Systems and methods for docking medical instruments - Patents.com

Abstract

Certain aspects relate to systems and techniques for docking medical instruments. For example, a medical system can include a drive output that rotates and engages a corresponding drive input on a robotic medical instrument, a motor configured to rotate the drive output, and a torque sensor configured to measure torque applied to the drive output. The robotic medical instrument can include a pre-tensioned pull wire actuated by the drive input. The system can activate the motor associated with the drive output to rotate the drive output in response to a torque signal from the torque sensor associated with the drive output to align the drive output with the drive input.

Description

[Technical field]

[0001] (Priority Application) This application claims priority to U.S. Provisional Patent Application No. 62 / 738,483, filed Sep. 28, 2018, the disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THEINVENTION The systems and methods disclosed herein are directed to docking medical instruments, and more particularly, to systems and methods for docking a robotic medical instrument, which may include a pre-tensioned pull wire, to a corresponding instrument drive mechanism. [Background technology]

[0003] Robotically controllable medical systems can be used in a wide variety of medical procedures, including endoscopic, laparoscopic, and others. In some of these procedures, a robotically controlled medical instrument can be docked to an instrument positioning device, such as a robotic arm. Once docked, the instrument positioning device can manipulate the medical instrument to perform the procedure. Summary of the Invention [Means for solving the problem]

[0004] The systems, methods, and devices of the present disclosure each have several innovative aspects, no single one of which is solely responsible for the desirable attributes disclosed herein.

[0005] In a first aspect, a robotic medical system includes an instrument drive mechanism including a drive output configured to rotate and engage a corresponding drive input on a handle of a robotic medical instrument, the robotic medical instrument including a pre-tensioned pull wire actuated by the drive input, a motor associated with the drive output and configured to rotate the drive output, and a torque sensor associated with the drive output and configured to measure torque imparted to the drive output; and at least one computer-readable memory in communication with at least one processor having computer-executable instructions stored therein for causing the at least one processor to activate the motor associated with the drive output to rotate the drive output in response to a torque signal from the torque sensor associated with the drive output.

[0006] In some embodiments, the robotic medical system may include one or more of the following functions in any combination: (a) instructions to rotate the drive outputs to align the drive outputs with corresponding drive outputs; (b) instructions to cause the processor to start the motors in response to the torque signal exceeding a threshold; (c) instructions to cause the processor to stop the motors in response to the torque signal falling below the threshold; (d) the torque signal indicates a direction of torque applied on the drive outputs and instructions to cause the processor to start the motors to rotate in the same direction as the direction of the applied torque; and (e) instructions to cause the processor to stop the motors in response to the torque signal exceeding a threshold. (f) the rotational speed of the motor is constant; (g) the drive output is a gear and the drive input is a socket; (h) the drive output is a socket and the drive input is a gear; (i) the instructions cause the processor to start a motor associated with the drive output when the system is in a loaded implement state to rotate the drive output in response to the torque signal; (j) the torque sensor includes a strain gauge; (k) the strain gauge is positioned between a housing of the implement drive mechanism and the motor; and / or (l) the torque sensor is bidirectional.

[0007] In another aspect, a computer readable medium can include instructions configured to cause at least one processor to receive a torque signal from a torque sensor associated with a drive output of an instrument drive mechanism, and in response to the torque signal from the torque sensor exceeding a threshold, start a motor associated with the drive output to rotate the drive output, and stop the motor in response to the torque signal from the torque sensor falling below the threshold.

[0008] In some embodiments, the computer readable medium may further include one or more of the following features in any combination: (a) the instructions are configured to the at least one processor to rotate the drive output to align the drive output with the drive input or the robotic medical instrument, the robotic medical instrument including at least one pre-tensioned pull wire associated with the drive input; (b) the torque signal indicates a direction of torque applied on the drive output, and the instructions are configured to activate the motor to rotate the motor in the same direction as the direction of the applied torque; (c) the instructions are configured to cause the motor to rotate the drive output at a rotational speed proportional to a measured torque determined based on the torque signal; (d) the instructions are configured to cause the motor to rotate the drive output at a constant rotational speed; and / or (e) the instructions are configured to cause the at least one processor to activate the motor associated with the drive output to rotate the drive output in response to the torque signal when the system is in a loaded instrument state.

[0009] In another aspect, a method for matching a drive input of a robotic medical instrument and a drive output of an instrument drive mechanism includes receiving a torque signal from a torque sensor associated with the drive output of the instrument drive mechanism, the torque signal indicative of a torque applied to the drive output, comparing the torque signal to a threshold value; starting a motor of the instrument drive mechanism associated with the drive output to rotate the drive output in response to the torque signal exceeding the threshold value; and stopping the motor in response to the torque signal from the torque sensor falling below the threshold value.

[0010] In some embodiments, the method may include one or more of the following features in any combination: (a) the drive output is rotated to align the drive output with a drive input of the robotic medical instrument; (b) the robotic medical instrument includes at least one pre-tensioned pull wire associated with the drive input; (c) the torque signal indicates a direction of torque applied on the drive output, and the method includes starting the motor to rotate the motor in the same direction as the direction of the applied torque; (d) the rotational speed of the motor is proportional to a measured torque determined based on the torque signal; (e) the rotational speed of the motor is constant; (f) the drive output is a gear and the drive input is a socket; (g) the drive output is a socket and the drive input is a gear; and / or (h) the starting and stopping steps occur when the instrument is in a loaded instrument state.

[0011] In another aspect, a robotic medical system comprises an instrument drive mechanism comprising: a drive output configured to rotate and engage a drive input on a handle of a robotic medical instrument, the robotic medical instrument including a pull wire associated with the drive input; a motor associated with the drive output and configured to rotate the drive output; and a torque sensor associated with the drive output and configured to measure torque imparted to the drive output; and at least one computer readable memory in communication with the at least one processor, the memory having computer executable instructions stored in the at least one computer readable memory to cause the at least one processor to actuate the motor associated with the drive output to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by a torque sensor associated with the drive output exceeds a threshold value, cause the motor to rotate the drive output in a second direction until a second rotational position at which the torque signal measured by the torque sensor exceeds a threshold value, and determine a rotational distance between the first and second rotational positions.

[0012] In some embodiments, the system may include one or more of the following features in any combination, where (a) the rotation distance is indicative of a gap between the drive output and the drive input, (b) a torque signal exceeding a threshold is indicative of the drive output contacting the drive input, (c) the instructions to the at least one processor to rotate the drive output to articulate the elongate shaft of the medical instrument, the rotation being based at least in part on the determined rotation distance, (d) the drive output is a gear and the drive input is a socket, (e) the drive output is a socket and the drive input is a gear, (f) the instructions to the processor to activate a motor associated with the drive output to rotate the drive output to align the drive output with the drive input in response to the torque signal when the system is in a homing state, (g) the system enters the homing state after the medical instrument is docked to the instrument drive mechanism, (h) the torque sensor includes a strain gauge, (i) the strain gauge is positioned between a housing and the motor of the instrument drive mechanism, and / or (j) the torque sensor is bidirectional.

[0013] In another aspect, a computer readable medium includes instructions configured to at least one processor to activate a motor associated with the drive output to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by a torque sensor associated with the drive output of an instrument drive mechanism exceeds a threshold value, cause the motor to rotate the drive output in a second direction to a second rotational position at which a torque signal measured by the torque sensor exceeds the threshold value, and determine a rotational distance between the first and second rotational positions.

[0014] In some embodiments, the computer readable instructions may further include one or more of the following features in any combination, (a) the rotation distance indicates a gap between the drive output and a drive input of a robotic medical instrument docked to the instrument drive mechanism; (b) a torque signal exceeding a threshold indicates the drive output contacting the drive input; (c) the instructions cause the at least one processor to rotate the drive output to articulate the elongate shaft of the medical instrument, the rotation based at least in part on the determined rotation distance; (d) the instructions cause the at least one processor to activate a motor associated with the drive output to rotate the drive output to align the drive output with the drive input in response to the torque signal when the system is in a homing state; and / or (e) the system is in a homing state after the medical instrument is docked to the instrument drive mechanism.

[0015] In another aspect, a method includes actuating a motor associated with a drive output of an instrument drive mechanism to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by a torque sensor associated with the drive output exceeds a threshold value, causing the motor to rotate the drive output in a second direction to a second rotational position at which a torque signal measured by the torque sensor exceeds a threshold value, and determining a rotational distance between the first rotational position and the second rotational position.

[0016] The method may include one or more of the following features in any combination, (a) the rotational distance is indicative of a clearance between the drive output and a drive input of a robotic medical instrument docked to the instrument drive mechanism; (b) a torque signal exceeding a threshold is indicative of the drive output contacting the drive input; and / or (c) rotating the drive output to articulate the elongate shaft of the medical instrument, the rotation being based at least in part on the determined rotational distance.

[0017] In another aspect, a robotic medical system includes an instrument drive mechanism comprising a drive output configured to rotate and engage a corresponding drive input on a handle of a robotic medical instrument, the robotic medical instrument comprising a drive output with a pre-tensioned pull wire actuated by the drive input, a motor associated with the drive output and configured to rotate the drive output, and a sensor configured to detect when the handle of the robotic medical instrument is within a threshold load distance from the instrument drive mechanism. The system also includes at least one computer-readable memory in communication with the at least one processor, the memory storing computer-executable instructions that cause the at least one processor to determine, based on the output of the sensor, that the robotic medical instrument is within the threshold load distance of the instrument drive mechanism, and activate a motor associated with the drive output to oscillate the drive output to facilitate alignment of the drive output and the corresponding drive input.

