1454. Thus, joint motion previously predicted to be in the linear region may now be in the nonlinear region, or vice versa. Similarly, joint motion previously predicted to de-articulate may now articulate, or vice versa. Thus, the current tilt zone may need to be reset at the correct tilt zone (e.g., the post-transition relaxation zone) after application of the homing offset 1454 so that the expected joint motion within the zone matches the actual joint motion within the zone. Resetting the current tilt zone may help to implement the relaxation following block 1512.

[0224] Referring back to block 1510, if the condition is not met, process 1500 may proceed to block 1516. At block 1516, process 1500 involves determining whether the commanded relaxation of block 1506 is complete. That is, the robotic system determines whether the pulley has been fully rotated to the relaxation pulley rotation that is estimated to provide zero tilt. If the pulley has been fully rotated, or some other condition indicates completion of early termination of relaxation, the process may proceed to block 1518. If not, process 1500 may proceed to block 1508 to continue monitoring tension.

[0225] At block 1518, process 1500 involves taking any optional corrective action. Block 1514 may be optional if relaxation is paused, for example, due to detection of potential harm to the endoscope, the robotic system, or the patient, or if relaxation conditions were not achievable. Corrective action may include a variety of actions ranging from stopping robotic control, reversing the direction of relaxation, or notifying the robotic system and / or user of the relaxation failure.

[0226] It will be understood that any block and any step within a block may be performed / executed independently of other blocks and steps. Additionally, any block and any step within a block may be performed automatically or upon command. For example, the tension-based relaxation of block 1512 may be performed as part of process 1500 when the robotic system is initialized, when the endoscope is docked, or when commanded by a user or the robotic system.

[0227] Passive Homing Algorithm Robotic control of an endoscope involves calculating the pulley rotations required to achieve a desired endoscope articulation. The pulley rotations are calculated relative to a home (e.g., reference) position. As explained above, homing may refer to the process of finding a home position and, in some cases, may further include adjusting the indexing of the pulley rotations so that the home position is located at zero pulley rotation. That is, homing may configure the home position so that the endoscope is straight at the home position corresponding to zero pulley rotation.

[0228] Finding the home position can be hindered by the presence of a central dead band (e.g., central dead band 1109 in FIG. 11A ), a characteristic exhibited by dual-wire pulleys. Within the central dead band, the pull wire attached to the dual-wire pulley may not apply enough tension to cause endoscope articulation. That is, if the endoscope is straightened, it will remain straight throughout the range of pulley rotations within the central dead band. Because the articulation response to any pulley rotation within the central dead band corresponds to a straight endoscope, any pulley rotation can be identified as the home position. Therefore, finding the home position of a dual-wire pulley may additionally involve finding a pulley rotation that has a known relationship to the center of the central dead band, such as the center or both ends of the central dead band.

[0229] Accurate identification of the home position can be important in endoscope control. If the home position is incorrectly identified, the kinematic model for the endoscope will not accurately match the designed actual endoscope articulation, and controlling the endoscope with an incorrect home position can result in significantly larger pauses, rapid or jerky movements, and / or inconsistent articulation speeds. Furthermore, an incorrect home position can potentially result in unacceptably large forces on the patient's anatomical structures, potentially causing damage.

[0230] A passive homing algorithm may enable the robotic system to identify the correct home position and thus enable proper alignment between modeled and physical joint movements. A passive homing algorithm is “passive” in the sense that (i) the algorithm does not run separately but runs only when the robotic system actively commands joint movements, and / or (ii) the algorithm does not command any joint movements but relies on commanded joint movements independently of the algorithm. In other words, a passive homing algorithm may not initiate or command any joint movements by itself; rather, it monitors the presence of misalignment during other commanded joint movements and, if appropriate, corrects the misalignment by homing. For example, a passive homing algorithm may run as a background process during actively commanded joint movements to monitor tension on a pull wire. While mere monitoring may not initiate or cause joint movements, it can inform the robotic system whether the measured tension aligns with the expected tension of the model. When there is misalignment, the passive homing algorithm may perform homing. The passive nature of the algorithm can be advantageous because, due to its non-initiating and non-articulating nature, there is no risk of uncommanded articulation caused by the algorithm. Therefore, the algorithm cannot pose a patient safety risk. The algorithm is described in relation to FIG. 16.

