Advanced basket drive mode

Abstract

The robotic system includes a robotic manipulator configured to manipulate a medical instrument having a basket, open the basket at a first opening speed and a faster second opening speed, and close the basket at a first closing speed and a faster second closing speed. The system includes an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movement and preprogrammed actions. Control circuitry of the robotic system is configured to trigger a first programmed action of the robotic manipulator to open the basket at the second faster opening speed in response to receiving a first user interaction via the input device, and to trigger a second preprogrammed action to close the basket at the second faster closing speed in response to receiving a second user interaction via the input device.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 62 / 956,071, filed December 31, 2019, entitled Advanced Basket Drive Mode, the disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THEINVENTION The present disclosure relates to the fields of medical devices and procedures, and user interfaces. [Background technology]

[0003] Various medical procedures use one or more devices configured to penetrate the human anatomy to reach a treatment site. Certain surgical procedures involve inserting one or more devices through the patient's skin or an orifice to reach a treatment site where an object such as a urinary stone may be extracted from the patient. Summary of the Invention [Means for solving the problem]

[0004] Described herein are one or more systems, devices, and / or methods for assisting physicians and others in controlling medical instruments to access objects, such as urinary stones, present within the human anatomy.

[0005] One general aspect includes a robotic system for performing a medical procedure. The robotic system includes a robotic manipulator configured to manipulate a medical instrument having a basket and configured to access a human anatomy, to open the basket at a first opening speed and a second opening speed that is faster than the first opening speed, and to close the basket at a first closing speed and a second closing speed that is faster than the first closing speed. The system may include an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, which may include at least one of directly controlled movements and preprogrammed actions. The system may further include a control circuit communicatively coupled to the input device and the robotic manipulator. The control circuitry is configured to trigger a first pre-programmed operation of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed operation including opening the basket at a second opening speed, and to trigger a second pre-programmed operation of the robotic manipulator in response to receiving a second user interaction via the input device, the second pre-programmed operation including closing the basket at a second closing speed. Other embodiments of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each configured to perform the operations of the method.

[0006] Implementations of the robotic system may include one or more of the following features: The robotic system may include a ureteroscope. The medical procedure may include ureteroscopy. The input device may include a directional control configured to direct movement of the robotic manipulator along multiple axes and a plurality of buttons including a first button and a second button. The first user interaction may include double tapping the first button. The second user interaction may include double tapping the second button. The control circuitry may be further configured to trigger a third pre-programmed operation of the robotic manipulator in response to the first button and the second button being simultaneously tapped, the third pre-programmed operation including moving forward and backward repeatedly a short distance at an accelerated speed. The control circuitry may be further configured to trigger a third pre-programmed operation of the robotic manipulator in response to the third user interaction being received, the third pre-programmed operation including moving forward and backward repeatedly a short distance at an accelerated speed. The second pre-programmed operation may further include detecting a torque in a drive mechanism of the basket and stopping the closure of the basket in response to the torque exceeding a threshold. At least one of the first user interaction and the second user interaction may include a voice command. Embodiments of the described technology may include machinery, a method or process, or computer software on a computer-accessible medium.

[0007] One general aspect includes a method of controlling a medical instrument using a robotic manipulator. The method may include using the robotic manipulator to manipulate a medical instrument including a basket for accessing a human anatomy, the robotic manipulator configured to open the basket at a first opening speed and a second opening speed, the robotic manipulator further configured to close the basket at a first closing speed and a second closing speed, and receiving one or more user interactions via an input device to trigger preprogrammed operations by the robotic manipulator. The method may further include triggering a first preprogrammed operation of the robotic manipulator in response to receiving the first user interaction via the input device, the first preprogrammed operation including opening the basket at a second opening speed that is faster than the first opening speed. The method may further include triggering a second preprogrammed operation of the robotic manipulator in response to receiving the second user interaction via the input device, the second preprogrammed operation including closing the basket at a second closing speed that is faster than the first closing speed. Other embodiments of this aspect include corresponding computer systems, devices, and computer programs stored on one or more computer storage devices, each configured to perform the operations of the methods.

[0008] Implementations of the method may include one or more of the following features: The first user interaction may include double tapping a first button of the input device, and the second user interaction may include double tapping a second button of the input device. The method may further include triggering a third pre-programmed operation of the robotic manipulator including repeatedly moving forward and backward a short distance at an accelerated rate in response to the first button and the second button being tapped simultaneously. The method may further include moving a center position of the third pre-programmed operation of the robotic manipulator along the first axis in response to receiving an input of movement along the first axis on the input device, and repeating moving forward and backward a short distance at the center position. The third pre-programmed operation may further include a repeated rotational movement. The method may further include manipulating an endoscope using the robotic manipulator to access a human anatomy, the endoscope may be configured to capture images of a medical instrument within the human anatomy. The method may further include receiving a third user interaction via the input device to directly control movement of the medical instrument, and manipulating the medical instrument along one or more axes of movement based on the received third user interaction using the robotic manipulator. The second pre-programmed operation may further include detecting torque in a drive mechanism of the basket, and stopping closure of the basket in response to the torque exceeding a threshold. Embodiments of the described technology may include machine tools, methods or processes, or computer software on a computer-accessible medium.

[0009] One general aspect includes a control system for controlling a robotic device to perform a medical procedure. The control system may include an input device configured to receive one or more user interactions and initiate one or more actions, including at least one of directly controlled movements and preprogrammed movements, by the robotic device. The control system may further include a communication interface configured to transmit commands to the robotic device corresponding to the directly controlled movements and the preprogrammed movements, the commands including the robotic device moving a medical instrument having a basket and configured to access a human anatomy, opening the basket at a first opening speed and a second opening speed that is faster than the first opening speed, and closing the basket at a first closing speed and a second closing speed that is faster than the first closing speed. The control system may further include a control circuit communicatively coupled to the input device and the communication interface. The control circuitry is configured to trigger a first pre-programmed operation of the robotic device in response to receiving the first user interaction, the first pre-programmed operation including opening the basket at a second opening speed, and to trigger a second pre-programmed operation of the robotic device in response to receiving the second user interaction, the second pre-programmed operation including closing the basket at a second closing speed. Other embodiments of this aspect include corresponding computer systems, devices, and computer programs recorded on one or more computer storage devices, each configured to perform the operations of the method.

[0010] An implementation of the control system may include one or more of the following features: The input device may include a directional control configured to direct movement of the robotic device along multiple axes and a plurality of buttons including a first button configured to trigger a first preprogrammed action and a second button configured to trigger a second preprogrammed action. Double tapping the first button may trigger the first preprogrammed action, and double tapping the second button may trigger the second preprogrammed action. Tapping the first button once may trigger a third preprogrammed action different from the first preprogrammed action, and tapping the second button once may trigger a fourth preprogrammed action different from the second preprogrammed action. The control circuitry may be further configured to trigger a third preprogrammed action of the robotic device including moving forward and backward a short distance repeatedly at an accelerated rate in response to the first button and the second button being tapped simultaneously. The control circuitry may be further configured to move a center location of the third pre-programmed motion of the robotic device along the first axis in response to receiving a request for movement along the first axis via the directional control, and to repeat moving forward and backward a short distance at the center location. The input device may include a microphone configured to obtain voice user commands, and the control circuitry is further configured to distinguish between a first voice user command corresponding to the first user interaction and a second voice user command corresponding to the second user interaction. The robotic device may be located at a first geographic location different from a second geographic location of the control system, and the communication interface is further configured to transmit the command over a wide area network. An embodiment of the described technology may include machinery, a method or process, or computer software on a computer-accessible medium.

[0011] One general aspect is one or more non-transitory computer-readable media storing computer-executable instructions that, when executed by a control circuit, cause the control circuit to perform operations including manipulating a medical instrument including a basket for accessing a human anatomy using a robotic device, where the robotic device is configured to open the basket at a first opening speed and a second opening speed, and where the robotic device is further configured to close the basket at a first closing speed and a second closing speed; receiving, via an input device, one or more inputs for triggering pre-programmed operations by the robotic device; and, in response to the first input being received via the input device, triggering a first pre-programmed operation of the robotic device including opening the basket at a second opening speed that is faster than the first opening speed; and, in response to the second input being received via the input device, triggering a second pre-programmed operation of the robotic device including closing the basket at a second closing speed that is faster than the first closing speed. Other embodiments of this aspect include corresponding computer systems, devices, and computer programs stored on one or more computer storage devices, each configured to perform the operations of the methods.

[0012] An embodiment of the non-transitory computer readable medium may include one or more of the following features: The first input may include double tapping a first button of an input device, and the second input may include double tapping a second button of an input device. The computer executable instructions may be further configured to cause the control circuitry to perform an operation including triggering a third pre-programmed action of the robotic device in response to the first button and the second button being simultaneously tapped, the third pre-programmed action including moving forward and backward repeatedly a short distance at an accelerated rate. The computer executable instructions may be further configured to cause the control circuitry to perform an operation including receiving, via the input device, a third input for controlling direct movement of the robotic device, and using the robotic device to manipulate the medical instrument along one or more axes of movement based on the received third input. An embodiment of the described technology may include machine tools, methods or processes, or computer software on a computer accessible medium.

[0013] 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, for example, a disclosed embodiment may achieve or optimize one advantage or group of advantages as taught or suggested herein, but may not necessarily achieve other advantages also shown herein. [Brief description of the drawings]

[0014] Various embodiments are shown in the drawings for illustrative purposes only and should not be construed as limiting the scope of the present disclosure. Furthermore, various features of different disclosed embodiments may be combined to form additional embodiments, which are also part of this disclosure. Reference numerals may be repeated throughout the drawings to indicate correspondence between referenced elements. [Figure 1] 1 illustrates an exemplary medical system for performing or assisting in the performance of a medical procedure in accordance with certain embodiments. [Figure 2A] 1A and 1B show perspective and top views, respectively, of a controller of a medical system, in accordance with certain embodiments. [Figure 2B] 1A and 1B show perspective and top views, respectively, of a controller of a medical system, in accordance with certain embodiments. [Figure 3A] 1 illustrates a urinary stone trapping procedure, according to certain embodiments. [Figure 3B] 1 illustrates a urinary stone trapping procedure, according to certain embodiments. [Figure 3C] 1 illustrates a urinary stone trapping procedure, according to certain embodiments. [Figure 4A] 1 illustrates a basket retrieval device and several basket configurations, according to certain embodiments. [Figure 4B] 1 illustrates a basket retrieval device and several basket configurations, according to certain embodiments. [Diagram 5] FIG. 13 is a flow diagram of a pre-programmed quick release process, in accordance with certain embodiments. [Figure 6] FIG. 13 is a flow diagram of a pre-programmed rapid close process, according to certain embodiments. [Figure 7] FIG. 13 is a flow diagram of a pre-programmed rapid close process, according to certain embodiments. [Figure 8] 1 illustrates exemplary details of a robotic system 110, in accordance with certain embodiments. [Figure 9] 1 illustrates exemplary details of a control system 140, according to certain embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] The headings provided herein are merely for convenience and do not affect the scope or meaning of the present disclosure. Although certain preferred embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses and modifications and equivalents thereof. Thus, the scope of claims that may arise herein is not limited by any of the specific embodiments described below. For example, in any method or process disclosed herein, the acts and operations may be performed in any suitable order and are not necessarily limited to the specific disclosed order. Various operations may be described as multiple separate operations to facilitate understanding of a particular embodiment. However, the order of description should not be construed to imply that these operations are dependent on a particular order. Furthermore, the structures, systems, and / or devices described herein may be implemented as integral or separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily achieved by a particular embodiment. Thus, for example, various embodiments, while achieving or optimizing one advantage or set of advantages as taught or set forth herein, do not necessarily achieve other aspects or advantages also set forth herein.