[0018] The system may include one or more of the following features in any combination, where (a) the instructions further configure the processor to place the motor in an admittance mode and the robotic medical instrument is within a threshold load distance of the instrument drive mechanism; (b) the sensor is a proximity sensor; (c) the sensor is a magnetic sensor; (d) the sensor is an RFID reader; (e) the oscillation of the drive output includes rotation of the drive output back and forth in a clockwise and counterclockwise direction over a rotational range of at least 30 degrees, at least 20 degrees, at least 15 degrees, at least 10 degrees, at least 5 degrees, at least 3 degrees, or at least 1 degree; and (f) the oscillation of the drive output is less than or equal to 30 degrees, less than or equal to 20 degrees, including rotation of the drive output back and forth in clockwise and counterclockwise directions over a rotational range of 15 degrees or less, 10 degrees or less, 5 degrees or less, 3 degrees or less, or 1 degree or less; (g) the instructions further configure the processor to determine that a robotic medical instrument is docked to the instrument drive mechanism based on the output of the sensor and to stop causing vibration of the drive output when the robotic medical instrument is docked; (h) the threshold load distance is at least 20 cm, at least 15 cm, at least 10 cm, at least 5 cm, or at least 1 cm; and / or (i) the threshold load distance is 20 cm or less, 15 cm or less, 10 cm or less, 5 cm or less, or 1 cm or less.

[0019] In another aspect, a method includes determining, based on an output of a sensor on the instrument drive mechanism, that the robotic medical instrument is within a threshold load distance of the instrument drive mechanism, and actuating a motor associated with a drive output of the instrument drive mechanism to oscillate the drive output to facilitate alignment of the drive output and a corresponding drive input when the robotic medical instrument is within the threshold load distance of the instrument drive mechanism.

[0020] The method may include one or more of the following features in any combination: (a) placing the motor in an admittance mode where the robotic medical instrument is within a threshold load distance of the instrument drive mechanism; (b) the sensor is a proximity sensor; (c) the sensor is a magnetic sensor; (d) the sensor is an RFID reader; (e) the oscillation of the drive output includes rotation of the drive output back and forth in a clockwise and counterclockwise direction over a rotational range of at least 30 degrees, at least 20 degrees, at least 15 degrees, at least 10 degrees, at least 5 degrees, at least 3 degrees, or at least 1 degree; and (f) the oscillation of the drive output includes rotation of the drive output back and forth in a clockwise and counterclockwise direction over a rotational range of at least 70 degrees, at least 20 degrees, at least 20 degrees, at least 30 degrees, at least 40 degrees, at least 50 degrees, at least 60 degrees, at least 80 degrees, at least 90 degrees, at least 10 degrees, at least 10 degrees, at least 10 degrees, at least 20 degrees, at least 1 ... (g) determining based on the output of the sensor that the robotic medical instrument is docked to the instrument drive mechanism and ceasing the vibration of the drive output when the robotic medical instrument is docked; (h) the threshold loading distance is at least 20 cm, at least 15 cm, at least 10 cm, at least 5 cm, or at least 1 cm; and / or (i) the threshold loading distance is 20 cm or less, 15 cm or less, 10 cm or less, 5 cm or less, or 1 cm or less. [Brief description of the drawings]

[0021] The disclosed aspects are hereinafter described in conjunction with the accompanying drawings, which illustrate, by way of example, but not by way of limitation, the disclosed aspects, and in which like designations refer to like elements. [Figure 1] 1 illustrates an embodiment of a cart-based robotic system positioned for diagnostic and / or therapeutic bronchoscopy. [Diagram 2] 2 depicts a further embodiment of the robotic system of FIG. 1. [Diagram 3] 2 illustrates an embodiment of the robotic system of FIG. 1 positioned for ureteroscopy. [Figure 4] 2 illustrates the embodiment of the robotic system of FIG. 1 positioned for a vascular procedure. [Diagram 5] 1 illustrates an embodiment of a table-based robotic system positioned for a bronchoscopy procedure. [Figure 6] FIG. 6 is an alternative view of the robotic system of FIG. [Figure 7] 1 illustrates an exemplary system configured to accommodate a robotic arm(s). [Figure 8] 1 illustrates an embodiment of a table-based robotic system configured for a ureteroscopy procedure. [Figure 9] 1 illustrates an embodiment of a table-based robotic system configured for a laparoscopic procedure. [Figure 10] FIG. 10 is an embodiment of the table-based robotic system of FIGS. 5-9 with pitch or tilt adjustment. [Figure 11] FIG. 11 provides a detailed illustration of the interface between the table and column of the table-based robotic system of FIGS. [Figure 12] 1 illustrates an alternative embodiment of a table-based robotic system. [Figure 13] FIG. 13 illustrates an end view of the table-based robotic system of FIG. [Figure 14] FIG. 1 shows an end view of a table-based robotic system with a robotic arm attached. [Figure 15] 1 illustrates an exemplary instrument driver. [Figure 16] 1 illustrates an exemplary medical instrument with paired instrument drivers. [Figure 17] 13 shows an alternative design of the instrument driver and instrument, where the axis of the drive unit is parallel to the axis of the elongated shaft of the instrument. [Figure 18] 1 illustrates an instrument having an instrument-based insertion architecture. [Figure 19] 1 illustrates an exemplary controller. [Figure 20] FIG. 1 is a block diagram illustrating a localization system according to an illustrative embodiment that estimates the position of one or more elements of the robotic system of FIGS. 1-10 (such as the position of the tool of FIGS. 16-18). [Figure 21A]1A and 1B show isometric and end views, respectively, of an embodiment of an instrument drive mechanism including a plurality of drive outputs configured to engage a corresponding plurality of drive inputs of a medical instrument. [Figure 21B] 1A and 1B show isometric and end views, respectively, of an embodiment of an instrument drive mechanism including a plurality of drive outputs configured to engage a corresponding plurality of drive inputs of a medical instrument. [Figure 22A] 1A and 1B show isometric and end views, respectively, of an embodiment of an instrument handle of a medical instrument including multiple drive inputs configured to engage corresponding multiple drive outputs of an instrument drive mechanism. [Figure 22B] 1A and 1B show isometric and end views, respectively, of an embodiment of an instrument handle of a medical instrument including multiple drive inputs configured to engage corresponding multiple drive outputs of an instrument drive mechanism. [Diagram 23] FIG. 13 shows a perspective view of the instrument drive output engaging the instrument drive output during docking of a medical instrument to the instrument drive mechanism. [Figure 24] 1 illustrates an embodiment of a drive output matched with one embodiment of a drive input. [Figure 25A] 13A and 13B show alignment of the drive output with the drive input, and FIGURE 14 shows the drive output and drive input in a first misaligned position. [Figure 25B] 13 shows the alignment of the drive output with the drive input.14 shows the drive output and the drive input in a second misaligned position. [Figure 25C] 1 shows the alignment of the drive output with the drive input. 2 shows the drive input and drive output in aligned positions. [Figure 25D] 25A-25C show an example graph of the output of a torque sensor associated with a drive output during the matching process shown in FIGS. [Figure 26] FIG. 1 is a block diagram illustrating an embodiment of a medical system configured to match a drive input of a medical instrument and a drive output of an instrument drive mechanism. [Figure 27] 1 is a flow chart illustrating an exemplary method for matching a drive output of an instrument drive mechanism with a drive input of a medical instrument. [Figure 28A]1 illustrates an exemplary homing process using a drive output and a drive input; [Figure 28B] 1 illustrates an exemplary homing process using a drive output and a drive input, the drive output being rotated in a first direction to a first rotational position; [Figure 28C] 1 illustrates an exemplary homing process using a drive output and a drive input, and shows the drive output rotated in a second direction to a second rotational position. [Figure 28D] 28A-28C show an exemplary homing process using a drive output and a drive input.FIGS. 28A-28C show graphs of the output of a torque sensor associated with the drive output during the homing process shown in FIG. [Figure 29] 1 is a flow chart illustrating an example homing method for a medical system. [Diagram 30] 1 illustrates an example of a robotic medical system during docking of a medical instrument to an instrument drive mechanism. [Diagram 31] 1 is a flowchart illustrating an exemplary matching method for a robotic medical system. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0022] 1. Overview. Aspects of the present disclosure may be integrated into a robotic-enabled medical system capable of performing a variety of medical procedures, including both minimally invasive procedures such as laparoscopy, and non-invasive procedures such as endoscopic procedures. Among endoscopic procedures, the system may perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0023] In addition to performing a wide range of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist the physician. Additionally, the system can provide the physician with the ability to perform procedures from an ergonomic position without the need for awkward arm movements and positions. Still further, the system can provide the physician with the ability to perform procedures with improved ease of use, as one or more of the instruments of the system can be controlled by a single user.

[0024] Various embodiments are described below in conjunction with the drawings for purposes of explanation. It should be understood that many other implementations of the disclosed concepts are possible, and that various advantages may be achieved in the disclosed implementations. Headings are included herein for reference and to aid in locating the various sections. These headings are not intended to limit the scope of the concepts described therein. Such concepts may have applicability throughout this specification.