[0231] 16 is an exemplary tension-articulation response plot 1600 illustrating the relationship between pullwire tension and endoscope articulation, in accordance with one or more embodiments. The tension-articulation response plot 1600 is plotted on a plane having an X-axis representing applied tension on the pullwire and a Y-axis representing endoscope articulation (denoted as φ).

[0232] The passive homing algorithm uses the relationship in the tension-joint motion response plot 1600 to identify the home position. Assume the dual-wire pulley is in an initialized state, has a pulley rotation corresponding to a straight endoscope (e.g., an endoscope with zero tilt), and is then driven in either a clockwise or counterclockwise direction. While the pulley is driven within the central deadband, zero or minimum tension is expected in the pullwires. That is, the tension should be at or near the origin of the tension-joint motion response plot 1600. As the pulley is driven further, eventually, at least one pullwire will become taut as the pulley leaves either edge of the central deadband (e.g., driven at the associated pulley rotation). When the pullwire becomes taut, for example, the tension may increase abruptly to a first tension point 1608a. That is, at the edge of the central deadband, the tension suddenly emerges from the zero or minimum tension zone observed in the central deadband. The pulley rotation that causes the sudden onset of tension corresponds to a pulley rotation at the edge of the central deadband. The algorithm can set / reset the home position based on the observation that the pulley rotation should correspond to the edge of the central deadband. The algorithm is described in more detail in connection with FIG. 17.

[0233] 17 is a flow diagram of a process 1700 for passively homing an endoscope, according to one or more embodiments. For example, process 1700 may be implemented in connection with articulation of an endoscope shaft via robotic control of a pull wire tensioning pulley / mechanism associated with the endoscope (e.g., integrated into the handle of the endoscope). Process 1700 may be implemented, at least in part, by control circuitry of any of the system components disclosed herein, such as a robotic cart / system and / or a control tower / system. For ease of description below, a robotic system is chosen.

[0234] At block 1702, process 1700 involves setting, receiving, accessing, or otherwise determining one or more threshold levels / values ​​associated with the passive homing algorithm. Such threshold parameters may include a bypass tension threshold (BTT) 1606, an allowable pulley rotation threshold (PRT), and / or an allowable center dead zone tension band (CDZTB) 1604. Such parameters may be maintained as global values ​​associated with one or more endoscopic devices, or may be determined / set by the robotic system as processor- and / or instrument-specific values, such as inherent to the kinematic model of the endoscopic device. In some implementations, process 1700 may involve identifying the particular instrument / endoscope used in process 1700, such as by a unique identifier or other identification, which may be manually identified and / or entered, or may be automatically read / queried (e.g., using radio frequency identification (RFID) or other technology) when the endoscope is docked to the robotic system. The system may maintain specifications / parameters associated with various instrument identifiers, and process 1700 may involve accessing such parameters for the particular instrument / endoscope utilized.

[0235] At block 1704, process 1700 involves docking an endoscope and initializing its kinematic model. The endoscope may be docked and pre-articulated. Pre-articulation of the endoscope may cause misalignment between the kinematic model and the physical endoscope behavior. A passive homing algorithm may partially or completely resolve the misalignment.

[0236] At block 1706, process 1700 involves receiving user input commanding the user's desired articulation. Such user input may be received via a controller or other user input device, where manual (or other) engagement with one or more input mechanisms (e.g., buttons, joysticks, sliders, levers, knobs, etc.) can generate commands that are received by a robotic system (e.g., a robotic control tower / cart). Following receipt of the user input, the robotic system begins articulating the endoscope by driving pulley rotation.

[0237] At block 1708, process 1700 involves monitoring tension and pulley rotation. The tension and pulley rotation may be monitored for each time sample or each sampling period. In some implementations, the tension monitoring associated with block 1706 may be performed using a lookback window configured to store the monitored tension over time, for example, over each time sample. The lookback window may provide a mechanism by which the mean, median, or mode of the monitored tension may be determined to provide a more accurate and / or more reliable measure of tension.

[0238] The tension may be compared to a bypass tension threshold (BTT) 1606. If the tension is greater than the bypass tension threshold (BTT) 1606, it may indicate that the endoscope is pre-articulated with the corresponding pulley revolution having already exited the central deadband. For example, in the tension-articulation response plot 1600 of FIG. 16, the third tension point 1608c is associated with a tension magnitude that exceeds the bypass tension threshold (BTT) 1606. In these instances, it may be difficult to determine the tension at which the endoscope will exit the central deadband. Therefore, the process 1700 can proceed directly to block 1716.