[0016] Certain standard positional anatomical terms may be used herein to refer to animal, and specifically human, anatomical structures with respect to preferred embodiments. Certain spatially related terms, such as "outer," "inner," "superior," "lower," "below," "top," "vertical," "horizontal," "top," "bottom," and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure. It is understood that these terms are used herein to describe the positional relationship of the element(s) / structure(s) as illustrated. It is understood that the spatially related terms are intended to encompass different orientations of one or more element(s) / structure(s) during use or operation in addition to the orientation depicted. For example, it is understood that an element / structure described as "above" another element / structure may indicate a position below or to the side of the other element / structure if the orientation of the intended patient or element / structure is changed, and vice versa.

[0017] Overview The present disclosure relates to techniques and systems for controlling medical devices, such as basket retrieval devices for retrieving urinary stones. Basket retrieval devices can be used in a variety of situations during medical procedures, such as ureteroscopy. For example, the basket can be used to capture urinary stones, release urinary stones, reposition urinary stones, shake off tissue on the basket, and / or unblock urinary stones. Techniques for operating the basket retrieval device vary depending on the situation. The basket can be controlled to open / close, insert / remove, and / or rotate at different speeds depending on the situation. In some embodiments, the movement of the basket retrieval device is coordinated with the movement of the scope for better feedback and control. Typically, basket retrieval devices are operated by two people: a physician who controls the insertion / retraction of the basket retrieval device, and an assistant who controls the opening and closing of the basket itself. Thus, collaboration and coordination between the physician and assistant is essential to operate the device properly.

[0018] Kidney stone disease, also known as urolithiasis, is a relatively common medical condition involving the formation of solid pieces of material called "kidney stones," "urinary stones," "nephrolithiasis," "nephrolithiasis," or "nephrolithiasis." Urinary stones can form and / or be found in the kidneys, ureters, and bladder (called "bladder stones"). These urinary stones form as a result of mineral concentration and can cause significant abdominal pain if they reach a size sufficient to block the flow of urine through the ureter or urethra. Urinary stones can be formed from calcium, magnesium, ammonia, uric acid, cysteine, and / or other compounds.

[0019] To remove urinary stones from the bladder and ureters, surgeons typically use a ureteroscope, which is inserted through the urethra into the urinary tract. Typically, the ureteroscope includes an endoscope at its distal end configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotripsy mechanism, such as a basket retrieval device, for capturing or destroying urinary stones. As noted above, during a ureteroscopy procedure, one physician / technician may control the position of the ureteroscope and another physician / technician may control the dissection and cutting mechanism.

[0020] In one exemplary maneuver, the physician attempts to capture a stone while having the assistant control the opening and closing of the basket. This requires some coordination, as the physician inserts and articulates the basket (the scope may be simultaneously actuated) while the assistant rapidly closes the basket until the stone is fully captured. Another maneuver involving expelling the stone requires the assistant to open the basket a maximum amount and at a high speed to expel the stone. In a maneuver to shake off the tissue, the assistant or physician must rapidly rock the basket back and forth so that the tissue falls out of the basket. In a maneuver to reposition the stone in the basket, the assistant may need to open the basket slightly to allow the stone to rotate. In doing so, the physician rocks the basket retrieval device back and forth, sometimes inserting and retracting the basket retrieval device, while simultaneously assisting in positioning the basket.

[0021] As mentioned above, basket manipulation can be at various levels of complexity depending on the medical procedure. Conventional approaches using a single, low-speed basket drive mode that requires two user actions are not flexible and easy to use for physicians. Therefore, there is a need for more dynamic basket manipulation and more advanced basket drive modes that allow the physician to also control the basket (e.g., adjust basket speed and / or open / close basket) to allow for simultaneous control of multiple instruments.

[0022] In many embodiments, the techniques and systems are described with respect to minimally invasive procedures. However, the techniques and systems may be implemented in the context of any medical procedure, such as percutaneous, non-invasive, therapeutic, diagnostic, non-percutaneous, or other types of procedures that involve punctures and / or small incisions in the body to insert medical instruments and achieve access to a target site. Endoscopic procedures may include bronchoscopy, ureteroscopy, gastroscopy, nephroscopy, nephrectomy, and the like. Furthermore, in many embodiments, the techniques and systems are described as being implemented as robotic-assisted procedures. However, it should be understood that the techniques and systems may be implemented in other procedures, such as fully robotic medical procedures.

[0023] For ease of illustration and explanation, the techniques and systems will be described in the context of removing urinary stones, such as kidney stones, from the kidney, although, as noted above, the techniques and systems can be used to perform other procedures.

[0024] Healthcare System FIG. 1 illustrates an exemplary medical system 100 for performing or assisting in the performance of a medical procedure according to one or more embodiments. An embodiment of the medical system 100 can be used for surgical and / or diagnostic procedures. The medical system 100 includes a robotic system 110 configured to collaborate with and / or control a medical instrument 120 to perform a procedure on a patient 130. The medical system 100 also includes a control system 140 configured to interface with the robotic system 110 and provide information regarding the procedure and / or perform various other operations. For example, the control system 140 can include a display 142 that presents a user interface 144 to assist a physician 160 in using the medical instrument 120. Additionally, the medical system 100 can include a table 150 configured to support the patient 130 and / or an imaging sensor 180, such as a camera, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) device, or the like.

[0025] In some embodiments, the physician performs a minimally invasive medical procedure, such as a ureteroscopy. The physician 160 can interact with the control system 140 to control the robotic system 110 and navigate the medical instrument 120 (e.g., basket retrieval device and / or scope) through the urethra to the kidney 170 where the urinary stone 165 is located. The control system 140 can provide information about the medical instrument 120, such as real-time images from the medical instrument 120 or imaging sensor 180, via the display 142 to assist the physician 160 in navigation. Once at the site of the kidney stone, the medical instrument 120 can be used to break up and / or capture the urinary stone 165.

[0026] In some implementations using the medical system 100, the physician 160 can perform a percutaneous procedure. By way of illustration, if the patient 130 has a kidney stone 165 in the kidney 170 that is too large to be removed through the urinary tract, the physician 160 can perform a procedure to remove the kidney stone through a percutaneous access point in the patient 130. For example, the physician 160, through interaction with the control system 140, can control the robotic system 110 to steer the medical instrument 120 (e.g., a scope) from the urethra to the kidney 170 where the stone 165 is located. The control system 140 can provide information about the medical instrument 120, such as real-time images from the medical instrument 120 or the imaging sensor 180, via the display 142 to assist the physician 160 in steerage of the medical instrument 120. Once at the site of the kidney stone, the medical instrument 120 can be used to specify a target location (e.g., a desired site for accessing the kidney) for a second medical instrument (not shown) to percutaneously access the kidney. To minimize damage to the kidney, the physician 160 may specify a particular papilla as a target location for the second medical instrument to enter the kidney. However, another target location may be specified or determined. Once the second medical instrument reaches the target location, the physician 160 may use the second medical instrument and / or another medical instrument to remove the kidney stone from the patient 130 through the percutaneous access point. Although the above percutaneous procedures are described in the context of using the medical instrument 120, in some embodiments, the percutaneous procedures may be performed without the assistance of the medical instrument 120. Additionally, the medical system 100 may be used to perform a variety of other procedures.

[0027] In the example of FIG. 1, the medical instrument 120 is implemented as a basket retrieval device. Therefore, for ease of description, the medical instrument 120 is also referred to as a "basket retrieval device 120". However, the medical instrument 120 can be implemented as various types of medical instruments, including, for example, a scope (sometimes referred to as an "endoscope"), a needle, a catheter, a guidewire, a lithotriptor, forceps, a vacuum, a scalpel, combinations thereof, and the like. In some embodiments, the medical instrument is a steerable device, and in other embodiments, the medical instrument is a non-steerable device. In some embodiments, a surgical instrument refers to a device configured to be punctured or inserted through the human anatomy, such as a needle, scalpel, guidewire, and the like. However, a surgical instrument may also refer to another type of medical instrument. In some embodiments, multiple medical instruments may be used. For example, an endoscope may be used with the basket retrieval device 120. In some embodiments, the medical instrument 120 may be a composite device incorporating several instruments, such as a vacuum, a basket retrieval device, a scope, or various combinations of instruments.

[0028] The robotic system 110 may be configured to at least partially assist in a medical procedure. The robotic system 110 may be deployed in a variety of ways depending on the particular procedure. The robotic system 110 may include one or more robotic arms 112 (robotic arms 112(a), 112(b), 112(c)) to collaborate with and / or control the medical instrument 120. As shown, each robotic arm 112 may include multiple arm segments coupled to joints. This allows for multiple degrees of freedom of movement. In the example of FIG. 1, the robotic system 110 is positioned adjacent to the lower abdomen of the patient 130, and the robotic arms 112 are actuated to collaborate with and position the medical instrument 120 to access an access point, such as the urethra, of the patient 130. With the robotic system 110 properly positioned, the medical instrument 120 may be inserted into the patient 130 robotically using the robotic arms 112, manually by the physician 160, or a combination thereof.

[0029] The robotic system 110 may also include a base 114 coupled to the one or more robotic arms 112. The base 114 may include various subsystems, such as control electronics, a power source, a pneumatic system, a light source, actuators (e.g., motors for moving the robotic arms), control circuitry, memory, and / or a communication interface. In some embodiments, the base 114 includes input / output (I / O) devices 116 configured to receive inputs, such as user inputs for controlling the robotic system 110, and provide outputs, such as patient status, medical instrument position, and the like. The I / O devices 116 may include a controller, a mouse, a keyboard, a microphone, a touchpad, other input devices, or combinations thereof. The I / O devices may include output components, such as speakers, displays, haptic feedback devices, other output devices, or combinations thereof. In some embodiments, the robotic system 110 is mobile (e.g., the base 114 includes wheels). As a result, the robotic system 110 may be placed in an appropriate or desired location for a procedure. In other embodiments, the robotic system 110 is a stationary system. Moreover, in some embodiments, the robotic system 110 is integral with the platform 150 .