[0025] A. Robot System - Cart Robot-enabled medical systems can be configured in a variety of ways depending on the particular procedure. FIG. 1 illustrates an embodiment of a cart-based robot-enabled system 10 deployed for diagnostic and / or therapeutic bronchoscopy procedures. During bronchoscopy, the system 10 can include a cart 11 having one or more robotic arms 12 for delivering medical instruments, such as a steerable endoscope 13, which can be a procedure-specific bronchoscope for bronchoscopy, to a natural orifice access point (i.e., the patient's mouth, which in this example is positioned on a table) for delivering diagnostic and / or therapeutic tools. As shown, the cart 11 can be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arms 12 can be actuated to position the bronchoscope relative to the access point. The arrangement of FIG. 1 can also be utilized when performing gastro-intestinal (GI) procedures with a gastroscope, a specialized endoscope for GI procedures. FIG. 2 depicts an exemplary embodiment of the cart in more detail.

[0026] With continued reference to FIG. 1, once the cart 11 is properly positioned, the robotic arm 12 can insert the steerable endoscope 13 into the patient robotically, manually, or a combination thereof. As shown, the steerable endoscope 13 may comprise at least two nested parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument driver from a set of instrument drivers 28, with each instrument driver coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers 28, which facilitates coaxial alignment of the leader portion with the sheath portion, creates a "virtual rail" 29 that can be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or positions. The virtual rails described herein are shown in the figures using dashed lines, and thus the dashed lines do not indicate the physical structure of the system. Translation of the instrument drivers 28 along the virtual rails 29 nests the inner leader portion relative to the outer sheath portion, or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 29 may be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and position of the virtual rail 29 as shown represents a compromise that provides the physician access to the endoscope 13 while minimizing friction from bending the endoscope 13 into the patient's mouth.

[0027] After insertion, the endoscope 13 may be directed down the patient's trachea and lungs using precise commands from the robotic system until it reaches the desired destination or surgical site. To enhance navigation through the patient's pulmonary network and / or reach a desired target, the endoscope 13 may be manipulated to telescope the inner leader portion out from the outer sheath portion for enhanced articulation and a larger bend radius. The use of a separate instrument driver 28 also allows the leader portion and sheath portion to be driven independently of one another.

[0028] For example, the endoscope 13 may be directed to deliver a biopsy needle to a target, such as a lesion or nodule in the patient's lung. The needle may be deployed down a working channel that spans the length of the endoscope to obtain a tissue sample that is analyzed by a pathologist. Depending on the results of the pathology, additional tools may be deployed down the working channel of the endoscope for additional biopsies. After identifying the nodule as malignant, the endoscope 13 may endoscopically deliver an instrument to resect the potential cancerous tissue. In some cases, diagnostic and therapeutic procedures may be provided in separate procedures. In these situations, the endoscope 13 may also be used to deliver fiducials to "mark" the location of the target nodule. In other examples, diagnostic and therapeutic procedures may be delivered during the same procedure.

[0029] The system 10 may also include a movable tower 30 that may be connected to the cart 11 via a support cable to provide support for control, electronics, fluidics, optics, sensors, and / or power to the cart 11. Locating such functionality within the tower 30 allows for a smaller form factor cart 11 that can be more easily adjusted and / or repositioned by the operating physician and his / her staff. Additionally, the division of functionality between the cart / table and the support tower 30 reduces clutter in the operating room and facilitates improved clinical workflow. The cart 11 may be positioned in close proximity to the patient, while the tower 30 may be stored in a remote location so as to be out of the way during the procedure.

[0030] In supporting the robotic system described above, the tower 30 may include a computer-based control system component(s) that stores computer program instructions in a non-transitory computer-readable storage medium, such as, for example, a persistent magnetic storage drive, a solid-state drive, or the like. Execution of these instructions, whether execution occurs in the tower 30 or the cart 11, may control the entire system or subsystem(s). For example, when executed by a processor in the computer system, the instructions may cause the robotic system components to actuate associated carriages and arm mounts, operate a robotic arm, and control a medical instrument. For example, in response to receiving a control signal, motors in the joints of the robotic arm may position the arm in a particular pose.

[0031] The tower 30 may also include pumps, flow meters, valve controls, and / or fluid access to provide controlled irrigation and aspiration functions to a system that may be deployed through the endoscope 13. These components may also be controlled using the computer system of the tower 30. In some embodiments, irrigation and aspiration capabilities may be delivered directly to the endoscope 13 through separate cable(s).

[0032] The tower 30 may include voltage and surge protection designed to provide filtered and protected power to the cart 11, thereby avoiding the need to place power transformers and other auxiliary power components within the cart 11 and making the cart 11 smaller and more mobile.

[0033] The tower 30 may also include support equipment for sensors located throughout the robotic system 10. For example, the tower 30 may include optoelectronic equipment for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In combination with a control system, such optoelectronic equipment may be used to generate real-time images for display in any number of consoles deployed throughout the system, including in the tower 30. Similarly, the tower 30 may also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. The tower 30 may also be used to house and position EM field generators for detection by EM sensors in or on the medical instrument.

[0034] The tower 30 may also include a console 31 in addition to other consoles available to the rest of the system, for example a console mounted on the top of the cart. The console 31 may include a user interface for the physician operator and a display screen, such as a touch screen. The consoles in the system 10 are generally designed to provide both pre-operative and real-time information of the procedure, such as robotic control and navigation and localization information for the endoscope 13. If the console 31 is not the only console available to the physician, the console 31 may be used by a second operator, such as a nurse, to monitor the health or vital signs of the patient and the operation of the system 10, as well as provide procedure-specific data, such as navigation and localization information. In other embodiments, the console 30 is housed in a body separate from the tower 30.

[0035] The tower 30 may be coupled to the cart 11 and the endoscope 13 via one or more cables or connections (not shown). In some embodiments, support functions from the tower 30 may be provided to the cart 11 through a single cable, simplifying and decluttering the operating room. In other embodiments, certain functions may be combined with separate wiring and connections. For example, power may be provided to the cart 11 through a single power cable, while support for control, optics, fluidics, and / or navigation may be provided through separate cables.

[0036] FIG. 2 provides a detailed view of an embodiment of a cart 11 from a system usable with the cart-based robot shown in FIG. 1. The cart 11 generally includes an elongated support structure 14 (often referred to as a "column"), a cart base 15, and a console 16 at the top of the column 14. The column 14 may include one or more carriages, such as a carriage 17 (alternatively an "arm support") for supporting the deployment of one or more robotic arms 12 (three are shown in FIG. 2). The carriage 17 may include an individually configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 12 for better positioning relative to the patient. The carriage 17 also includes a carriage interface 19 that allows the carriage 17 to translate vertically along the column 14.

[0037] The carriage interface 19 is connected to the column 14 through slots, such as slots 20 located on either side of the column 14 to guide the vertical translation of the carriage 17. The slots 20 include vertical translation interfaces for positioning and holding the carriage 17 at various vertical heights relative to the cart base 15. The vertical translation of the carriage 17 allows the cart 11 to adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, an individually configurable arm mount on the carriage 17 allows the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0038] In some embodiments, a slot cover may be added to the slot 20 that is flush and parallel with the slot surface to prevent dirt and fluids from entering the interior chamber of the column 14 and the vertical translation interface as the carriage 17 translates vertically. The slot cover may be deployed through a pair of spring spools that are located near the vertical top and bottom of the slot 20. The cover is coiled within the spools until it is deployed to expand and contract from the coiled state as the carriage 17 translates vertically up and down. The spring loading of the spools provides a force to retract the cover onto the spool as the carriage 17 translates towards the spool, while also maintaining a tight seal as the carriage 17 translates away from the spool. The cover may be connected to the carriage 17 using, for example, a bracket within the carriage interface 19 to ensure that the cover expands and contracts properly as the carriage 17 translates.

[0039] Column 14 may include an internal mechanism, such as gears and motors, designed to use a vertically aligned leadscrew to mechanically translate carriage 17 in response to control signals generated in response to user input, such as input from console 16.

[0040] The robotic arms 12 may generally comprise a robotic arm base 21 and end effectors 22 separated by a series of links 23 connected by a series of joints 24, each with an independent actuator, each with an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arms 12. Each of the robotic arms 12 may have seven joints, thus providing seven degrees of freedom. A large number of joints results in a large number of degrees of freedom, allowing for "redundant" degrees of freedom. Having redundant degrees of freedom allows the robotic arms 12 to position their respective end effectors 22 at specific positions, orientations, and trajectories in space using different link positions and joint angles. This allows the system to position and orient the medical instrument from a desired point in space, while allowing the physician to move the arm joints to a clinically advantageous position away from the patient to create better access while avoiding arm collisions.

[0041] The cart base 15 balances the weight of the column 14, carriage 17, and robotic arm 12 on the floor. Thus, the cart base 15 houses the heavier parts such as electronics, motors, power supplies, and components that allow the cart 11 to be either mobile and / or immobilized. For example, the cart base 15 includes casters 25 in the form of rollable wheels that allow the cart 11 to be easily moved around the room before a procedure. After reaching the appropriate position, the casters 25 may be immobilized using wheel locks to hold the cart 11 in place during a procedure.

[0042] The console 16 positioned at the vertical end of the column 14 provides both a user interface and a display screen (or dual-purpose device, e.g., touch screen 26) for receiving user input to provide both pre-operative and intra-operative data to the physician user. Potential pre-operative data on the touch screen 26 may include pre-operative planning, navigation and mapping data derived from a pre-operative computerized tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data on the display may include optical information provided by tools, sensor and coordinate information from sensors, and vital patient statistics such as respiration, heart rate, and / or pulse. The console 16 may be positioned and angled to allow a physician to access the console 16 from the side of the column 14 opposite the carriage 17. From this position, the physician can view the console 16, the robotic arm 12, and the patient while operating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 to aid in maneuvering and stabilizing the cart 11.