[0239] The pulley rotation may be compared to an acceptable pulley rotation threshold (PRT). If the pulley rotation is greater than the acceptable pulley rotation threshold (PRT), it may indicate that the endoscope is experiencing articulation that is undesirable for homing. For example, in the tension-articulation response plot 1600 of FIG. 16, the second tension point 1608b and the fourth tension point 1608d are associated with tensions that are less in magnitude than the bypass tension threshold (BTT) 1606 and therefore satisfy the tension conditions described above. However, the tension-articulation response plot 1600 shows substantial positive articulation at the fourth tension point 1608d, indicating that the endoscope is not near the central deadband and that any further articulation is unlikely to find a “break” point that exits the central deadband. Such substantial articulation, including articulation at the fourth tension point 1608d, may be prevented from undergoing homing based on a determination that the corresponding pulley rotation is too great to associate the articulation with the central deadband. For example, the fourth tension point 1608d is associated with a pulley rotation near maximum articulation and at the beginning of articulation disengagement, which is associated with a substantially large pulley rotation. The substantially large pulley rotation exceeds the allowable pulley rotation threshold (PRT) and therefore does not satisfy the pulley rotation threshold condition. In contrast, the second tension point 1608b is associated with a pulley rotation near the beginning of articulation, which is associated with a pulley rotation that is smaller than the pulley rotation associated with the fourth tension point 1608d and may be equal to or less than the allowable pulley rotation threshold (PRT). The passive homing algorithm may be executed from the second tension point 1608b. That is, the allowable pulley rotation threshold (PRT) may provide a boundary for potential homing pulley rotations and prevent homing at physically irrelevant pulley rotations. If the pulley rotation is deemed physically irrelevant for homing, the process 1700 may proceed directly to block 1716.

[0240] If both of the above conditions do not prevent the robotic system from further implementing the passive homing algorithm (e.g., not proceeding to block 1716), the monitored tension may be compared to an acceptable central dead zone tension band (CDZTB) 1604. If the tension is greater than the acceptable central dead zone tension band (CDZTB) 1604, the robotic system has found a "break" point (e.g., first tension point 1608a).

[0241] At block 1710, process 1700 involves calculating a homing offset based on the measured and modeled pulley rotations at the "break" point. Specifically, the homing offset may be calculated as the difference between the modeled and measured pulley rotations at the edge of the central deadband.

[0242] An exemplary articulation response plot 1750, plotted on a plane with the X-axis representing pulley rotation (denoted j) and the Y-axis representing endoscope articulation (denoted φ), is shown for reference. A central dead zone 1760 is shown on the X-axis. The modeled pulley rotation 1756 at the edge of the central dead zone 1760 is on the modeled response 1752, and the measured pulley rotation 1758 is on the physical endoscope behavior 1754. The difference 1762 is the homing offset.

[0243] At block 1712, process 1700 involves applying a homing offset to future pulley rotations. Applying the homing offset may align the modeled response 1752 with the physical endoscope behavior 1754. After application, the physical endoscope behavior 1754 may have its pulley home position at the center of the central deadband 1760.

[0244] In some implementations, blocks 1710 and 1712, which involve calculating and applying a homing offset, may be prevented from further execution until the endoscope is redocked and its kinematic model is reinitialized. That is, one passive homing is performed per docking. This prevention may be due to the consideration that once execution of block 1712 ensures alignment of the kinematic model, further alignment is not required unless the endoscope is redocked and block 1704 is executed. This prevention may involve resetting a flag indicating execution of block 1712 during initialization in block 1704 and setting the flag after execution of block 1712. The flag may be checked before blocks 1710 and / or 1712 to determine whether to allow execution of one or both of the blocks.

[0245] At block 1714, the process 1700 involves resetting the modeled joint motion at the measured pulley rotation to an empirically known value. In the example joint motion response plot 1750, the empirically known value at the pulley home position may be zero slope.

[0246] At block 1716, process 1700 involves exiting (e.g., terminating) the passive homing algorithm. In some implementations, if block 1712 was not executed before reaching this block 1716 (e.g., tension is above bypass tension threshold (BTT) 1606 or measured pulley rotation is above allowable pulley rotation threshold (PRT)), the passive homing algorithm may be executed again upon receiving another user input at block 1706.