[0030] The robotic system 110 can be coupled to any component of the medical system 100, such as the control system 140, the platform 150, the imaging sensor 180, and / or the medical instrument 120. In some embodiments, the robotic system is communicatively coupled to the control system 140. In one example, the robotic system 110 can receive control signals from the control system 140 to perform operations, such as positioning the robotic arm 112 in a particular manner, manipulating the scope, etc. In response, the robotic system 110 can control components of the robotic system 110 to perform operations. In another example, the robotic system 110 can receive images from the scope showing the internal anatomy of the patient 130 and / or transmit the images to the control system 140 (which can then be displayed on the control system 140). Additionally, in some embodiments, the robotic system 110 is coupled to components of the medical system 100, such as the control system 140, to receive data signals, power, etc. Other devices, such as other medical implements such as IV bags, blood packs, etc., may also be coupled to the robotic system 110 or other components of the medical system 100 depending on the medical procedure being performed.

[0031] The control system 140 may be configured to provide various functions to assist in the performance of a medical procedure. In some embodiments, the control system 140 may be coupled to the robotic system 110 and may be operable in cooperation with the robotic system 110 to perform a medical procedure on the patient 130. For example, the control system 140 may communicate with the robotic system 110 via a wireless or wired connection (e.g., to control the robotic system 110, the basket retrieval device 120, receive image(s) captured by the scope, etc.), control the flow of fluid through the robotic system 110 through one or more flow paths, provide power to the robotic system 110 via one or more electrical connections, provide optical signals to the robotic system 110 via one or more optical fibers or other components, etc. Additionally, in some embodiments, the control system 140 may communicate with the scope to receive sensor data. Additionally, in some embodiments, the control system 140 may communicate with the platform 150 to position the platform 150 in a particular orientation or otherwise control the platform 150.

[0032] 1 , the control system 140 includes various I / O devices configured to assist the physician 160 or others in performing a medical procedure. In some embodiments, the control system 140 includes an input device 146 that is used by the physician 160 or another user to control the basket type retrieval device 120. For example, the input device 146 can be used to steer the basket type retrieval device 120 within the patient 130. The physician 160 can provide input via the input device 146, and in response, the control system 140 can send control signals to the robotic system 110 to operate the medical instrument 120.

[0033] The input device 146 is shown as a controller in the example of FIG. 1, but can be implemented as various types of I / O devices, such as a touch screen / pad, a mouse, a keyboard, a microphone, a smart speaker, etc. As also shown in FIG. 1, the control system 140 can include a display 142 to provide various information related to the procedure. For example, the control system 140 can receive real-time images taken by a scope and display them via the display 142. Additionally / or, the control system 140 can receive signals (e.g., analog, digital, electrical, acoustic / sonic, pneumatic, tactile, hydraulic, etc.) to a medical monitor and / or a sensor associated with the patient 130, and the display 142 can present information related to the health status of the patient 130 and / or the environment of the patient 130. Such information may include, for example, information displayed via a medical monitor, including heart rate (e.g., electrocardiogram (ECG), heart rate variability (HRV), etc.), blood pressure / velocity, muscle biosignals (e.g., electromyogram (EMG)), body temperature, oxygen saturation (e.g., SpO2), carbon dioxide (CO2) in the brain (e.g., electroencephalogram (EEG)), environmental temperature, etc.

[0034] In some embodiments, the input device 146 is configured to directly control the movement of the basket type retrieval device 120 as well as trigger pre-programmed actions. In one embodiment, direct control includes movement that continues as long as active input is provided by the user, for example, by pushing a joystick or activating a button. Direct control may include movement along one or more axes, such as insertion / retraction, clockwise / counterclockwise rotation, left / right, and / or up / down movement. Pre-programmed actions may include quick opening, quick closing, rocking, or other predefined actions that are triggered by command and do not require continuous input from the user. By using pre-programmed actions, the operation of the basket type retrieval device is simplified, since complex movements can be initiated by simplified commands. For example, rather than requiring coordination between the physician 160 and an assistant to close the basket on a stone, a quick closing action can be triggered by a single user using a simplified command (e.g., pressing or double tapping a button).

[0035] In the case of a quick opening, the basket opens at a speed faster than the normal opening speed of the basket. In some circumstances, the user can also use the quick opening to quickly open the basket to prepare for stone capture and release the stone. In one embodiment, the normal opening is directly controlled by the user. For example, the basket drive mechanism can open the basket as long as the button is pressed, but stops when the button is released or a torque threshold level is reached, which usually indicates that the basket is fully open. This allows for finer control of the basket mechanism. In contrast, in certain embodiments, the quick opening is pre-programmed to complete a series of operations in response to a trigger. The drive mechanism then actuates the basket and keeps it open until the aforementioned threshold torque level is reached or a new command (e.g., pressing a button) is received. The combination of normal opening and quick opening can provide the user with a higher degree of control and flexibility during a medical procedure. That is, normal opening is used when finer control is required, and quick opening is used when speed and / or timing are important.

[0036] In the case of rapid closure, the basket is closed at a speed faster than the normal closure speed of the basket. In some situations, rapid closure may be used to allow the user to quickly grasp the stone and also to quickly close the basket when not in use. In one embodiment, the normal closure is directly controlled by the user. For example, the basket drive mechanism can close the basket as long as the button is pressed, but stops when the button is released or a torque threshold level is reached. This usually indicates that the basket is fully closed or the stone has been captured. This allows for finer control of the basket mechanism. On the other hand, in certain embodiments, the rapid closure is pre-programmed to complete a sequence of operations in response to a trigger. The drive mechanism then actuates the basket and keeps it closed until the threshold torque level mentioned above is reached or a new command (e.g., button press) is received. The combination of normal closure and rapid closure can provide the user with a higher degree of control and flexibility during a medical procedure. That is, normal closure is utilized when finer control is required and rapid closure is utilized when speed and / or timing are important.

[0037] In one embodiment, the rocking motion of the basket retrieval device may be triggered by simultaneously pressing and holding two buttons on the input device 146. In other embodiments, other button presses, touch screen selections, voice commands, and / or other user inputs may be used to trigger the rocking motion. In some embodiments, the rocking motion is a pre-programmed motion. In this case, the basket retrieval device is inserted / retracted back and forth such that the basket moves a fixed amount faster than the normal basket insertion speed. For example, the basket retrieval device may move (e.g., insert / retract) at a normal speed (1x speed) during direct control and move at an accelerated speed (e.g., 1.5x, 2x, 3x, etc.) during pre-programmed motion. This high frequency dynamic motion may be used to shake off tissue adhering to the basket, to shake off stones during stone release, and / or to dislodge stone blockages.

[0038] In some embodiments, the rocking motion includes a variable motion. For example, the user can use the direct control motion to move the basket retrieval device from a first location where the rocking motion is being performed to a second location where the rocking motion continues to be performed. In this situation, a pre-programmed motion is combined with the direct control motion. The variable rocking motion can be used to adjust the stone position to address stone blockage. In one embodiment, the variable rocking motion is triggered by simultaneously pressing and holding the first and second buttons, while the joystick movement provides the direction of movement (e.g., insertion / retraction). While the user presses the first and second buttons, the basket rocks back and forth a certain amount. The user can move the basket to a new position by continuing to press and hold both buttons and using the joystick to insert or retract. When the user releases the joystick that was being operated during insertion, the basket returns to the rocking mode with its movement trajectory moved to the position indicated to the user. In variable rocking mode, the user can perform rocking to unstick or rotate the stone, then perform insertion or retraction to adjust the rocking position, e.g., based on visual feedback received from the scope or imaging sensor 180, and continue the rocking action until the stone is repositioned in a given position.

[0039] 1 further illustrates various anatomical structures of a patient 130 that are relevant to certain aspects of the present disclosure. In particular, the patient 130 includes a kidney 170 that is fluidly connected to a bladder 171 via a urethra 172, and a urethra 173 that is fluidly connected to the bladder 171. As shown in the close-up depiction of the kidney 170, the kidney includes a renal calyx 174 (e.g., a large and a small calyx), a renal papilla (including a renal papilla 176, also referred to as "papilla 176"), and a renal pyramid (including a renal pyramid 178). In these examples, a kidney stone 165 is present near the papilla 176; however, kidney stones may be present elsewhere within the kidney 170.

[0040] As shown in FIG. 1, to remove a kidney stone 165 in an exemplary minimally invasive procedure, a physician 160 can position the robotic system 110 at the foot of the platform 150 and begin delivering the medical instrument 120 into the patient 130. In particular, the robotic system 110 can be positioned near the lower abdominal region of the patient 130 and positioned for direct, linear access to the urethra 173 of the patient 130. From the foot of the platform 150, the robotic arm 112(B) can be controlled to provide access to the urethra 173. In this example, the physician 160 inserts the medical instrument 120 at least partially into the urethra along this direct, linear access path (also referred to as a "virtual rail"). The medical instrument 120 can include a lumen configured to accommodate a scope and / or a basket-type retrieval device, which aids in the insertion of the device into the anatomy of the patient 130.

[0041] Once the robotic system 110 is properly positioned and / or the medical instrument 120 is at least partially inserted into the urethra 173, the scope may be inserted into the patient 130 robotically, manually, or a combination thereof. For example, the physician 160 may connect the medical instrument 120 to the robotic arm 112(C). The physician 160 may then navigate the medical instrument 120 within the patient 130 through interaction with the control system 140, such as the input device 146. For example, the physician 160 may control the robotic arm 112(C) by providing input via the input device 146 to navigate the basket retrieval device 120 through the urethra 173, the bladder 171, the ureter 172, and the kidney 170.

[0042] Control system 140 may include various components (also referred to as "subsystems") to enhance its functionality. For example, control system 140 may include various subsystems such as control electronics, power supplies, pneumatic systems, light sources, actuators, control circuits, memory, and / or communication interfaces. In some embodiments, control system 140 includes a computer-based control system that stores executable instructions that, when executed, perform various operations. In some embodiments, control system 140 is mobile, as shown in FIG. 1, while in other embodiments, control system 140 is a stationary system. Although various functions and components are described as being implemented by control system 140, any of the functions and / or components may be integrated with and / or performed by other systems and / or devices, such as robotic system 110 and / or platform 150.

[0043] The medical system 100 can provide various advantages such as providing guidance (e.g., instrument tracking, patient status, etc.) to assist in performing the procedure; allowing the physician to perform the procedure in a comfortable position, i.e., without awkward movements / positions; thus allowing a single physician to perform the procedure with one or more medical instruments; avoiding radiation exposure (e.g., for fluoroscopy); performing the procedure without changing the procedure settings; providing continuous suction for more efficient removal of objects (e.g., removing kidney stones); etc. Furthermore, the medical system 100 can provide non-radiation based steering and localization techniques to reduce the physician's exposure to radiation and / or reduce the amount of equipment in the operating room. Furthermore, the medical system 100 can divide the functions into a control system 140 and a robotic system 110, each of which can be independently mobile. Such division of functions and / or mobility may allow control system 140 and / or robotic system 110 to be located in an optimal location for a particular medical procedure, may maximize the working area around the patient, and / or may provide an optimized location for the physician to perform the procedure. For example, it may be possible for many portions of a procedure to be performed by robotic system 110 (located relatively close to the patient), while the physician comfortably manages the procedure from control system 140 (which may be located further away).