[0043] FIG. 3 illustrates an embodiment of the robot-enabled system 10 positioned for ureteroscopy. In a ureteroscopy procedure, the cart 11 may be positioned to deliver a ureteroscope 32, a procedure-specific endoscope designed to traverse the patient's urethra and ureters, to the patient's lower abdominal region. In a ureteroscopy, it may be desirable for the ureteroscope 32 to be directly aligned with the patient's urethra to reduce friction and forces on sensitive anatomical structures in the area. As shown, the cart 11 may be aligned to the table legs to allow the robotic arm 12 to position the ureteroscope 32 for direct, linear access to the patient's urethra. From the table legs, the robotic arm 12 may insert the ureteroscope 32 along a virtual rail 33 directly through the urethra and into the patient's lower abdomen.

[0044] After insertion into the urethra using control techniques similar to those in bronchoscopy, the ureteroscope 32 may be navigated to the bladder, ureters, and / or kidneys for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 may be aimed into the ureter and kidney to fragment kidney stone buildup using a laser or ultrasonic lithotripsy device positioned down the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments may be removed using a basket deployed under the ureteroscope 32.

[0045] FIG. 4 shows an embodiment of the robot-enabled system 10 similarly positioned for a vascular procedure. In a vascular procedure, the system 10 may be configured such that the cart 11 can deliver a medical instrument 34, such as a steerable catheter, to an access point in the femoral artery in the patient's leg. The femoral artery presents both a larger diameter for navigation and a less circuitous path to the patient's heart, simplifying navigation. As in a ureteroscopic procedure, the cart 11 may be positioned toward the patient's leg and lower abdomen, allowing the robotic arm 12 to provide a virtual rail 35 with direct linear access to the femoral artery access point in the patient's thigh / hip region. After insertion into the artery, the medical instrument 34 may be directed and inserted by translating the instrument driver 28. Alternatively, the cart may be positioned around the patient's upper abdomen to reach alternative vascular access points, such as the carotid and brachial arteries near the shoulder and wrist.

[0046] B. Robot System - Table An embodiment of a robot-enabled medical system may also incorporate a patient table. The incorporation of a table reduces the amount of capital equipment in the operating room by eliminating carts and allows greater access to the patient. FIG. 5 shows an embodiment of such a robot-enabled system deployed for a bronchoscopy procedure. The system 36 includes a support structure or column 37 for supporting a platform 38 (shown as a "table" or "bed") above the floor. As with cart-based systems, the end effector of the robotic arm 39 of the system 36 includes an instrument driver 42 designed to manipulate an elongated medical instrument, such as the bronchoscope 40 of FIG. 5, through or along a virtual rail 41 formed from the linear alignment of the instrument driver 42. In practice, a C-arm for providing fluoroscopic imaging may be positioned above the upper abdominal region of the patient by placing emitters and detectors around the table 38.

[0047] FIG. 6 provides an alternative view of the system 36 without the patient and medical instruments for illustrative purposes. As shown, the column 37 may include one or more carriages 43, illustrated as a ring shape in the system 36, which may be the base for one or more robotic arms 39. The carriages 43 may translate along a vertical column interface 44 that spans the length of the column 37 to provide different vantage points at which the robotic arms 39 may be positioned to reach the patient. The carriage(s) 43 may rotate around the column 37 using a mechanical motor positioned within the column 37 to allow the robotic arms 39 to have access to multiple sides of the table 38, such as both sides of the patient. In embodiments with multiple carriages, the carriages may be individually positioned on the column and may translate and / or rotate independently of the other carriages. The carriages 43 do not have to surround the column 37 or even be circular, but the ring shape as illustrated facilitates rotation of the carriages 43 around the column 37 while maintaining structural balance. Rotation and translation of carriage 43 allows system 36 to align medical instruments such as endoscopes and laparoscopes to different access points on the patient. In other embodiments (not shown), system 36 can include a patient table or bed with adjustable arm supports in the form of parallel running bars or rails. One or more robotic arms 39 can be mounted on adjustable arm supports that can be adjusted vertically (e.g., via a shoulder with an elbow joint). By providing vertical adjustment, robotic arm 39 can advantageously be stored compactly under a patient table or bed and then raised during a procedure.

[0048] The robotic arm 39 may be attached to the carriage 43 via a set of arm mounts 45 that include a series of joints that may individually rotate and / or telescope to provide additional configurability to the robotic arm 39. Additionally, the arm mounts 45 may be positioned on the carriage 43 such that, when the carriage 43 is appropriately rotated, the arm mounts 45 may be positioned either on the same side of the table 38 (as shown in FIG. 6 ), on opposite sides of the table 38 (as shown in FIG. 9 ), or on adjacent sides of the table 38 (not shown).

[0049] The column 37 structurally provides support for the table 38 and a path for the vertical translation of the carriage 43. Internally, the column 37 may include a lead screw for guiding the vertical translation of the carriage, and a motor for mechanizing the translation of the carriage 43 based on the lead screw. The column 37 may also transmit power and control signals to the carriage 43 and to a robotic arm 39 mounted thereon.

[0050] The table base 46 serves a similar function as the cart base 15 of the cart 11 shown in FIG. 2, housing the heavier components to counterbalance the table / bed 38, column 37, carriage 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during a procedure. The casters that deploy from the bottom of the table base 46 may extend in opposite directions on either side of the base 46 and be retracted when the system 36 needs to be moved.

[0051] With continued reference to FIG. 6 , the system 36 may also include a tower (not shown) that divides the functionality of the system 36 between the table and the tower to reduce the form factor and bulk of the table. As with the previously disclosed embodiments, the tower may provide various support functions to the table, such as processing, computing, and control capabilities, power, fluidics, and / or optical and sensor processing. The tower may also be movable so that it can be positioned away from the patient to improve physician access and keep the operating room neat and tidy. Additionally, locating components in the tower allows for more storage space in the table base 46 for potential accommodation of the robotic arm 39. The tower may also include a master controller or console that provides both a user interface for user input, such as a keyboard and / or pendant, and a display screen (or touch screen) for pre-operative and intra-operative information, such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also include a holder for a gas tank used for insufflation.

[0052] In some embodiments, the table base may house and store the robot arm when not in use. FIG. 7 shows a system 47 for housing the robot arm in an embodiment of a table-based system. In the system 47, the carriage 48 may be translated vertically into the base 49 to house the robot arm 50, arm mount 51, and carriage 48 therein. The base cover 52 may be translated and retracted to open to deploy the carriage 48, arm mount 51, and robot arm 50 about the column 53, and closed to house and protect them when not in use. The base cover 52 may be sealed with a membrane 54 along the edge of its opening to prevent dirt and fluid ingress when closed.

[0053] FIG. 8 shows an embodiment of a robot-usable table base system configured for ureteroscopic procedures. For ureteroscopic procedures, the table 38 may include a swivel portion 55 for positioning the patient off-angle from the column 37 and table base 46. The swivel portion 55 may rotate or pivot about a pivot point (e.g., positioned below the patient's head) to position the bottom of the swivel portion 55 away from the column 37. For example, pivoting the swivel portion 55 allows a C-arm (not shown) to be positioned above the patient's lower abdomen without competing for space with the column (not shown) below the table 38. By rotating the carriage 35 (not shown) about the column 37, the robotic arm 39 may insert the ureteroscope 56 directly into the patient's groin area along a virtual rail 57 to reach the urethra. In ureteroscopy, stirrups 58 may be secured to a swivel portion 55 of table 38 to support the position of the patient's legs during the procedure and allow clear access to the patient's groin area.

[0054] In a laparoscopic procedure, minimally invasive instruments may be inserted into a patient's anatomy through a small incision(s) in the patient's abdominal wall. In some embodiments, the minimally invasive instruments include an elongated rigid member, such as a shaft, that is used to access an anatomical structure within the patient. After distension of the patient's abdominal cavity, the instruments may be oriented to perform a surgical or medical task, such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may comprise a scope, such as a laparoscope. FIG. 9 shows an embodiment of a robotic table-based system configured for laparoscopic procedures. As illustrated in FIG. 9, the carriage 43 of the system 36 may be rotated and vertically adjusted to position a pair of robotic arms 39 on either side of the table 38 such that the instruments 59 may be positioned using arm mounts 45 to pass through minimal incisions on either side of the patient to reach the patient's abdominal cavity.

[0055] To accommodate laparoscopic procedures, the robotic table system may also tilt the platform to a desired angle. FIG. 10 shows an embodiment of a robotic medical system with pitch or tilt adjustment. As shown in FIG. 10, the system 36 can accommodate the tilt of the table 38 to position one portion of the table at a greater distance from the floor than the other portion. In addition, the arm mount 45 may rotate to match the tilt so that the robotic arm 39 maintains the same planar relationship as the table 38. To accommodate steeper angles, the column 37 may also include a nesting portion 60 that allows the column 37 to extend vertically to prevent the table 38 from contacting the floor or colliding with the table base 46.

[0056] FIG. 11 provides a detailed illustration of the interface between the table 38 and the column 37. The pitch rotation mechanism 61 may be configured to change the pitch angle of the table 38 relative to the column 37 in multiple degrees of freedom. The pitch rotation mechanism 61 may be enabled by the positioning of orthogonal axes 1, 2 at the column-table interface, each actuated by a separate motor 3, 4 in response to an electrical pitch angle command. Rotation along one screw 5 allows tilt adjustment in one axis 1, while rotation along the other screw 6 allows tilt adjustment along the other axis 2. In some embodiments, a ball joint may be used to change the pitch angle of the table 38 relative to the column 37 in multiple degrees of freedom.