[0247] Further embodiments Depending on the embodiment, certain acts, events, or functions of any of the processes or algorithms described herein may be performed in a different order, added, merged, or omitted entirely. Thus, in a particular embodiment, not all of the described acts or events may be required to perform a process.

[0248] In particular, conditional language used herein, such as "can," "could," "might," "may," "eg," and the like, unless specifically stated otherwise or understood otherwise within the context in which it is used, is intended to have its ordinary meaning and is generally intended to convey that certain embodiments include certain features, elements, and / or steps, while other embodiments do not. Thus, such conditional language is not generally intended to imply that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining whether those features, elements, and / or steps are included in or performed in any particular embodiment, with or without author input or prompting. Terms such as "comprising," "including," "having," and the like are synonymous and used in their ordinary sense, inclusively in a non-limiting manner, and do not exclude additional elements, features, acts, operations, etc. Also, when the term "or" is used, for example, to connect a list of elements, the term "or" is used in its inclusive sense (and not its exclusive sense) to mean one, some, or all of the listed elements. Unless specifically stated otherwise, conjunctive language such as the phrase "at least one of X, Y, and Z" is understood in the context as it is commonly used to convey that an item, term, element, etc. can be either X, Y, or Z. Thus, such conjunctive language is generally not intended to imply that a particular embodiment requires that at least one of X, at least one of Y, and at least one of Z, each be present.

[0249] In the foregoing description of the embodiments, it should be understood that various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure and aiding in understanding one or more of the various inventive aspects. However, this method of disclosure should not be interpreted as reflecting an intention that any claim requires more features than are expressly recited in that claim. Moreover, any component, feature, or step illustrated and / or described in a particular embodiment herein may be applied to or used in conjunction with any other embodiment. Moreover, no component, feature, step, or group of components, features, or steps is necessary or essential for each embodiment. Accordingly, it is intended that the scope of the invention(s) disclosed herein and claimed below should not be limited by the specific embodiments described above, but should be determined solely by a fair reading of the following claims.

[0250] It should be understood that certain ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply any physical characteristics or ordering. Thus, as used herein, ordinal terms (e.g., "first," "second," "third," etc.) used to modify elements such as structures, components, operations, etc., do not necessarily indicate a priority or order of the element with respect to any other elements, but rather may generally distinguish the element from other elements having a similar or identical name (apart from the use of the ordinal terminology). Additionally, as used herein, the indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Furthermore, an action performed "based on" a condition or event may also be performed based on one or more other conditions or events not expressly recited.

[0251] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the example embodiments belong. It is further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning consistent with their meaning in the context of the relevant art, and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

[0252] Spatially relative terms such as "outside," "inside," "upper," "lower," "below," "upper," "vertical," "horizontal," and similar terms may be used herein for ease of description to describe the relationship between one element or component and another element or component as illustrated in the figures. It should be understood that spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device shown in the figures were inverted, a device positioned "below" or "under" another device would be positioned "above" another device. Thus, the illustrative term "under" can include both lower and upper positions. Devices may also be oriented in other directions, and thus spatially relative terms may be interpreted differently depending on the orientation.

[0253] Unless otherwise specified, comparative and / or quantitative terms such as "less," "more," "greater than," etc. are intended to encompass the notion of equality. For example, "less" can mean "less than" in the strict mathematical sense as well as "less than or equal to."

[0254] [Embodiment] (1) A robot system, an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and a memory storing computer-executable instructions that, when executed, cause the processor to: determining a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to relax the elongate shaft to a neutral position; driving the one or more drive outputs based at least in part on the pulley rotation; monitoring tension on one or more pull wires coupled to the pulley; The robotic system controls the one or more drive outputs based at least in part on the tension. (2) The robot system of embodiment 1, wherein the pulley is a dual wire pulley and the pulley rotation is determined based on a kinematic model for the dual wire pulley. (3) the neutral position is zero degrees of articulation; the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the tension is below a minimum tension threshold; A robot system as described in embodiment 1 or 2, wherein the controlling includes stopping the driving of the one or more output units based on the tension falling below the minimum tension threshold. (4) the memory further includes computer-executable instructions that, when executed, cause the processor to: determining that the magnitude of the tension is increasing; 4. The robot system of claim 3, wherein the one or more drive outputs are driven in a direction opposite to the pulley rotation. (5) the memory further includes computer-executable instructions, which, when executed, cause the processor to: Determine the homing offset, A robot system as described in embodiment 1 or 2, wherein the homing offset is applied to a kinematic model associated with the elongated shaft.