[0044] In some embodiments, the control system 140 can function even if it is in a different geographic location from the robotic system 110. For example, in telemedicine, the control system 140 is configured to communicate with the robotic system 110 over a wide area network. In some situations, the robotic system 110 can be in a different hospital, with the doctor 160 and the control system 140 in one hospital. In this situation, the doctor can perform the medical procedure remotely. This can be useful for hospitals in remote locations, such as rural areas, where the rules of thumb for certain procedures are limited; that is, such hospitals can rely on more experienced doctors in other locations. In some embodiments, the control system 140 can work with various robotic systems 110, for example, by selecting a particular robotic system and forming a secure network connection (e.g., using a password, encryption, authentication token, etc.). Thus, a doctor in one location can perform a medical procedure in various different locations by setting up a connection with the robotic system 110 in each of the different locations as described above.

[0045] In some embodiments, the robotic system 110, the platform 150, the medical instrument 120, the needle, and / or the imaging sensor 180 are communicatively coupled to each other through a network, which may include wireless and / or wired networks. Exemplary networks include one or more personal area networks (PANs), one or more local area networks (LANs), one or more wide area networks (WANs), one or more Internet area networks (IANs), one or more cellular networks (IANs), one or more cellular networks, the Internet, etc. In some embodiments, the control system 140, the robotic system 110, the platform 150, the medical instrument 120, and / or the imaging sensor 180 are connected for communication, fluid / gas exchange, power exchange, etc. through one or more support cables.

[0046] Although not shown in FIG. 1 , in some embodiments, the medical system 100 includes and / or is linked to a medical monitor configured to monitor the health of the patient 130 and / or the environment in which the patient 130 resides. For example, the medical monitor may be located in the same environment in which the medical system 100 is located, such as in an operating room. The medical monitor may be physically and / or electrically coupled to one or more sensors configured to detect or determine one or more physical, physiological, chemical, and / or biological signals, parameters, characteristics, conditions and / or conditions associated with the patient 130 and / or its environment. For example, the one or more sensors may be configured to determine / detect any type of physical characteristic, including temperature, pressure, vibration, tactile / haptic characteristics, sound, optical levels or characteristics, load or weight, flow rate (e.g., of a target gas and / or liquid), amplitude, phase, and / or orientation of magnetic and electronic fields, constituent concentrations associated with a substance in gas, liquid, or solid form, etc. The one or more sensors can provide sensor data to a medical monitor, which can present information regarding the health of the patient 130 and / or the environment of the patient 130. The information can include information displayed via the medical monitor, including, for example, heart rate (e.g., ECG, HRV, etc.), blood pressure / velocity, muscle biosignals (e.g., EMG), body temperature, oxygen saturation (e.g., SpO2), CO2 volume, brain waves (e.g., EEG), environmental temperature, etc. In some embodiments, the medical monitor and / or the one or more sensors are coupled to a control system 140, which is configured to provide information regarding the health of the patient 130 and / or the environment of the patient 130.

[0047] Exemplary Controller 2A and 2B show perspective and top views, respectively, of a controller 200 of the control system 140, according to certain embodiments. As shown in FIG. 1, in some embodiments, the input device 146 is or includes the controller 200. The controller face may include one or more joysticks 205, 215 and one or more D-pad 210 axial movement inputs. In some embodiments, the joysticks 205, 215 provide analog inputs, while the D-pad 210 provides digital inputs. The controller face may further include a number of buttons 220 to provide additional control. In the example shown in FIG. 2B, the controller 200 includes four buttons, R1 225, R2 230, L1 235, and L2 240, on the top side of the controller. In other embodiments, the number and / or layout of buttons may differ. In some embodiments, the controller 200 may be a gaming console controller adapted to function with the robotic system 110. For example, the controller game firmware may be overwritten with medical device firmware, and / or an input device manager may be installed in a component of the medical system 100 (e.g., the control system 140) to translate inputs from the controller into inputs that can be interpreted by the robotic system 110.

[0048] In one embodiment, a quick-open can be triggered by double-tapping the lower right button (R2 225) on the top of the pendant, and a quick-close can be triggered by double-tapping the lower left button (L2 240) on the top of the pendant. A user can double-tap to perform a quick-open and quick-close of the basket. The double-tap operation allows the user easy access to pre-programmed commands by using the two top buttons (R2, L2). Meanwhile, other inputs on the controller can be used for other functions, including other medical instrument control, such as scope insertion, scope articulation, and / or basket insertion. These other functions can be triggered simultaneously or independently of the pre-programmed actions. It will be apparent that in other embodiments, the controller can be configured differently. For example, a quick-open / quick-close can be triggered using other buttons and / or other interactions (e.g., using a single tap, a double tap, a long button press, etc.). In one embodiment, the button function assignments are switched so that the L2 button triggers a quick open and the R2 button 225 triggers a quick close.

[0049] In one embodiment, the rocking action of the basket style retrieval device can be triggered by simultaneously pressing and holding both the top right bottom button (R2 225) and the top left bottom button (L2 24). By requiring the pressing of both buttons, the button used for quick opening and quick closing (R2 / L2) serves two functions. Thus, more commands can be assigned to the inputs of the controller 200. In one embodiment, the R2 and L2 buttons serve three functions. That is, a single tap on the R2 and L2 buttons each triggers a different action. For example, a single tap on R2 can initiate a normal opening speed of the basket, and a single tap on L2 can initiate a normal closing speed of the basket. The assignment can be vice versa. In other embodiments, other button presses can trigger the rocking action.

[0050] As described in FIG. 1, the rocking motion may include variable motion. In one embodiment, the first joystick 205 may be configured to directly control the insertion and retraction motion of the basket type retrieval device 120. While holding R2 and L2 to trigger the rocking motion, the user may move the joystick 205 to further insert the basket type retrieval device 120 to a new location within the patient's body. Alternatively, the user may move the joystick 205 to retract the basket type retrieval device 120 to a new location toward the insertion point into the body. When the user releases the joystick 205 (still holding R2 and L2), the rocking motion may continue in the same trajectory at the new location. The insertion and retraction may be assigned to other controller inputs, such as the second joystick 215 or the D-pad 210.

[0051] In some embodiments, the operation of the controller 200 may be customizable. The control system 140 may include a user interface that allows a user to assign pre-programmed actions (e.g., quick open / close, swing, etc.) to a desired controller layout. For example, a user may assign quick open or quick close to either the top button 220, the D-pad 210, or one of the joysticks 205, 215.

[0052] In some embodiments, triggering a preprogrammed action may be at least partially automated. Machine learning or computer vision algorithms may be implemented to recognize a condition in which the basket retrieval device 120 is in the proper position to execute a preprogrammed action. For example, the medical system 100 may use its imaging sensor 180, scope, or another sensor device to recognize that the basket is close enough to the urinary stone 165 to trigger a rapid opening to capture the device. When a threshold distance is reached, a rapid opening may be triggered to rapidly open the basket. Additional preprogrammed actions may be coupled to the rapid opening. For example, a preprogrammed action may be triggered to further insert the basket retrieval device 120 after releasing the basket so that the urinary stone is surrounded by the basket (a preprogrammed "forward insertion" action). A rapid closure may then be automatically triggered to capture the urinary stone 165.

[0053] As a safety precaution, the pre-programmed actions may be configured to trigger automatically only in certain modes where automatic actions are permitted ("auto-capture" mode). This auto-capture mode may be enabled using one of the buttons or other inputs on the controller 200 or via a menu setting in the control system 140 interface. In some circumstances, the physician 160 moves the basket retrieval device 120 to a suitable position near the urinary stone 165 by directly controlled motion. The physician can then enable the auto-capture mode. If the stone is close enough to meet or exceed the distance threshold, the pre-programmed auto-capture action (e.g., rapid opening, forward insertion, and / or rapid closing) is automatically triggered. If the distance is greater than the distance threshold, the physician can further adjust the position of the basket retrieval device 120 until the pre-programmed auto-capture action is triggered.

[0054] 2A and 2B show one embodiment of the controller 200, other types of controllers or other input devices may also be used with the control system 140. For example, the input device 146 of the control system 140 may be wireless (e.g., Wi-Fi, Bluetooth, etc.) or wired (e.g., Universal Serial Bus (USB)). In another example, the input device 146 may be a graphical user interface (GUI) implemented on a touch screen device such as a tablet or smartphone. In one example, the controller may be a smart speaker with a built-in microphone that accepts voice commands. In another example, the input device 146 may be a controller for a virtual reality or augmented reality system.

[0055] Urinary stone capture 3A-3C illustrate a urinary stone trapping procedure according to certain embodiments. In these examples, the medical system 100 is positioned in an operating room to remove kidney stones from a patient 130. In many instances of such procedures, the patient 130 is in a variable-speed supine position with a slight lateral tilt for access to the rear or side of the patient 130. The urinary stone trapping procedure may also be performed with the patient in a normal supine position, as shown in FIG. 1. FIGS. 3A-3C illustrate the use of the medical system 100, in which a minimally invasive procedure for removing kidney stones from the patient 130 is performed. The medical system 100 may also be used to remove kidney stones in other ways and / or to perform other procedures. Additionally, the patient 130 may be in other positions as needed for the procedure. The various actions shown in FIGS. 3A-3C and throughout this disclosure are described as being performed by a physician 160. It should be understood that these actions may be performed directly by the physician 160, indirectly by a physician assisted by the medical system 100, by a user under the direction of the physician, by another user (e.g., a technician), and / or by any other user.

[0056] 3A-3C , the functions may be performed using any of the robotic arms 112. Furthermore, any additional robotic arms and / or systems may be used to perform the procedure. Additionally, the robotic system 110 may be used to perform other portions of the procedure.

[0057] In block 305, the basket type retrieval device 120 is navigated to the kidney 170 and brought into proximity with the urethral stone 165. In some circumstances, the physician 160 or other user uses the input device 146 to directly control the movement of the basket type retrieval device 120. Such directly controlled movements may include insertion / retraction, bending the basket type retrieval device 120 side to side, rotation, and / or normal opening / closing of the basket. Through various movements, the basket type retrieval device 120 is positioned in proximity to the stone.

[0058] In block 310, a pre-programmed quick-opening motion is triggered in response to a user input (e.g., double tapping a button). Quick-opening opens the basket of the basket-type retrieval device 120 at a faster rate. Using quick-opening allows the basket-type retrieval device 120 to reach a state for capturing the urinary stone 165 more quickly, and reduces the chance that other motions (e.g., by the basket-type retrieval device or by respiratory / circulatory / urinary flow motions within the kidney) will displace the basket-type retrieval device 120. The quick-opening motion can be triggered by double tapping a controller 200 button, by using a different input on the controller, or by using another type of input device, such as a voice command.

[0059] In some embodiments, a laser, shock wave device, or other device is used to break up the concretion. The laser or other device may be incorporated into the basket retrieval device 120 or may be a separate medical instrument. The device for breaking up the concretion may also be controlled by the same input device (e.g., controller 200) used to trigger the quick-open, quick-close, and / or rocking actions. In some circumstances, the concretion 165 is small enough that it does not need to be broken up into smaller pieces. In such cases, the process may skip block 315 and proceed to block 320.