[0057] For example, pitch adjustment is particularly useful when attempting to position the table in the Trendelenburg position, i.e., positioning the patient's lower abdomen higher off the floor than the patient's upper abdomen for lower abdominal surgery. The Trendelenburg position allows gravity to slide the patient's internal organs toward the patient's upper abdomen, emptying the abdominal cavity for entry of minimally invasive tools to perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

[0058] 12 and 13 show isometric and end views of another embodiment of a table-based surgical robotic system 100. The surgical robotic system 100 includes one or more adjustable arm supports 105 (see, e.g., FIG. 14 ) that can be configured to support one or more robotic arms relative to the table 101. In the illustrated embodiment, a single adjustable arm support 105 is shown, but additional arm supports can be provided on the opposite side of the table 101. The adjustable arm support 105 can be configured to move relative to the table 101 to adjust and / or change the position of the adjustable arm support 105 and / or any robotic arms attached thereto relative to the table 101. For example, the adjustable arm support 105 can be adjusted with one or more degrees of freedom relative to the table 101. The adjustable arm support 105 provides great versatility to the system 100, including the ability to easily accommodate one or more adjustable arm supports 105 and any robotic arms attached thereto under the table 101. The adjustable arm support 105 can be raised from a stowed position to a position below the top surface of the table 101. In other embodiments, the adjustable arm support 105 can be raised from a stowed position to a position above the top surface of the table 101.

[0059] The adjustable arm support 105 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment of Figs. 12 and 13, the arm support 105 is configured with a fourth degree of freedom, indicated by an arrow in Fig. 12. The first degree of freedom allows for adjustment of the adjustable arm support 105 in the z-direction ("Z lift"). For example, the adjustable arm support 105 can include a carriage 109 configured to be able to move up and down along or relative to the column 102 that supports the table 101. The second degree of freedom can allow the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 can include a rotational joint, which can, for example, allow the adjustable arm support 105 to be aligned with the bed in a Trendelenburg position. The third degree of freedom can allow the adjustable arm support 105 to "pivot up", which can be used to adjust the distance between the side of the table 101 and the adjustable arm support 105. A fourth degree of freedom may allow translation of an adjustable arm support 105 along the longitudinal length of the table.

[0060] The surgical robotic system 100 of Figures 12 and 13 can include a table supported by a column 102 attached to a base 103. The base 103 and column 102 thus support the table 101 against a support surface. A bed axis 131 and a support axis 133 are shown in Figure 13.

[0061] The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the adjustable arm support 105 can be mounted to the table 101 or the base 103. The adjustable arm support 105 can include a carriage 109, a bar or rail connector 111, and a bar or rail 107. In some embodiments, one or more robotic arms mounted to the rail 107 can translate and move relative to each other.

[0062] The carriage 109 may be attached to the column 102 by a first joint 113, which allows the carriage 109 to move relative to the column 102 (e.g., up and down a first or vertical axis 123). The first joint 113 may provide a first degree of freedom ("Z lift") for the adjustable arm support 105. The adjustable arm support 105 may include a second joint 115 that provides a second degree of freedom (tilt) for the adjustable arm support 105. The adjustable arm support 105 may include a third joint 117 that may provide a third degree of freedom ("pivot up") for the adjustable arm support 105. An additional joint 119 (shown in FIG. 13) may be provided that mechanically constrains the third joint 117 to maintain the orientation of the rail 107 when the rail connector 111 is rotated about a third axis 127. The adjustable arm support 105 can include a fourth joint 121 that can provide a fourth degree of freedom (translation) for the adjustable arm support 105 along a fourth axis 129 .

[0063] 14 shows an end view of a surgical robotic system 140A having two adjustable arm supports 105A, 105B mounted on either side of a table 101. A first robotic arm 142A is mounted to a bar or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A mounted to the rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can be attached to one or more robotic medical instruments or tools. Similarly, the second robotic arm 142B includes a base 144B mounted to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to attach to one or more robotic medical instruments or tools.

[0064] In some embodiments, one or more of the robotic arms 142A, 142B comprise arms with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B can include eight degrees of freedom, including an insertion axis (one degree of freedom including insertion), wrist (three degrees of freedom including wrist pitch, yaw and roll), elbow (one degree of freedom including elbow pitch), shoulder (two degrees of freedom including shoulder pitch and yaw), and base 144A, 144B (one degree of freedom including translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arms 142A, 142B, while in other embodiments, the instrument itself provides the insertion via an instrument-based insertion architecture.

[0065] C. Instrument Drivers and Interfaces The end effector of the robotic arm of the system may include (i) an instrument driver (alternatively called an "instrument drive mechanism" or "instrument device manipulator") that incorporates electromechanical means for actuating the medical instrument, and (ii) a removable or detachable medical instrument that may lack any electromechanical components such as a motor. This dichotomy may be driven by the need to sterilize medical instruments used in medical procedures, their complex mechanical assemblies and sensitive electronics making it impossible to adequately sterilize expensive capital equipment. Thus, medical instruments can be designed to be detached, removed, and replaced from the instrument driver (and thus the system) for individual sterilization or disposal by the physician or physician's staff. In contrast, instrument drivers do not need to be replaced or sterilized and can be draped for protection.

[0066] FIG. 15 illustrates an exemplary instrument driver. The instrument driver 62, located at the distal end of the robotic arm, includes one or more drive units 63 arranged with parallel axes to provide a controlled torque to the medical instrument via a drive shaft 64. Each drive unit 63 includes an individual drive shaft 64 for interacting with the instrument, a gearhead 65 for converting the rotation of the motor shaft to a desired torque, a motor 66 for generating the drive torque, an encoder 67 for measuring the speed of the motor shaft and providing feedback to the control circuit, and a control circuit 68 for receiving the control signal and operating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument driver 62 can provide multiple (four as shown in FIG. 15) independent drive outputs to the medical instrument. In operation, the control circuit 68 receives the control signal, sends a motor signal to the motor 66, compares the resulting motor speed measured by the encoder 67 to a desired speed, and modulates the motor signal to generate the desired torque.

[0067] For procedures requiring a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile drape, located between the instrument driver and the medical instrument. The primary purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument driver to the drive input of the instrument while maintaining physical separation, and therefore sterility, between the drive shaft and the drive input. Thus, an exemplary sterile adapter may include a set of rotational inputs and outputs intended to mate with the drive shaft of the instrument driver and a drive input for the instrument. The sterile drape, which is connected to the sterile adapter, is composed of a thin flexible material, such as a transparent or translucent plastic, and is designed to cover the instrument driver, the robotic arm, and capital equipment, such as a cart (in a cart-based system) or a table (in a table-based system). The use of the drape allows the capital equipment to be placed in close proximity to the patient while still being positioned in an area that does not require sterility (i.e., a non-sterile field). On the other side of the sterile drape, the medical instrument may interface with the patient in an area that requires sterility (i.e., a sterile field).

[0068] D. Medical equipment 16 shows an exemplary medical instrument with a paired instrument driver. Similar to other instruments designed for use with a robotic system, the medical instrument 70 comprises an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as an "instrument handle" due to its design intended for manual interaction by a physician, may generally comprise a rotatable drive input 73, e.g., a receptacle, pulley, or spool, designed to mate with a drive output 74 that extends through a drive interface on an instrument driver 75 at the distal end of a robotic arm 76. When physically connected, latched, and / or coupled, the mated drive input 73 of the instrument base 72 may share a rotational axis with the drive output 74 in the instrument driver 75 to enable the transfer of torque from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may comprise a spline designed to mate with a receptacle on the drive input 73.

[0069] The elongated shaft 71 is designed to be delivered either through an anatomical opening or lumen, such as in an endoscope, or through a minimally invasive incision, such as in a laparoscope. The elongated shaft 71 may be either flexible (e.g., with properties similar to an endoscope) or rigid (e.g., with properties similar to a laparoscope), or may include a customized combination of both flexible and rigid portions. If designed for a laparoscope, the distal end of the rigid elongated shaft may be connected to a surgical tool or medical instrument, e.g., a grasper or scissors, that can be actuated based on forces from a tendon as the drive input rotates in response to torque received from the drive output 74 of the instrument driver 75, and an end effector extending from a jointed wrist formed from a clevis having at least one degree of freedom. If designed for an endoscopy, the distal end of the flexible elongated shaft may include a steerable or controllable bend that can be articulated and bent based on torque received from the drive output 74 of the instrument driver 75.

[0070] Torque from the instrument driver 75 is transferred downstream of the elongated shaft 71 using tendons along the elongated shaft 71. These individual tendons, such as pull wires, may be individually secured to individual drive inputs 73 in the instrument handle 72. From the handle 72, the tendons are directed along the elongated shaft 71 to one or more pull lumens and secured to a distal portion of the elongated shaft 71, or to a wrist at the distal portion of the elongated shaft. During a surgical procedure, such as a laparoscopic, endoscopic, or hybrid procedure, these tendons may be coupled to a distally attached end effector, such as a wrist, grasper, or scissors. Under such a configuration, torque exerted on the drive input 73 transfers tension to the tendons, thereby actuating the end effector in some way. In some embodiments, during a surgical procedure, the tendons can rotate the joint about an axis, thereby moving the end effector in one direction or another. Alternatively, the tendon may be connected to one or more jaws of a grasper at the distal end of the elongate shaft 71, with tension from the tendon causing the grasper to close.