[0255] (6) The robot system of embodiment 5, wherein the elongated shaft is docked to the end effector with a non-zero articulation, and determining the homing offset includes determining the non-zero articulation. (7) determining the homing offset includes driving the one or more drive outputs based at least in part on the pulley rotation; increasing the tension over a period of time; and the tension at the end of the period is above a maximum tension threshold during relaxation. 7. The robot system of claim 6, further comprising determining a point in the kinematic model. (8) The robot system of embodiment 7, wherein determining the homing offset includes calculating the homing offset based on a difference between the point and a pulley rotation corresponding to an edge of a central dead zone. (9) The memory further includes computer-executable instructions, which, when executed, cause the processor to: A robot system as described in embodiment 1 or 2, which receives a relaxation command. (10) A method for robotically articulating an instrument, said method comprising: determining a pulley rotation that, when applied by a robotic manipulator to a pulley coupled to an elongate shaft, would be expected to relax the elongate shaft to a neutral position; driving one or more drive outputs based at least in part on the pulley rotation; monitoring tension on one or more pull wires coupled to the pulley; and controlling the driving of the one or more drive outputs based at least in part on the tension.

[0256] (11) A robot system, an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and a memory storing computer-executable instructions that, when executed, cause the processor to: determining a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to articulate the elongate shaft to a desired articulation; driving the one or more drive outputs based at least in part on the pulley rotation; While driving the one or more drive outputs, monitoring tension on one or more pull wires coupled to the pulley; determining that the tension is greater than an acceptable central deadband tension band; A robot system that performs homing and determines a homing offset. (12) The robot system of embodiment 11, wherein the pulley is a dual wire pulley and the pulley rotation is determined based on a kinematic model for the dual wire pulley. (13) The robot system of claim 11 or 12, wherein performing the homing includes calculating the homing offset based on a difference between a first pulley rotation associated with the tension that is greater than the allowable central deadband tension band and a second pulley rotation that corresponds to an edge of the central deadband. (14) The robot system of embodiment 13, wherein the performing of the homing is performed during initial articulation of the elongated shaft. (15) The memory further includes computer-executable instructions, which, when executed, cause the processor to: 13. A robot system as described in embodiment 11 or 12, wherein the homing offset is applied to a kinematic model associated with the elongated shaft.

[0257] (16) The step of monitoring tension on the one or more pull wires further comprises: sampling the monitored tension over a look-back window; Calculating at least one of the mean, median, or mode of the monitored tension over the lookback window. (17) The robot system of claim 11 or 12, wherein the elongated shaft is docked to the end effector with a non-zero articulation, and determining the homing offset includes determining the non-zero articulation. (18) The memory further includes computer-executable instructions, which, when executed, cause the processor to: determining that the tension is greater than a bypass tension threshold; 13. The robot system of claim 11 or 12, wherein the homing is terminated based at least in part on determining that the tension is greater than the bypass tension threshold. (19) The memory further includes computer-executable instructions, which, when executed, cause the processor to: determining that the current pulley rotation exceeds an acceptable pulley rotation threshold; 13. The robot system of claim 11 or 12, wherein the homing is terminated based at least in part on determining that the current pulley rotation exceeds the allowable pulley rotation threshold. (20) The robot system of embodiment 11 or 12, wherein at least one of an allowable central dead zone tension band, a bypass tension threshold, or an allowable pulley rotation threshold is associated with the kinematic model for the elongated shaft.

Claims

1. 1. A robotic system comprising: an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and a memory storing computer-executable instructions that, when executed, cause the processor to: determining a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to relax the elongate shaft to a neutral position; driving the one or more drive outputs based at least in part on the pulley rotation; monitoring tension on one or more pull wires coupled to the pulley; The robotic system controls the one or more drive outputs based at least in part on the tension.

2. The robotic system of claim 1 , wherein the pulley is a dual-wire pulley and the pulley rotation is determined based on a kinematic model for the dual-wire pulley.