[0060] Optionally, in block 315, a pre-programmed rocking motion is triggered to help break up the stone blockage or otherwise move the stone(s). For example, as described above, if the urinary stone 165 breaks into smaller pieces, the rocking motion can be used to disperse the stone. The rocking motion can be a pre-programmed motion where the basket retrieval device is inserted / retracted back and forth such that the basket moves a fixed amount at a speed faster than the normal basket insertion speed. The pre-programmed rocking motion can be triggered by pressing two buttons on the controller 200 simultaneously, by using another input on the controller, or by using another type of input device such as a voice command.

[0061] In block 320, the opened basket is manipulated to encircle the urinary stone 165 or smaller fragments thereof. In some scenarios, the manipulation is performed by a directly controlled movement by the physician 160 of the basket-type retrieval device 120. In some embodiments, a pre-programmed forward insertion motion can be utilized to encircle the stone with the basket. For example, if the basket is formed by wires, the forward insertion motion can optionally include a slight lateral motion to deflect to one side to avoid the stone hitting the distal end of the wire-formed basket. Once the stone has passed the distal end, an optional lateral motion can be applied to the basket in the opposite direction to the lateral displacement motion already performed to center the stone around the basket. In other embodiments, such as using a basket formed by multiple teeth, the insertion of the basket is coupled to the closure of the teeth to center the basket longitudinally around the stone and prevent the stone from moving during basket closure.

[0062] The forward insertion motion may be triggered by using an input on the controller 200 or by using another type of input device, such as a voice command. Although a pre-programmed forward insertion motion is described above, this motion can also be achieved by a directly controlled motion by the user to encircle the urinary stone.

[0063] In block 325, the programmed rapid closure motion is triggered in response to a user input (e.g., double tapping a button). Rapid closure causes the basket of the basket type retrieval device 120 to close at a faster rate. The closure motion may continue until the basket is fully closed and / or a threshold torque is reached. When the basket drive mechanism reaches a torque threshold, this may indicate that the basket is closing on the stone. This prevents further closure of the basket. By limiting the torque, the basket may be protected from any damage due to increased stress / force applied during closure. By using rapid closure, the basket type retrieval device 120 may capture the urinary stone 165 more quickly. And the likelihood that another movement (e.g., by the patient or the basket type retrieval device 120) will displace the basket type retrieval device 120 is reduced. The rapid closure motion may be triggered by double tapping a controller 200 button, by using a different input on the controller, or by using another type of input device, such as a voice command. Optionally, a rocking action may be triggered to help adjust the position of the stone 165 for easier removal of the stone from the kidney.

[0064] At block 330, the basket retrieval device 120 is withdrawn from the kidney 170 and from the patient's body. A quick-open motion may optionally be triggered as the basket retrieval device 120 is withdrawn from the patient's body to rapidly release any trapped stones.

[0065] If additional stones (or larger fragments of the stone 165) are present, the basket retrieval device 120 may be reinserted into the patient to capture any remaining large fragments. In some embodiments, a vacuum instrument may be used to facilitate removal of the fragments. In some circumstances, the stone fragments may be small enough to be naturally passed from the patient.

[0066] Exemplary Basket Collection Device FIG. 4A illustrates a basket retrieval device 120 according to certain embodiments. The basket retrieval device 120 may include a basket 405 formed distally, a handle 410 proximally, a sheath 415 between the basket and the handle, and a basket drive mechanism 420. The basket may be formed in various manners to capture the urinary stone. In some embodiments, the basket is formed by two or more wire loops 425. The wire loops expand to form a space in which the stone is manipulated and contract around the stone to capture it. As shown in FIG. 4B, the wire may be configured to form various shapes such as a bulb, teardrop, spiral, bowl shape, etc. In other embodiments, the basket is formed by two substantially oval or round bowls, where the recesses face each other to form a hollow area for the urinary stone. In some embodiments, the basket is formed by a number of tines configured to close around the stone. The basket can be made from a variety of materials, such as nitinol, nickel, titanium, steel, cobalt chrome alloys, other types of metals, ceramics, polymers such as plastics, or combinations thereof.

[0067] The handle 410 of the basket retrieval device 120 may be manipulated by a user or a robot. In some embodiments, the basket drive mechanism 420 is integrated into the handle. For example, the drive mechanism may perform a sliding or twisting motion to open and close the basket. In one embodiment, the drive mechanism may perform an open state, which causes the basket wires to extend from the sheath, resulting in an open basket state. The drive mechanism may perform a closed state, which causes the basket wires to retract toward the sheath, resulting in the basket collapsing. If a urinary stone is inside the basket, it is captured by closing the basket wires.

[0068] A scope (not shown) that may be part of or used in conjunction with the basket retrieval device 120 may be configured to be maneuvered within the human anatomy, such as within a natural opening or lumen of the human anatomy. For example, the scope may include a channel through which a distal portion of the basket retrieval device 120 may be inserted. The scope may include, for example, a ureteroscope (e.g., for accessing the urinary tract), a laparoscope, a nephroscope (e.g., for accessing the kidney), a bronchoscope (e.g., for accessing the bronchi), a colonoscope (e.g., for accessing the colon), an arthroscope (e.g., for accessing a joint), a cystoscope (e.g., for accessing the bladder), and the like. The scope may also be articulatable, such as at a distal portion of the scope, such that it may be maneuvered within the human anatomy. The scope may include telescopic portions, such as at an inner tip portion and an outer sheath portion, such that the scope may be manipulated to extend telescopically. In some embodiments, the scope includes a working channel for deploying medical instruments (e.g., lithotriptor, basket device, forceps, etc.), irrigation, and / or suction to a working area at the distal end of the scope. The scope may house an optical assembly that may include an imaging device, such as an optical camera, and wires and / or optical fibers for transmitting signals from or to the distal end of the scope. The scope may also house optical fibers for carrying light from a proximally located light source, such as a light emitting diode, to the distal end of the scope. The distal end of the scope may also include openings for working channels for delivering tools, irrigation, and / or suction to the surgical site. The distal end of the scope may further include a port for an imaging device, such as a camera, that may be configured to capture images of the internal anatomical space. The distal end of the scope may include a port for a light source for illuminating the anatomical space when the imaging device is used. In some embodiments, the scope is configured to be controlled by the robotic system 110. The scope may include components for cooperating with the robotic system 110.

[0069] Pre-programmed exercise examples 5 is a flow diagram of a pre-programmed rapid-open process 500, according to certain embodiments. The rapid-open process 500 can be performed by the robotic system 110 or by another component of the medical system 100 of FIG. 1. For example, the robotic system 110 can manipulate the basket retrieval device 120 with one or more of its arms. The process 500 can be performed according to input provided by a user (e.g., a physician) or can be at least partially automated. The following describes one possible sequence for the process, although in other embodiments, the process can be performed in a different order.

[0070] In block 505, the control system 140 of the robotic system 110 receives a first user input from the input device 146. For example, the input may be a double tap of a button, a voice command, or other input. In one embodiment, the first input is a double tap of a first button on the controller 200 of FIGS. 2A and 2B.

[0071] At block 510, the robotic system 110 cooperates with the basket drive mechanism to open the basket 405 of the basket type retrieval device 120 at an accelerated speed. In some embodiments, the basket drive mechanism 420 is configured to operate at least two speeds: a first speed corresponding to a normal opening speed of the basket, and a second speed that is faster than the first speed. In one embodiment, the normal opening speed is used when the basket is opened using direct control motion rather than a preprogrammed motion.

[0072] In block 515, a torque sensor, which may be located in the basket retrieval device 120 or the robotic arm 112, determines the torque applied to the basket 405 by the basket drive mechanism 420. If the torque reaches or exceeds a torque limit set for the robotic system 110, the drive mechanism is disengaged. For example, the torque limit may be reached if there is tissue preventing the basket from opening. If the torque limit is reached, the process 500 proceeds to block 520. If not, the process 500 proceeds to block 525.

[0073] At block 520, a torque limit is reached and the drive mechanism is disengaged. The basket is prevented from opening further, as further movement could damage the basket 405 or surrounding tissue.

[0074] At block 525, the rapid opening movement is completed. The basket 405 may be fully open (e.g., as indicated by drive mechanism torque) or may otherwise reach a desired open state. For example, the rapid opening movement may be configured to stop at 50%, 60%, 70%, 80%, 90%, 100%, or other amount of fully open basket. In one embodiment, the target amount of basket opening is set based on the detected size of the urinary stone.

[0075] 6 is a flow diagram of a pre-programmed rapid closure process 600, according to certain embodiments. The rapid closure process 600 can be performed by the robotic system 110 or by another component of the medical system 100. For example, the robotic system 110 can manipulate the basket retrieval device 120 with one or more of its arms. The process 600 can be performed according to input provided by a user (e.g., a physician) or can be at least partially automated. The following describes one possible sequence for the process, although in other embodiments, the process can be performed in a different order.

[0076] In block 605, the control system 140 of the robotic system 110 receives a second user input from the input device 146. For example, the input may be a double tap of a button, a voice command, or other input. In one embodiment, the second input is a double tap of a second button on the controller 200 of FIGS. 2A and 2B.

[0077] In block 610, the robotic system 110 cooperates with the basket drive mechanism to close the basket 405 of the basket type retrieval device 120 at an accelerated speed. In some embodiments, the basket drive mechanism 420 is configured to operate at least two speeds: a first speed corresponding to a normal closing speed of the basket, and a second speed that is faster than the first speed. In one embodiment, the normal closing speed is used when the basket is closed using direct control motion rather than a preprogrammed motion.

[0078] In block 615, the torque sensor determines the torque applied to the basket 405 by the basket drive mechanism 420. If the torque reaches or exceeds the torque limit set for the robotic system 110, the drive mechanism is disengaged. For example, the torque limit may be reached if there is tissue or a urinary stone preventing the basket from opening. If the torque limit is reached, the process 600 proceeds to block 620. If not, the process 600 proceeds to block 625.

[0079] At block 620, a torque limit is reached and the drive mechanism is disengaged. The basket is prevented from closing further, as further movement could damage the basket 405 or surrounding tissue.

[0080] At block 625, the rapid closing movement is completed. The basket 405 may be fully closed (e.g., as indicated by drive mechanism torque) or may otherwise reach a desired closed state. For example, the rapid closing movement may be configured to stop at 50%, 60%, 70%, 80%, 90%, 100%, or other amount of the basket being fully closed. In one embodiment, the target amount of basket closure is set based on the detected size of the urinary stone 165. For example, if the urinary stone is large, then the basket may close a little before contacting or surrounding the urinary stone.

[0081] 7 is a flow diagram of a pre-programmed rapid closure process 700, according to certain embodiments. The swinging process 700 can be performed by the robotic system 110 or by another component of the medical system 100. For example, the robotic system 110 can manipulate the basket retrieval device 120 with one or more of its arms. The process 700 can be performed according to input provided by a user (e.g., a physician) or can be at least partially automated. The following describes one possible sequence for the process, although in other embodiments, the process can be performed in a different order.