[0071] In endoscopy, the tendons may be coupled to a flex or articulating section located along (e.g., at the distal end) of the elongate shaft 71 via adhesive, control rings, or other mechanical fixation. If fixedly attached to the distal end of the flex, torque exerted on the drive input 73 is transferred downstream of the tendons, causing the softer flex (sometimes referred to as the articulable section or region) to flex or articulate. Along the non-flexing portions, it may be advantageous to spiral or convolute the individual pull lumens that direct the individual tendons along (or inwardly) the wall of the endoscope shaft to counterbalance the radial forces resulting from tension in the pull wires. The angle of the spirals and / or the spacing between them can be altered or designed for a particular purpose, with tighter spirals exhibiting less shaft compression under load forces, while lesser amounts of spirals resulting in greater shaft compression under load forces but limited bending. At the other end of the spectrum, the pull lumen may be oriented parallel to the longitudinal axis of the elongate shaft 71 to allow for controlled articulation at a desired bend or articulatable section.

[0072] In endoscopy, the elongated shaft 71 houses several components that aid in robotic procedures. The shaft 71 may include a working channel for deploying surgical tools (or medical instruments), irrigating, and / or aspirating the surgical field at the distal end of the shaft 71. The shaft 71 may also house wires and / or optical fibers for transmitting signals to / from an optical assembly at the distal tip, which may include an optical camera. The shaft 71 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 shaft 71.

[0073] At the distal end of the instrument 70, the distal tip may include a working channel opening for delivering tools to the surgical site for diagnosis and / or treatment, irrigation, and aspiration. The distal tip may also include a port for a camera, such as a fiberscope or digital camera, to capture images of the internal anatomical space. Relatedly, the distal tip may also include a port for a light source to illuminate the anatomical space when the camera is in use.

[0074] 16, the drive shaft axis, and therefore the drive input axis, is orthogonal to the axis of the elongated shaft 71. However, this arrangement complicates the roll ability of the elongated shaft 71. Allowing the elongated shaft 71 to roll along its axis while holding the drive input 73 stationary results in undesirable entanglement of the tendons as they extend from the drive input 73 and enter the pull lumen within the elongated shaft 71. Such resulting entanglement of tendons can confuse control algorithms intended to predict the movement of the flexible elongated shaft 71 during an endoscopic procedure.

[0075] FIG. 17 shows an alternative design of the instrument driver and instrument, where the axis of the drive unit is parallel to the axis of the elongated shaft of the instrument. As shown, a circular instrument driver 80 includes four drive units with parallel aligned drive outputs 81 at the end of a robotic arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument driver 80, which is driven by one of the drive units in the assembly 83. In response to torque provided by the rotating drive units, the rotating assembly 83 rotates along a circular bearing connecting the rotating assembly 83 to a non-rotating portion 84 of the instrument driver 80. Power and control signals may be transferred from the non-rotating portion 84 of the instrument driver 80 to the rotating assembly 83 via electrical contacts that may be maintained throughout the rotation by a brushed slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be responsive to a separate drive unit that is integrated into the non-rotatable portion 84 and thus not parallel to the other drive units. The rotation mechanism 83 enables the instrument driver 80 to rotate the drive units and their respective drive outputs 81 as a single unit about the instrument driver axis 85 .

[0076] Similar to the previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown with a clear exterior skin for purposes of illustration) with a number of drive inputs 89 (such as receptacles, pulleys, and spools) configured to receive the drive outputs 81 in the instrument driver 80. Unlike the previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87 with an axis that is substantially parallel to the axis of the drive inputs 89, rather than orthogonal as in the design of FIG.

[0077] When coupled to the rotation assembly 83 of the instrument driver 80, the medical instrument 86, comprising an instrument base 87 and an instrument shaft 88, rotates with the rotation assembly 83 about the instrument driver axis 85. Because the instrument shaft 88 is centrally located in the instrument base 87, the instrument shaft 88 is coaxial with the instrument driver axis 85 when attached. Thus, rotation of the rotation assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, as the instrument base 87 rotates with the instrument shaft 88, any tendons connected to the drive input 89 in the instrument base 87 do not become entangled during rotation. Thus, the parallelism of the axes of the drive output 81, drive input 89, and instrument shaft 88 allows for shaft rotation without entangling the control tendons.

[0078] 18 illustrates an instrument having an instrument-based insertion architecture, according to some embodiments. The instrument 150 can be coupled to any of the instrument drivers described above. The instrument 150 comprises an elongate shaft 152, an end effector 162 connected to the shaft 152, and a handle 170 coupled to the shaft 152. The elongate shaft 152 comprises a tubular member having a proximal portion 154 and a distal portion 156. The elongate shaft 152 comprises one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180 therethrough. Thus, the one or more cables 180 extend along the outer surface of the elongate shaft 152. In other embodiments, the cables 180 can also extend through the elongate shaft 152. In some embodiments, manipulation of one or more of these cables 180 (e.g., via an instrument driver) results in actuation of the end effector 162.

[0079] The instrument handle 170, which may also be referred to as an instrument base, may generally include a mounting interface 172 having one or more mechanical inputs 174, such as receptacles, pulleys, or spools, designed to reciprocally mate with one or more torque couplers on a mounting surface of an instrument driver. In some embodiments, the instrument 150 includes a series of pulleys or cables that allow the elongated shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself includes an instrument-based insertion architecture that accommodates the insertion of the instrument, thereby minimizing reliance on a robotic arm to provide insertion of the instrument 150. In other embodiments, the robotic arm may be significantly involved in the insertion of the instrument.

[0080] E. Controller Any of the robotic systems described herein can include an input device or controller for manipulating an instrument attached to the robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electronically, electrically, wirelessly, and / or mechanically) to the instrument such that manipulation of the controller causes a corresponding manipulation of the instrument, e.g., via master-slave control.

[0081] 19 is a perspective view of an embodiment of controller 182. In this embodiment, controller 182 comprises a hybrid controller that can have both impedance control and admittance control. In other embodiments, controller 182 can utilize only impedance or passive control. In other embodiments, controller 182 can utilize only admittance control. By being a hybrid controller, controller 182 can advantageously have a lower perceived inertia during use.

[0082] In the illustrated embodiment, the controller 182 is configured to enable operation of two medical instruments and includes two handles 184. Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.

[0083] 19, each positioning platform 188 includes a selective compliance assembly robot arm (SCARA arm) 198 coupled to a column 194 by a prismatic joint 196. The prismatic joint 196 is configured to translate along the column 194 (e.g., along rails 197) to allow each of the handles 184 to be translated in the z-direction, providing a first degree of freedom. The SCARA arm 198 is configured to allow movement of the handles 184 in the xy-plane, providing two additional degrees of freedom.

[0084] In some embodiments, one or more load cells are positioned within the controller. For example, in some embodiments, a load cell (not shown) is positioned within the body of each of the gimbals 186. By providing load cells, a portion of the controller 182 can operate under admittance control, thereby advantageously reducing the perceived inertia of the controller during use. In some embodiments, the positioning platform 188 is configured for admittance control while the gimbal 186 is configured for impedance control. In other embodiments, the gimbal 186 is configured for admittance control and the positioning platform 188 is configured for impedance control. Thus, in some embodiments, the translational or positional degree of freedom of the positioning platform 188 can rely on admittance control while the rotational degree of freedom of the gimbal 186 relies on impedance control.

[0085] F. Navigation and Control Traditional endoscopy may involve the use of fluoroscopy (e.g., as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide intraluminal guidance to the operating physician. In contrast, the robotic system contemplated by the present disclosure may provide non-radiation-based navigation and localization means to reduce the physician's exposure to radiation and reduce the amount of equipment in the operating room. As used herein, the term "localization" may refer to determining and / or monitoring the position of an object in a reference coordinate system. Techniques such as pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to achieve a radiation-free operating environment. In other cases where radiation-based imaging modalities are still used, pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to improve the information obtained solely by radiation-based imaging modalities.

[0086] 20 is a block diagram illustrating a localization system 90 for estimating a position of one or more elements of a robotic system, such as a position of an instrument, according to an exemplary embodiment. The localization system 90 may be a set of one or more computing devices configured to execute one or more instructions. The computing devices may be embodied by a processor (or processors) and computer readable memory in one or more of the components discussed above. By way of example, and not by way of limitation, the computing devices may be in the form of a tower 30 shown in FIG. 1, a cart 11 shown in FIGS. 1-4, a bed shown in FIGS. 5-14, etc.

[0087] 20, the localization system 90 may include a localization module 95 that processes the input data 91-94 to generate position data 96 of the distal tip of the medical instrument. The position data 96 may be data or logic that represents the location and / or orientation of the distal tip of the instrument relative to a frame of reference. The frame of reference may be relative to a known object, such as the patient's anatomy or an EM field generator (see discussion of EM field generators below).