3. the neutral position being zero degrees of articulation; the memory further includes computer-executable instructions that, when executed, cause the processor to determine that the tension is below a minimum tension threshold; The robot system of claim 1 or 2, wherein the controlling comprises ceasing the driving of the one or more output sections based on the tension falling below the minimum tension threshold.

4. The memory further includes computer-executable instructions that, when executed, cause the processor to: determining that the magnitude of the tension is increasing; The robotic system of claim 3 , wherein the one or more drive outputs are driven in a direction opposite to the pulley rotation.

5. The memory further includes computer-executable instructions that, when executed, cause the processor to: Determine the homing offset, The robotic system of claim 1 or 2, wherein the homing offset is applied to a kinematic model associated with the elongate shaft.

6. The robotic system of claim 5 , wherein the elongate shaft is docked to the end effector with a non-zero articulation, and wherein determining the homing offset includes determining the non-zero articulation.

7. determining the homing offset includes driving the one or more drive outputs based at least in part on the pulley rotation; increasing the tension over a period of time; and the tension at the end of the period is above a maximum tension threshold during relaxation. The robotic system of claim 6 , further comprising determining a point in the kinematic model.

8. 8. The robotic system of claim 7, wherein determining the homing offset comprises calculating the homing offset based on a difference between the point and a pulley rotation corresponding to an edge of a central deadband.

9. The memory further includes computer-executable instructions that, when executed, cause the processor to: The robot system of claim 1 or 2, wherein a relax command is received.

10. 1. A method for robotically articulating an instrument, the method comprising: determining a pulley rotation that, when applied by a robotic manipulator to a pulley coupled to an elongate shaft, would be expected to relax the elongate shaft to a neutral position; driving one or more drive outputs based at least in part on the pulley rotation; monitoring tension on one or more pull wires coupled to the pulley; and controlling the driving of the one or more drive outputs based at least in part on the tension.

11. 1. A robotic system comprising: an end effector including one or more drive outputs configured to cause articulation of an elongate shaft of an instrument coupled to the end effector; a processor; and a memory storing computer-executable instructions that, when executed, cause the processor to: determining a pulley rotation that, when applied by the end effector to a pulley coupled to the elongate shaft, would be expected to articulate the elongate shaft to a desired articulation; driving the one or more drive outputs based at least in part on the pulley rotation; While driving the one or more drive outputs, monitoring tension on one or more pull wires coupled to the pulley; determining that the tension is greater than an acceptable central deadband tension band; A robot system that performs homing and determines a homing offset.

12. 12. The robotic system of claim 11, wherein the pulley is a dual wire pulley and the pulley rotation is determined based on a kinematic model for the dual wire pulley.

13. 13. The robotic system of claim 11 or 12, wherein performing the homing includes calculating the homing offset based on a difference between a first pulley rotation associated with the tension that is greater than the allowable central deadband tension band and a second pulley rotation that corresponds to an edge of the central deadband.

14. The robotic system of claim 13 , wherein the performing the homing is performed during an initial articulation of the elongate shaft.

15. The memory further includes computer-executable instructions that, when executed, cause the processor to: The robotic system of claim 11 or 12, wherein the homing offset is applied to a kinematic model associated with the elongate shaft.

16. said monitoring tension on said one or more pull wires sampling the monitored tension over a look-back window; and calculating at least one of a mean, a median, or a mode of the monitored tension over the lookback window.

17. 13. The robotic system of claim 11 or 12, wherein the elongate shaft is docked to the end effector with a non-zero articulation, and wherein determining the homing offset comprises determining the non-zero articulation.

18. The memory further includes computer-executable instructions that, when executed, cause the processor to: determining that the tension is greater than a bypass tension threshold; The robotic system of claim 11 or 12, wherein the homing is terminated based at least in part on the determining that the tension is above the bypass tension threshold.

19. The memory further includes computer-executable instructions that, when executed, cause the processor to: determining that the current pulley rotation exceeds an acceptable pulley rotation threshold; The robotic system of claim 11 or 12, wherein the homing is terminated based at least in part on the determining that the current pulley rotation is greater than the allowable pulley rotation threshold.

20. 13. The robotic system of claim 11 or 12, wherein at least one of an allowable central deadband tension band, a bypass tension threshold, or an allowable pulley rotation threshold is associated with a kinematic model for the elongate shaft.

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