[0082] At block 705, the control system 140 of the robotic system 110 receives a third user input from the input device 146. For example, the input may be a long press of one or more buttons, a double tap of a button, a voice command, or other input. In one embodiment, the third input is a long press of a first button (associated with quick open) and a second button (associated with quick close) of the controller 200 of Figures 2A and 2B.

[0083] In block 710, the robotic system 110 begins moving the basket forward and backward a short distance at an accelerated speed. For example, the basket may move back and forth a few millimeters. In some circumstances, the basket may move a few centimeters. In some embodiments, the basket drive mechanism 420 is configured to operate the basket at at least two speeds: a first speed corresponding to a normal speed of movement of the basket, and a second speed that is faster than the first speed. In one embodiment, the normal speed of movement is used when the basket moves using direct control motion rather than a preprogrammed motion.

[0084] At block 715, while receiving the third user input, the control system 140 receives a fourth user input corresponding to the movement input. In one embodiment, the fourth input is movement along an axis (e.g., forward or backward) of a joystick of the controller 200. For example, the physician 160 may move the joystick while holding down the first button and the second button.

[0085] In block 720, the robotic system 110 moves the basket to a new location based on the fourth input. For example, if the joystick is moved upward, the basket is inserted further into the patient. If the joystick is moved backward, the basket is retracted toward the proximal end of the basket retrieval device 120.

[0086] In block 725, the robotic system 110 continues moving the basket back and forth a short distance at the new location, with the position or center of movement coinciding with the new location.

[0087] If at block 730 the third input is discontinued (e.g., the physician 160 releases the first and second buttons), the process 700 proceeds to block 735 where the rocking motion stops. If the third input is still ongoing, the process 700 proceeds to block 725 where the robotic system 110 continues the back and forth movement of the basket. In other embodiments, the rocking motion stops after a certain amount of time has elapsed or after a certain amount of repetitions of the movement have been completed, depending on the other inputs.

[0088] Exemplary Robotic System 8 illustrates exemplary details of a robotic system 110 in accordance with one or more embodiments. In this example, the robotic system 110 is shown as a mobile, cart-based, robot-enabled system. However, the robotic system 110 may also be implemented as a stationary system integrated into a pedestal.

[0089] The robotic system 110 may include a support structure 114 including an elongated portion 114(A) (also referred to as “column 114(A)”) and a base 114(B). The column 114(A) may include one or more carriages, such as carriage 1102 (alternatively referred to as “arm support 1102”), for supporting the deployment of one or more robotic arms 112 (three shown in FIG. 8 ). The carriage 1102 may include an individually configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 112 for positioning relative to the patient. The carriage 1102 also includes a carriage interface 1104 that allows the carriage 1102 to translate vertically along the column 114(A). The carriage interface 1104 is connected to the column 114(A) through slots, such as slots 1106, positioned on either side of the column 114(A) to guide the vertical translation of the carriage 1102. The slot 1106 includes a vertical translation interface for positioning and holding the carriage 1102 at various vertical heights relative to the base 114(B). The vertical translation of the carriage 1102 allows the robotic system 110 to adjust the reach of the robotic arm 112 to meet various table heights, patient sizes, physician preferences, and the like. Similarly, an individually configurable arm mount on the carriage 1102 can angle the robotic arm base 1108 of the robotic arm 112 in various configurations. The column 114(A) may include mechanisms therein, such as gears and / or motors, designed to use a vertically aligned leadscrew to mechanically translate the carriage 1102 in response to control signals generated in response to user inputs, such as inputs from the I / O device(s) 116.

[0090] In some embodiments, the slot 1106 may be added with a slot cover(s) that are flush and / or parallel to the slot surface to prevent dirt and / or fluids from entering the interior chamber of the column 114(A) and / or the vertical translation interface as the carriage 1102 translates vertically. The slot cover may be deployed through a pair of spring spools positioned near the vertical top and bottom of the slot 1106. The cover may be coiled within the spools until deployed to expand and contract as the carriage 1102 translates vertically up and down. The spring loading of the spools may provide a force to pull the cover onto the spools when the carriage 1102 translates towards the spools, while also maintaining a snug seal when the carriage 1102 translates away from the spools. The cover may be connected to the carriage 1102 using, for example, a bracket within the carriage interface 1104 to ensure that the cover expands and contracts appropriately as the carriage 1102 translates.

[0091] The base 114(B) can balance the weight of the column 114(A), the carriage 1102, and / or the arm 112 on a surface such as a floor. Thus, the base 114(B) can house heavier parts such as one or more electronics, motors, power supplies, etc., as well as components that allow for either movement and / or immobilization of the robotic system 110. For example, the base 114(B) can include rolling wheels 1116 (also referred to as "casters 1116") that allow the robotic system 110 to be moved around a room for a procedure. After reaching the appropriate position, the casters 1116 can be stationary using wheel locks to hold the robotic system 110 in place during a procedure. As shown, the robotic system 110 also includes a handle 1118 to aid in the manipulation and / or stabilization of the robotic system 110.

[0092] The robotic arms 112 may generally comprise a robotic arm base 1108 and end effectors 1110 separated by a series of links 1112 connected by a series of joints 1114. Each joint 1114 may comprise an independent actuator. Each actuator may comprise an independently controllable motor. Each independently controllable joint 1114 represents an independent degree of freedom available to the robotic arms 112. For example, each of the arms 112 may have seven joints, thus providing seven degrees of freedom. However, any degree of freedom may be achieved with any number of joints. In examples, multiple joints provide multiple degrees of freedom, allowing for "redundant" degrees of freedom. Redundant degrees of freedom allow the robotic arms 112 to position their respective end effectors 1110 at specific positions, orientations, and / or trajectories in space using different joint positions and / or joint angles. In some embodiments, the end effectors 1110 may be configured to cooperate with and / or control medical instruments, devices, objects, and the like. The freedom of movement of the arm 112 may allow the robotic system 110 to position and / or orient a medical instrument from a desired point in space and / or may allow a physician to move the arm 112 to a clinically advantageous position during a procedure for access while preventing arm collisions.

[0093] As shown in FIG. 8 , the robotic system 110 can further include I / O device(s) 116. The I / O device(s) 116 can include a display, a touch screen, a touch pad, a projector, a mouse, a keyboard, a microphone, a speaker, a controller, a camera (e.g., for receiving gesture input), or another I / O device for receiving input and / or providing output. The I / O device(s) 116 can be configured to receive touch, voice, gesture, or any other type of input. The I / O device(s) 116 can be located at a vertical end of the column 114(A) (e.g., at the top of the column 114(A)) and / or can provide a user interface for receiving user input and / or providing output. For example, the I / O device(s) 116 can include a touch screen (e.g., a dual-purpose device) for receiving input and providing pre-operative and / or intra-operative data to a physician. Exemplary pre-operative data may include pre-operative planning, navigation and mapping data derived from a pre-operative computed tomography (CT) scan, and / or notes from a pre-operative patient interview. Exemplary intra-operative data may include optical information provided by tools / instruments, sensors, coordinate information from sensors, and vital patient statistics such as respiration, heart rate, and / or pulse. The I / O device(s) 116 may be positioned and / or tilted to allow the physician to access the I / O device(s) 116 from various positions, such as on the opposite column 114(A) side of the carriage 1102. From this position, the physician may view the I / O device(s) 116, the robotic arm 112, and / or the patient while operating the I / O device(s) 116 from behind the robotic system 110.

[0094] The robotic system 110 can include various other components. For example, the robotic system 110 can include one or more control electronics / circuitry, a power source, a pneumatic system, a light source, an actuator (e.g., a motor for moving the robotic arm 112), a memory, and / or a communication interface (e.g., for communicating with another device). In some embodiments, the memory can store computer-executable instructions that, when executed by the control circuitry, cause the control circuitry to perform any of the operations described herein. For example, the memory can store computer-executable instructions that, when executed by the control circuitry, cause the control circuitry to receive input and / or control signals related to the operation of the robotic arm 112 and, in response, place the robotic arm 112 in a particular position and / or steer a medical instrument connected to the end effector 1110.

[0095] In some embodiments, the robotic system 110 is configured to cooperate with and / or control a medical instrument, such as the basket retrieval device 120. For example, the robotic arm 112 may be configured to control the position, orientation, and / or articulation of the tip of the scope (e.g., the sheath and / or tip of the scope). In some embodiments, the robotic arm 112 may be configured / configurable to manipulate the scope using an elongated motion member. The elongated motion member may include one or more pull wires (e.g., pull wires or push wires), cables, fibers, and / or flexible shafts. By way of example, the robotic arm 112 may be configured to actuate multiple pull wires coupled to the scope to redirect the tip of the scope. The pull wires may include any suitable or desired material, such as metallic and / or non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, and the like. In some embodiments, the scope is configured to exhibit a non-linear behavior in response to a force applied by the elongated motion member. Non-linear behavior can be due to the stiffness and compressibility of the scope, as well as slack or stiffness variability between different elongated motion members.

[0096] Exemplary Control System FIG. 9 illustrates exemplary details of a control system 140 according to one or more embodiments. As illustrated, the control system 140 may include one or more of the following components, devices, modules, and / or units (referred to herein as "components"), separately / individually and / or in combination / collectively: control circuitry 1202, data storage / memory 1204, one or more communication interfaces 1206, one or more power supply units 1208, one or more I / O components 1210, and / or one or more wheels 1212 (e.g., casters or other types of wheels). In some embodiments, the control system 140 may comprise a housing / enclosure configured and / or sized to house or contain at least a portion of one or more of the components of the control system 140. In this example, the control system 140 is illustrated as a cart-based system that is movable with one or more wheels 1212. In some cases, after reaching the appropriate position, the one or more wheels 1212 are secured using wheel locks, which may hold the control system 140 in place. However, the robotic system 140 may also be implemented as a stationary system integrated into another system / device, or the like.

[0097] Although certain components of the control system 140 are illustrated in FIG. 9, it should be understood that additional components not illustrated may be included in embodiments according to the present disclosure. Additionally, in some embodiments, certain of the illustrated components may be omitted. Although the control circuit 1202 is illustrated as a separate component in the diagram of FIG. 9, it should be understood that any or all of the remaining components of the control system 140 may be at least partially realized within the control circuit 1202. That is, the control circuit 1202 may include various devices (active and / or passive), semiconductor materials, and / or regions, layers, regions, and / or portions thereof, conductors, leads, vias, connections, etc. The control system 140 and / or portion(s) thereof may be at least partially formed and / or implemented by such circuit components / devices.

[0098] The various components of the control system 140 may be electrically and / or communicatively coupled using certain connectivity circuits / devices / features that may or may not be part of the control circuitry 1202. For example, the connectivity feature(s) may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuitry of the control system 140. In some embodiments, two or more of the control circuitry 1202, data storage / memory 1204, communication interface(s) 1206, power supply unit(s) 1208, and / or input / output (I / O) component(s) 1210 may be electrically and / or communicatively coupled to one another.