[0088] The various input data 91-94 will now be described in more detail. Pre-operative mapping can be accomplished utilizing the acquisition of low-dose CT scans. The pre-operative CT scans are reconstructed into three-dimensional images that are visualized, for example, as cross-sectional "slices" of the patient's internal anatomy. When analyzed as a whole, an image-based model can be generated for the anatomical cavities, spaces, and structures of the patient's anatomy, such as the patient's pulmonary network. Techniques such as center-line geometry can be determined and approximated from the CT images to create a three-dimensional volume of the patient's anatomy, referred to as model data 91 (also referred to as "pre-operative model data" when generated using only pre-operative CT scans). The use of center-line geometry is discussed in U.S. Patent Application Serial No. 14 / 523,760, the contents of which are incorporated herein in their entirety. Network topological models may also be derived from CT images and are particularly suited for bronchoscopy.

[0089] In some embodiments, the instrument may be equipped with a camera to provide visual data (or image data) 92. The localization module 95 may process the visual data 92 to enable one or more visual-based (or image-based) position tracking modules or functions. For example, the pre-operative model data 91 may be used in conjunction with the visual data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope or an instrument advancing through a working channel of the endoscope). For example, using the pre-operative model data 91, the robotic system may generate a library of predicted endoscopic images from the model based on the expected path of travel of the endoscope, with each image linked to a location in the model. During surgery, this library may be referenced by the robotic system to compare real-time images captured by a camera (e.g., a camera at the distal end of the endoscope) to those in the image library to assist with localization.

[0090] Other computer vision based tracking techniques use feature tracking to determine the movement of the camera and therefore the endoscope. Some features of the localization module 95 may identify circular geometric shapes in the pre-operative model data 91 that correspond to anatomical lumens and track changes in those geometries to determine which anatomical lumens have been selected as well as the relative rotational and / or translational movement of the camera. The use of a phase map may further enhance vision based algorithms or techniques.

[0091] Optical flow, another computer vision based technique, may analyze the displacement and translation of image pixels in a video sequence in the visual data 92 to infer camera motion. Examples of optical flow techniques may include motion detection, object segmentation calculations, luminance, motion compensated coding, stereo disparity measurements, etc. By comparing multiple frames over multiple iterations, the movement and position of the camera (and therefore the endoscope) can be determined.

[0092] The localization module 95 can use real-time EM tracking to generate a real-time position of the endoscope in a global coordinate system that can be aligned to the patient's anatomy represented by the pre-operative model. In EM tracking, an EM sensor (or tracker) including one or more sensor coils embedded at one or more locations and orientations in a medical instrument (e.g., an endoscopic instrument) measures variations in an EM field generated by one or more static EM field generators positioned at known locations. The position information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) can be placed in close proximity to the patient to generate a low-intensity magnetic field that can be detected by the embedded sensor. The magnetic field induces small currents in the sensor coils of the EM sensor, which can be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations can be "registered" intraoperatively to the patient's anatomy (e.g., the pre-operative model) to determine a geometric transformation that aligns a single location in the coordinate system with a location in the pre-operative model of the patient's anatomy. Once registered, an EM tracker embedded at one or more locations on the medical instrument (e.g., the distal tip of an endoscope) can provide a real-time indication of the medical instrument's progression through the patient's anatomy.

[0093] The robotic commands and kinematic data 94 may also be used by a localization module 95 to provide localization data 96 for the robotic system. The device pitch and yaw resulting from the articulation commands may be determined during pre-operative calibration. Intraoperatively, these calibration measurements may be used in combination with known insertion depth information to estimate the position of the instrument. Alternatively, these calculations may be analyzed in combination with EM, vision, and / or phase modeling to estimate the position of the medical instrument within the network.

[0094] As Fig. 20 illustrates, several other input data can be used by the localization module 95. For example, although not shown in Fig. 20, an instrument that utilizes shape sensing fabric can provide shape data that the localization module 95 can use to determine the position and shape of the instrument.

[0095] The localization module 95 may use a combination(s) of the input data 91-94. In some cases, such a combination may use a probabilistic approach in which the localization module 95 assigns confidence weights to the position determined from each of the input data 91-94. Thus, if the EM data may be unreliable (such as when EM interference is present), the confidence in the position determined by the EM data 93 may be reduced, and the localization module 95 may rely more heavily on the vision data 92 and / or the robot command and kinematic data 94.

[0096] As discussed above, the robotic systems discussed herein can be designed to incorporate a combination of one or more of the above techniques. The computer-based control system of the robotic system, whether based on a tower, bed, and / or cart, may store, for example in a non-transitory computer-readable storage medium, such as a persistent magnetic storage drive, solid-state drive, etc., computer program instructions that, when executed, cause the system to receive and analyze sensor data and user commands, generate system-wide control signals, and display navigation and localization data, such as instrument position within a global coordinate system, anatomical maps, etc.

[0097] 2. Medical equipment docking Embodiments of the present disclosure relate to devices, systems, and techniques for docking medical instruments. Some robotically controllable medical instruments include a base or handle that can dock with additional components of a robotic medical system. As an example, a robotically controllable endoscope may include a base or handle configured to dock with an instrument drive mechanism (IDM) on a robotic arm. The instrument drive mechanism can include a drive output that engages with a corresponding drive input of the medical instrument to facilitate and enable control of the medical instrument. In some embodiments, the systems and techniques disclosed herein are configured to facilitate matching between the drive output of the instrument drive mechanism and the drive input of the medical instrument. Matching the drive output with the drive input can facilitate docking of the medical instrument to the instrument drive mechanism. For example, matching the drive output and the drive input can quickly and easily dock the medical instrument to the instrument drive mechanism. The systems and techniques described herein can be used with robotically controllable medical systems, such as, for example, those described above with reference to FIGS. 1-20 and below, and other robotic systems. Exemplary medical instruments and instrument drive mechanisms are described above and below with reference to FIGS. 15-18, for example.

[0098] As shown in FIG. 16 during a robotic medical procedure, a medical instrument 70 may be docked to an instrument drive mechanism 75 that may be positioned on a robotic arm 76. The medical instrument 70 may include an instrument base or handle 72 configured to engage with the instrument drive mechanism 75. As shown, the instrument handle 72 may include a number of drive inputs 73 configured to engage with corresponding drive outputs 74 on the instrument drive mechanism 75. Detailed exemplary embodiments of the drive inputs and drive outputs are shown in FIGS. 21A-23 described below. As mentioned above, the drive output 74 may be driven by a motor within the instrument drive mechanism 75 (see FIG. 15). The drive output 74 may transmit rotation (or other motion) of the motor to the drive input 75 to control various functions of the medical instrument 70, such as articulation of the elongated shaft 71 of the medical instrument 70, or actuation of a tool positioned at the distal end of the elongated shaft 71. The instrument handle 72 may latch to the instrument drive mechanism 75 to hold the medical instrument 70 for use during the procedure.

[0099] When attempting to dock the medical instrument 70 to the instrument drive mechanism 75, the drive input 73 of the instrument handle 72 and the drive output 74 of the instrument drive mechanism 75 may not be aligned. Misalignment of the drive input 73 and drive output 74 may make it difficult or impossible to dock the medical instrument 70 to the instrument drive mechanism 75. In order for the medical instrument 70 to dock to the instrument drive mechanism 75, the drive output 74 or the drive input 73 may need to be rotated until properly aligned.

[0100] There are several ways in which the drive output 74 and the drive input 73 can be aligned. For example, in some embodiments, the instrument drive mechanism 75 may be configured such that the motor can be driven back. In such embodiments, the force of docking the medical instrument 70 to the instrument drive mechanism 75 may be sufficient to rotate the drive output 74 until it is properly aligned with the drive input 73. However, in some embodiments, this may require significant force as any resistance of the motors must be overcome as they are driven back. Similarly, in some embodiments, the motors in the instrument drive mechanism 75 may be turned off during docking to allow the drive output 74 to rotate until it is aligned with the drive input 73. The performance provided by these embodiments may be adjustable. For example, the torque required to rotate the drive output 74 may be adjustable.

[0101] As another example, in some embodiments, the force applied during docking may rotate the drive input 73 on the medical instrument 70 until it is properly aligned with the drive output 74 of the instrument drive mechanism 75. Some embodiments of the medical instrument 70 may include a pull wire that is actuated by the drive input 73 that is not pre-tensioned. In medical instruments 70 that do not include a pre-tensioned pull wire, the drive input 73 may have some tolerance to free movement. That is, in medical instruments 70 that do not include a pre-tensioned pull wire, it may be possible to rotate the drive input 73 (at least some rotation) without actuating the pull wire. Thus, in some embodiments, when the drive input 73 is misaligned with the drive output 74, the drive input 73 may rotate to align itself within this tolerance during docking.

[0102] Other embodiments of the medical instrument 70 may include a pre-tensioned pull wire. In some embodiments of these instruments (including a pre-tensioned pull wire), any rotation of the drive input 73 can cause a corresponding actuation of the pull wire. For example, if the tensioned pull wire is configured to cause articulation of the elongated shaft 71 of the instrument 70, any rotation of the drive input 73 will cause articulation of the elongated shaft 71. In these embodiments, it may not be desirable to allow the drive input 73 to rotate freely to facilitate alignment during docking. For example, it may not be desirable to allow the drive input 73 to rotate freely during docking, as this rotation may cause the elongated shaft 71 to articulate, which is unacceptable as it may be desirable for the elongated shaft 71 of the medical instrument 70 to remain straight during docking. Therefore, a method of automatically adjusting the drive output 74 to align with the drive input 75 may be desirable. Examples of such methods are described in more detail below.