[0099] As shown, the memory 1204 may include an input device manager 1216 and user interface components 1218 configured to facilitate various functionality described herein. In some embodiments, the input device manager 1216 and / or the user interface components 1218 may include one or more instructions executable by the control circuitry 1202 to perform one or more operations. Although many embodiments are described with respect to the components 1216-1218 including one or more instructions executable by the control circuitry 1202, any of the components 1216-1218 may be implemented, at least in part, as one or more hardware logic components, such as one or more application specific integrated circuits (ASICs), one or more field programmable gate arrays (FPGAs), one or more application specific standard products (ASSPs), one or more complex programmable logic devices (CPLDs), or the like. Additionally, although the components 1216-1218 are shown as being included within the control system 140, any of the components 1216-1218 may be implemented, at least in part, within another device / system, such as the robotic system 110, the platform 150, or another device / system. Similarly, any of the other components of control system 140 may be implemented, at least in part, within another device / system.

[0100] The input device manager 1216 may be configured to receive inputs from the input devices 146 and convert them into actions executable by the robotic system 110. For example, pre-programmed actions such as quick open, quick close, and swing actions may be stored in the input device manager 1216. These pre-programmed actions can then be assigned to desired inputs (e.g., one or two button presses, voice commands, joystick movements, etc.). In some implementations, the pre-programmed actions are determined by the manufacturer. In other forms, a user can modify existing pre-programmed actions and / or create new ones.

[0101] The user interface component 1218 can be configured to facilitate one or more user interfaces (also referred to as "one or more graphical user interfaces (GUIs)"). For example, the user interface component 1218 can generate configuration menus for assigning preprogrammed operations to input or setting menus, or for activating particular operational modes or deactivating selected preprogrammed operations in particular circumstances. The user interface component 1218 can also provide user interface data 1222 for display to the user.

[0102] The one or more communication interfaces 1206 may be configured to communicate with one or more devices / sensors / systems. For example, the one or more communication interfaces 1206 may be capable of wireless and / or wired data transmission and reception over a network. A network according to an embodiment of the present disclosure may include a local area network (LAN), a wide area network (WAN) (e.g., the Internet), a personal area network (PAN), a body area network (BAN), etc. In some embodiments, the one or more communication interfaces 1206 may implement wireless technologies such as Bluetooth, Wi-Fi, near field communication (NFC), etc.

[0103] The one or more power supply units 1208 may be configured to manage power for the control system 140 (and / or, in some cases, the robotic system 110). In some embodiments, the one or more power supply units 1208 include one or more batteries, such as lithium-based batteries, lead-acid batteries, alkaline batteries, and / or another type of battery. That is, the one or more power supply units 1208 may comprise one or more devices and / or circuits configured to provide a power source and / or to provide power management functions. Additionally, in some embodiments, the one or more power supply units 1208 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power source.

[0104] The one or more I / O components 1210 can include various components for receiving input and / or providing output, such as for interfacing with a user. The one or more I / O devices 1210 can be configured to receive touch, voice, gestures, or any other type of input. By way of example, the one or more I / O components 1210 can be used to provide input for device / system control for controlling the robotic system 110, i.e., steering a scope or other medical instrument attached to the robotic system 110, controlling the table 150, and controlling the fluoroscopy device 190. As shown, the one or more I / O components 1210 can include one or more displays 142 (also referred to as "one or more display devices 142") configured to display data. The one or more displays 142 can include one or more liquid crystal displays (LCDs), light emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type(s) of technology. In some embodiments, the one or more displays 142 include one or more touch screens configured to receive input and / or display data. Additionally, the one or more I / O components 1210 may include one or more input devices 146, which may include a touch screen, a touch pad, a controller, a mouse, a keyboard, a wearable device (e.g., an optical head mounted display), a virtual or augmented reality device (e.g., a head mounted display), and the like. The one or more I / O components 1210 may further include one or more speakers 1226 configured to output sound based on an audio signal, and / or one or more microphones 1228 to receive sound and generate an audio signal. In some embodiments, the one or more I / O components 1210 include or are implemented as a console.

[0105] Although not shown in FIG. 9 , the control system 140 can include and / or control other components, such as one or more pumps, flow meters, valve controls, and / or fluid access components, devices that can be deployed through the medical instrument, etc., to provide controlled irrigation and / or aspiration capabilities to the medical instrument (e.g., a scope). In some embodiments, irrigation and aspiration capabilities can be delivered directly to the medical instrument through separate cable(s). Additionally, the control system 140 can include voltage and surge protection designed to provide filtered and protected power to another device, such as the robotic system 110. This avoids placing power transformers and other auxiliary power components within the robotic system 110, resulting in a smaller, more mobile robotic system 110.

[0106] The robotic system 140 may also include support equipment for sensors deployed throughout the medical system 100. For example, the control system 140 may include optoelectronics for detecting, receiving, and / or processing data received from optical sensors and / or cameras. Such optoelectronics may be used to generate real-time images for display on any number of devices / systems, including the control system 140.

[0107] In some embodiments, the control system 140 can be coupled to the robotic system 110, the table 150, and / or medical instruments, such as the scope and / or basket retrieval device 120, via one or more cables or connections (not shown). In some forms, support functions from the control system 140 are provided via a single cable. This can simplify and reduce clutter in the operating room. In other embodiments, certain functions can be combined with separate wiring and connections. For example, power can be provided through a single power cable, while support for control, optics, fluidics, and / or navigation can be provided through separate cables.

[0108] The term "control circuitry" is used herein according to its broad and general meaning and may refer to any collection of one or more processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including same), microcontrollers, digital signal processors, microcomputers, central processing units, graphic 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 circuitry and / or operational instructions. The control circuitry may further include one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or device internal circuitry of the 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 includes a hardware state machine (and / or implements a software state machine), the data storage device(s) / register(s) that store the analog, digital, and / or logic circuits may be embedded within or external to the circuitry that includes the state machine, analog, digital, and / or logic circuits.

[0109] The term "memory" is used herein according to its broad general meaning and can refer to any suitable or desirable type of computer-readable medium. For example, a computer-readable medium can include one or more volatile, non-volatile, removable, and / or removable data storage devices implemented using any technology, layout, and / or data structure(s) / protocol that contains any suitable or desirable computer-readable instructions, data structures, program modules, or other types of data.

[0110] Computer-readable media that can be implemented according to embodiments of the present disclosure include, but are not limited to, phase change memory, static random access memory (SRAM), dynamic random access memory (DRAM), other types of random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technology, compact disk read-only memory (CD-ROM), digital versatile disk (DVD) or other optical storage device, magnetic cassette, magnetic tape, magnetic disk storage or other magnetic storage device, or other non-transitory medium that can be used to store information for access by a computing device. As used in a particular context herein, computer-readable media may not generally include communication media such as modulated data signals and carrier waves. Thus, computer-readable media should generally be understood to refer to non-transitory media.

[0111] Further embodiments In some embodiments, certain acts, events, or functions of any of the processes or algorithms described herein may be performed in a different order, added, combined, or omitted entirely, and thus, in certain embodiments, not all described acts or events are required to implement a process.

[0112] As used herein, hypothetical language, such as "can," "could," "might," "may," "eg," among others, is intended to be general, unless specifically specified otherwise or understood otherwise within the context in which it is used, and is intended to convey generally that certain embodiments include certain features, elements, and / or steps and other embodiments do not. Thus, such hypothetical language is not intended to generally imply that features, elements, and / or steps are required in any manner for one or more embodiments, or that one or more embodiments necessarily include logic, with or without author input or prompting, for determining whether those features, elements, and / or steps are necessarily included or performed in any particular embodiment. Terms such as "comprising," "including," "having," and the like, are synonymous, intended to be general, and are used 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 otherwise noted, conjunctive language such as "at least one of X, Y, and Z" is generally understood to be used in the context of conveying that a feature, 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 at least one of X, Y, and at least one of Z.

[0113] In the description of the above embodiments, it should be understood that various features are grouped together in a single embodiment, figure, or description thereof for the purpose of making the disclosure easier to understand and contributing to the understanding of one or more of the various inventive aspects. However, the 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 enzymatic element, feature, or step illustrated and / or described in a particular embodiment herein may be applied to or used in conjunction with any other embodiment(s). Moreover, in each embodiment, there is no essential component, feature, step, or group of components, features, or steps. Thus, the scope of the invention as disclosed and claimed below should not be limited by the specific embodiments described above. It is intended that such scope be determined solely by a proper reading of the following claims.

[0114] It should be understood that, although certain order terms (e.g., "first" or "second") may be provided for ease of reference, they do not necessarily imply physical characteristics or order. Thus, as used herein, order 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 relative to any other elements, but rather may generally distinguish an element from another element having a similar or identical name (but because of the use of order terms). Furthermore, as used herein, the indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Furthermore, an operation performed "based on" a condition or event may also be performed based on one or more other conditions or events not expressly recited.

[0115] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by those skilled in the art to which the exemplary embodiments belong. 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 prior art and this disclosure, and it will be further understood that they will not be interpreted in an idealized or overly formal sense unless expressly defined herein.

[0116] Unless otherwise specified, comparison and / or quantitative terms such as "less than," "more than," "greater than," and the like are intended to encompass the concept of equivalents. For example, "less than" can mean "less than" as well as "less than" in the strict mathematical sense.

[0117] [Embodiment] (1) A robotic system for performing a medical procedure, comprising: 1. A robot manipulator comprising: manipulating a medical instrument comprising a basket and configured to access a human anatomy; opening the basket at a first opening speed and a second opening speed faster than the first opening speed; a robotic manipulator configured to close the basket at a first closing speed and at a second closing speed that is faster than the first closing speed; an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movements and pre-programmed movements; a control circuit communicatively coupled to the input device and the robotic manipulator, triggering a first pre-programmed operation of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed operation including opening the basket at the second opening speed; and control circuitry configured to trigger a second pre-programmed operation of the robotic manipulator, including closing the basket at the second closing speed, in response to receiving a second user interaction via the input device. (2) The robotic system of embodiment 1, wherein the medical instrument further comprises a ureteroscope. (3) The robotic system of embodiment 1, wherein the medical procedure includes ureteroscopy. (4) The input device includes a control pad, the control pad comprising: a directional control configured to direct movement of the robotic manipulator along a plurality of axes; A robot system as described in embodiment 1, comprising a plurality of buttons including a first button and a second button. (5) The robot system of embodiment 4, wherein the first user interaction includes double-tapping the first button.

[0118] (6) The robot system of embodiment 5, wherein the second user interaction includes double-tapping the second button. (7) The control circuit The robot system of embodiment 6, further configured to trigger a third pre-programmed action of the robot manipulator, which includes repeatedly moving forward and backward a short distance at an accelerated speed, in response to the first button and the second button being tapped simultaneously. (8) The control circuit The robot system of embodiment 1, further configured to trigger a third pre-programmed action of the robot manipulator in response to receiving a third user interaction, the third pre-programmed action including repeatedly moving forward and backward a short distance at an accelerated speed. (9) the second preprogrammed action: Detecting torque in a drive mechanism of the basket; 2. The robotic system of claim 1, further comprising: stopping the closing of the basket in response to the torque exceeding a threshold value. (10) The robot system of embodiment 1, wherein at least one of the first user interaction and the second user interaction includes a voice command.

[0119] (11) A method for controlling a medical instrument using a robotic manipulator, comprising: manipulating, using the robotic manipulator, a medical instrument for accessing a human anatomy, the medical instrument comprising a basket, the robotic manipulator configured to open the basket at a first opening speed and a second opening speed, the robotic manipulator further configured to close the basket at a first closing speed and a second closing speed; receiving one or more user interactions via an input device to trigger pre-programmed actions by the robotic manipulator; triggering a first pre-programmed operation of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed operation including opening the basket at the second opening speed that is faster than the first opening speed; and in response to receiving a second user interaction via the input device, triggering a second pre-programmed action of the robotic manipulator, the second pre-programmed action including closing the basket at a second closing speed that is faster than the first closing speed. (12) The method of embodiment 11, wherein the first user interaction includes double-tapping a first button of the input device and the second user interaction includes double-tapping a second button of the input device. (13) The method, 13. The method of claim 12, further comprising triggering a third pre-programmed action of the robotic manipulator in response to the first button and the second button being tapped simultaneously, the third pre-programmed action including repeatedly moving forward and backward a short distance at an accelerated speed. (14) The method, responsive to receiving an input on the input device for movement along a first axis, moving a center position of the third pre-programmed movement of the robotic manipulator along the first axis; and repeating moving forward and backward a short distance at the central location. (15) The method of embodiment 13, wherein the third preprogrammed action further comprises a repetitive rotational movement.

[0120] (16) The method, 12. The method of claim 11, further comprising using the robotic manipulator to manipulate an endoscope to access a human anatomical structure, the endoscope being configured to capture an image of the medical instrument within the human anatomical structure. (17) The method, receiving a third user interaction via an input device to directly control a movement of the medical instrument; 12. The method of claim 11, further comprising using the robotic manipulator to manipulate the medical instrument along one or more axes of movement based on the received third user interaction. (18) The second preprogrammed operation comprises: Detecting torque in a drive mechanism of the basket; 12. The method of claim 11, further comprising: stopping the closing of the basket in response to the torque exceeding a threshold value. (19) A control system for controlling a robotic device for performing a medical procedure, comprising: an input device configured to receive one or more user interactions and initiate one or more actions, including at least one of directly controlled movements and pre-programmed movements, by the robotic device; a communications interface configured to transmit commands to the robotic device corresponding to the directly controlled movements and the pre-programmed movements, the commands comprising: the robotic device moving a medical instrument comprising a basket and configured to access a human anatomy; opening the basket at a first opening speed and a second opening speed faster than the first opening speed; and closing the basket at a first closing speed and a second closing speed that is faster than the first closing speed. A control circuit communicatively coupled to the input device and the communication interface, the control circuit comprising: triggering a first pre-programmed operation of the robotic device in response to receiving a first user interaction, the first pre-programmed operation including opening the basket at the second opening speed; and control circuitry configured to trigger a second pre-programmed operation of the robotic device in response to receiving a second user interaction, the second pre-programmed operation including closing the basket at the second closing speed. (20) The input device, a directional control configured to direct movement of the robotic device along a plurality of axes; 20. The control system of embodiment 19, comprising a plurality of buttons including a first button configured to trigger the first pre-programmed operation and a second button configured to trigger the second pre-programmed operation.

[0121] (21) double-tapping the first button triggers the first pre-programmed action; A control system as described in embodiment 20, wherein double tapping the second button triggers the second pre-programmed action. (22) Tapping the first button once triggers a third pre-programmed action different from the first pre-programmed action; A control system as described in embodiment 20, wherein tapping the second button once triggers a fourth pre-programmed action that is different from the second pre-programmed action. (23) The control circuit The control system of embodiment 20, further configured to trigger a third pre-programmed action of the robotic device, including moving forward and backward repeatedly a short distance at an accelerated speed, in response to the first button and the second button being tapped simultaneously. (24) The control circuit responsive to receiving, via the directional control, a request to move along a first axis, moving a center location of the third pre-programmed movement of the robotic device along the first axis; 24. The control system of claim 23, further configured to repeat moving forward and backward a short distance at the central position. (25) The input device comprises a microphone configured to capture voice user commands; A control system as described in embodiment 19, wherein the control circuit is further configured to identify a first voice user command corresponding to the first user interaction and a second voice user command corresponding to the second user interaction.

[0122] (26) The robotic device is located at a first geographic location of the control system that is different from a second geographic location; 20. The control system of embodiment 19, wherein the communication interface is further configured to transmit the commands over a wide area network. (27) One or more non-transitory computer-readable media storing computer-executable instructions that, when executed by a control circuit, cause the control circuit to: manipulating a medical instrument for accessing a human anatomy using a robotic device, the medical instrument including a basket, the robotic device configured to open the basket at a first opening speed and a second opening speed, the robotic device further configured to close the basket at a first closing speed and a second closing speed; receiving, via an input device, one or more inputs for triggering a pre-programmed action by the robotic device; triggering a first pre-programmed operation of the robotic device in response to receiving a first input via the input device, the first pre-programmed operation including opening the basket at the second opening speed that is faster than the first opening speed; and in response to receiving a second input via the input device, triggering a second pre-programmed action of the robotic device including closing the basket at the second closing speed that is faster than the first closing speed. (28) One or more non-transitory computer-readable media as described in embodiment 27, wherein the first input includes double-tapping a first button of the input device and the second input includes double-tapping a second button of the input device. (29) The computer-executable instructions further comprising: One or more non-transitory computer-readable media as described in embodiment 28, further configured to perform an operation including triggering a third pre-programmed action of the robotic device including moving forward and backward a short distance repeatedly at an accelerated speed in response to the first button and the second button being tapped simultaneously. (30) The computer-executable instructions further comprising: receiving, via the input device, a third input for controlling a direct movement of the robotic device; 28. The one or more non-transitory computer-readable media of embodiment 27, further configured to cause the robotic device to perform an operation including manipulating the medical instrument along one or more axes of movement based on the received third input.

Claims

1. 1. A robotic system for performing a medical procedure, comprising:

1. A robot manipulator comprising: a robotic manipulator configured to manipulate a medical instrument comprising a basket and configured to access a human anatomy; an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movements and pre-programmed movements; a control circuit communicatively coupled to the input device and the robotic manipulator, and control circuitry configured to initiate a first pre-programmed operation of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed operation including repeatedly moving the basket forward and backward a short distance.

2. 10. The robotic system of claim 1, wherein the medical instrument further comprises a ureteroscope and the medical procedure comprises ureteroscopy.

3. The input device comprises a control pad, the control pad comprising: a directional control configured to direct movement of the robotic manipulator along a plurality of axes; and a plurality of user interface components including a first user interface component and a second user interface component.

4. A robotic system for performing a medical procedure, comprising:

1. A robot manipulator comprising: a robotic manipulator configured to manipulate a medical instrument comprising a basket and configured to access a human anatomy; an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movements and pre-programmed movements; a control circuit communicatively coupled to the input device and the robotic manipulator, and control circuitry configured to initiate a first pre-programmed operation of the robotic manipulator, the first pre-programmed operation including both inserting and retracting the basket, in response to receiving a first user interaction via the input device; The input device comprises a control pad, the control pad comprising: a directional control configured to direct movement of the robotic manipulator along a plurality of axes; a plurality of user interface components including a first user interface component and a second user interface component; The control circuit The robotic system is further configured to initiate the first pre-programmed movement of the robotic manipulator in response to the first user interface component and the second user interface component being simultaneously actuated.

5. 5. The robotic system of claim 4, wherein the first pre-programmed motion of the robotic manipulator includes repeatedly moving forward and backward a short distance.

6. 2. The robotic system of claim 1, wherein the control circuitry is configured to execute insertions and retractions in the preprogrammed motions of the robotic manipulator at a faster rate than the directly controlled movements.

7. 2. The robotic system of claim 1, wherein the control circuitry is configured to execute insertions and retractions in the preprogrammed motion of the robotic manipulator at a first speed that is a multiple of a second speed of the directly controlled movement.

8. A robotic system for performing a medical procedure, comprising:

1. A robot manipulator comprising: a robotic manipulator configured to manipulate a medical instrument comprising a basket and configured to access a human anatomy; an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movements and pre-programmed movements; a control circuit communicatively coupled to the input device and the robotic manipulator, initiating a first pre-programmed movement of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed movement including both inserting and retracting the basket; opening said basket to allow rotation of stones within said basket prior to both said insertion and said retraction; and a control circuit configured to close the basket to capture the stone after both the insertion and the retraction.

9. A robotic system for performing a medical procedure, comprising:

1. A robot manipulator comprising: a robotic manipulator configured to manipulate a medical instrument comprising a basket and configured to access a human anatomy; an input device configured to receive one or more user interactions and initiate one or more actions by the robotic manipulator, including at least one of directly controlled movements and pre-programmed movements; a control circuit communicatively coupled to the input device and the robotic manipulator, initiating a first pre-programmed movement of the robotic manipulator in response to receiving a first user interaction via the input device, the first pre-programmed movement including both inserting and retracting the basket; during execution of the first pre-programmed operation, in response to receiving a second user interaction via a directional control of the input device, stopping the first pre-programmed operation; in response to receiving the second user interaction, moving the basket to a new location; and control circuitry configured to resume the first pre-programmed operation at the new location.

10. 10. The robotic system of claim 9, wherein at least one user interface component is actuated to initiate the first pre-programmed action and is pressed and held during execution of the first pre-programmed action and the second pre-programmed action.

11. 1. A control system for controlling a robotic device for performing a medical procedure, comprising: an input device configured to receive one or more user interactions and initiate one or more actions, including at least one of directly controlled movements and pre-programmed movements, by the robotic device; a communications interface configured to transmit commands to the robotic device corresponding to the directly controlled movements and the pre-programmed movements, the commands comprising: a communication interface, the robotic device including a basket and configured to move a medical instrument to access a human anatomy; and A control circuit communicatively coupled to the input device and the communication interface, the control circuit comprising: and control circuitry configured to initiate a first pre-programmed operation of the robotic device in response to receiving a first user interaction, the first pre-programmed operation including repeatedly moving the basket forward and backward a short distance.

12. The input device is a directional control configured to direct movement of the robotic device along a plurality of axes; and a plurality of user interface components including a first user interface component configured to initiate the first pre-programmed action.

13. The control system of claim 12 , wherein double tapping the first user interface component initiates the first pre-programmed action.

14. The control system of claim 12 , wherein a single tap on the first user interface component initiates the first pre-programmed action.

15. The control circuit responsive to receiving a request for movement along a first axis via the directional control, moving a center location of the first pre-programmed movement of the robotic device along the first axis; The control system of claim 12 , further configured to alternate between moving forward and backward a short distance at the center position.

16. the input device comprises a microphone configured to capture voice user commands; The control system of claim 11 , wherein the control circuitry is further configured to identify a first voice user command corresponding to the first user interaction.

17. the robotic device is located at a first geographic location that is different from a second geographic location of the control system; The control system of claim 11 , wherein the communication interface is further configured to transmit the commands over a wide area network.

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