[0103] In some embodiments, the instrument drive mechanism 75 may include a sensor configured to sense a torque or force applied to the drive output 74. If the drive output 74 and the drive input 73 are misaligned, during docking of the medical instrument 70, the drive input 73 may contact and press against the drive output 74 when the medical instrument 70 and the instrument drive mechanism 75 are brought together. This contact between the drive output 74 and the drive input 73 experienced during misalignment may be determined based on the output of the sensor. For example, the misalignment may cause a torque to be applied to the drive output 74 by the drive input 73 that may be measured by the sensor. The measured torque may provide an indication that the drive output 74 and the drive input 73 are misaligned. In some embodiments, the system may activate a motor associated with the drive output 74 to rotate the drive output 74. The drive output 74 may rotate until it is aligned with the drive input 73. In some embodiments, the system determines that the drive output 74 is aligned with the drive input 73 when the measured torque applied to the drive output 74 decreases or drops to zero. When this occurs, the system may stop rotating the drive output 74.

[0104] Thus, in some embodiments, the system may be configured to automatically align the drive output 74 with the drive input 73 in response to a torque or force measured by a sensor associated with the drive output 74, the torque being caused by a misalignment between the drive output 74 and the drive input 73. This can advantageously facilitate docking of the medical instrument 70 to the instrument drive mechanism 75. In some embodiments, this advantageously allows for alignment of the drive output 74 with the drive input 73 without having to backdrive a motor associated with the drive output 74. Further, in some embodiments, it advantageously allows for alignment of the drive output 74 with the drive input 73 without requiring rotation of the drive input 73. Thus, in some embodiments, the automatic alignment systems described herein may be advantageously used with medical instruments that include pre-tensioned pull wires.

[0105] These and other features and advantages of the disclosed systems and methods are described in more detail below with reference to examples and embodiments shown in Figures 21A-29. These examples and embodiments are provided by way of illustration and are not intended to limit the present disclosure.

[0106] 21A and 21B show isometric and end views, respectively, of an embodiment of an instrument drive mechanism 200 including a plurality of drive outputs 208 configured to engage a corresponding plurality of drive inputs of a medical instrument. As shown, the instrument drive mechanism 200 can include a housing 202. The housing 202 can include a mounting surface 204 configured to dock to the medical instrument. The instrument drive mechanism 200 can include a latch mechanism 206 that secures the medical instrument to the instrument drive mechanism 200 when docked.

[0107] As shown in FIGS. 21A-B, the instrument drive mechanism 200 can include a drive output 208. The drive output 208 can be, for example, a rotatable element configured to be driven by a motor positioned within the housing. In the illustrated embodiment, the drive output 208 is configured as a spline or gear protruding from the mounting surface 204, although other configurations of the drive output 208 are possible. For example, the drive output 208 can include a receptacle or socket formed as a recess in the mounting surface 204. The drive output 208 is configured to couple with and engage a corresponding drive input on the medical instrument. The drive output 208 can be used to control the medical instrument during a procedure by transferring rotational motion (or other motion depending on the embodiment) from the motor in the instrument drive mechanism 208 to the drive input of the medical instrument.

[0108] In some embodiments, the instrument drive mechanism 200 may include additional mechanisms, such as a communications module 210. The communications module 210 may be configured to read information from a medical instrument docked to the instrument drive mechanism 200. In some embodiments, the communications module 210 (or some other portion of the instrument drive mechanism 200) comprises one or more proximity sensors. The proximity sensors may be configured to determine whether a medical instrument is the instrument drive mechanism or is docked to the instrument drive mechanism. The proximity sensors may comprise, for example, one or more magnetic proximity sensors.

[0109] 22A and 22B show isometric and end views, respectively, of an embodiment of an instrument handle 220 of a medical instrument including a plurality of drive inputs 228 configured to engage a corresponding plurality of drive outputs 208 of the instrument drive mechanism 200. As shown, the instrument handle 220 may include a housing 222. The housing 222 may include a mounting surface 224 configured to dock with the mounting surface 204 of the instrument drive mechanism 200. The instrument handle 220 may include a latch mechanism 226 that secures the instrument handle 220 to the instrument drive mechanism 200 when docked.

[0110] 22A-22B, the instrument handle 220 can include a drive input 228. The drive input 228 can be a rotatable element configured to be driven by the drive output 208 of the instrument drive mechanism 200. In the illustrated embodiment, the drive input 228 is configured as a receptacle or socket recessed into the mounting surface 224, although other configurations for the drive input 228 are possible. For example, the drive input 228 can include protruding splines or gears extending from the mounting surface 224.

[0111] In some embodiments, the instrument handle 220 may include additional mechanisms such as a communications module 230 that may be configured to transmit information to the communications module 210 of the instrument drive mechanism 200. In some embodiments, the communications module 230 (or some other portion of the instrument handle 220) comprises one or more proximity sensors. The proximity sensors may be configured to determine whether a medical instrument is at or docked to the instrument drive mechanism 200. The proximity sensors may comprise one or more magnetic proximity sensors.

[0112] 23 shows a perspective view of an embodiment of the instrument drive output 208 engaging the drive input 228 during docking of the instrument handle 220 to the instrument drive mechanism 200. As shown, the drive output 208 may include teeth 209 (e.g., ridges, protrusions, notches, recesses, etc.) configured to be received within corresponding grooves 229 of the drive input 229. In the illustrated example, the teeth 209 and grooves 229 interact to transmit rotational motion.

[0113] In many of the examples described below, the drive output 208 is shown as a gear including teeth 209, and the drive input 228 is configured as a socket including grooves 229. However, this need not be the case in all embodiments, and many other structural configurations for transmitting rotational motion between the drive output 208 and the drive input 228 are possible. For example, in some embodiments, the drive output 208 may include a socket, and the drive input 228 can include a gear configured to be received within the socket. As another example, in some embodiments, both the drive output 208 and the drive input 228 may be configured as gears configured to mesh with one another. For ease of explanation, the examples below will continue to describe and illustrate the drive output 208 and the drive input 228 as gears and as sockets, with the understanding that this is done by way of example and is not intended to limit the present disclosure to the particular illustrated structural arrangement. In other embodiments, the drive output 208 and the drive input 228 may be configured to transmit other types of motion, such as linear motion.

[0114] 24 shows an example diagram of drive output 208 being aligned with drive input 228. As shown, when aligned, teeth 209 of drive output 208 may be received within grooves 229 of drive input 228. In some embodiments, because teeth 209 are aligned within grooves 229, drive input 228 does not impart any torque or force to drive output 208, or vice versa. This may represent a desired alignment between drive input 228 and drive output 208. The illustrated alignment may also facilitate docking of a medical instrument to the instrument drive mechanism because, when aligned, drive output 208 may be easily received within drive input 228.

[0115] Figures 25A-25D show an example alignment process that may be used to align drive output 208 with drive input 228 during docking of a medical instrument to an instrument drive mechanism. Figures 25A-25C show example diagrams of drive output 208 and drive input 228 at various stages during the process, and Figure 25D shows an example graph showing the output of a torque sensor associated with drive output 208 during the process.

[0116] As shown in Fig. 25A, often times when attempting to dock a medical instrument to the instrument drive mechanism, one or more drive outputs 208 of the instrument drive mechanism and one or more drive inputs 228 of the medical instrument are not properly aligned. For example, teeth 209 of the drive output 208 may be misaligned with grooves 229 of the drive input 228, as shown in Fig. 25A. When this occurs, it can be difficult to fully dock the medical instrument to the instrument drive mechanism, as this can prevent the medical instrument and the instrument drive mechanism from fully mating. Therefore, it may be desirable to align the drive output 208 and the drive input 228.

[0117] When misaligned, the drive input 228 can impart a force to the drive output 208 that creates a torque τ as shown. The torque τ may be caused by the walls of the groove 229 pressing against the walls of the teeth 209 as the medical instrument is brought towards the instrument drive mechanism. This may be particularly true in embodiments where the medical instrument includes a pre-tensioned pull wire, as the drive input 228 may not be able to rotate freely in such instruments. Also, in some embodiments, the motor associated with the drive output 208 may not allow the drive output 208 to rotate freely, and thus contact between the misaligned drive output 208 and the drive input 228 can generate a torque τ as shown. A signal indicative of the torque τ can be sensed or measured by a sensor (such as a torque or force sensor) associated with the drive output 208. In FIG. 25A, the torque τ is shown to have a clockwise direction, but this need not be the case in all embodiments. For example, the torque τ may have a counterclockwise direction depending on how the drive output 208 and the drive input 228 are misaligned.

[0118] Based on the torque τ, as shown in FIG. 25B, the drive output 208 may be rotated in a rotational direction R, which is the same as the direction of the torque τ, to align the drive output 208 with the drive input 228. At the stage shown in FIG. 25B, the drive output 208 has been rotated in a clockwise direction. As shown in FIG. 25B, the drive output 208 is still misaligned with the drive input 228. However, the rotation R reduces the misalignment (compared to FIG. 25A). The rotation R may be driven by a motor associated with the drive output 208 in response to the measured torque τ, as discussed throughout this application.

[0119] As shown in FIG. 25C, rotation R of drive output 208 may continue until drive output 208 is aligned with drive input 228. At this stage, no torque τ is imparted to drive output 208 because drive output 208 and drive input 228 are aligned, as shown in FIG. 25C. Once aligned, teeth 209 of drive output 208 may be aligned with grooves 229 of drive input 228 as shown. Because teeth 209 of drive output 208 are aligned with grooves 229 of drive input 228, drive input 228 may not impart torque τ. This may trigger the motor to stop rotation of drive output 208. Once drive output 208 and drive input 228 are aligned, docking of the medical instrument to the instrument drive mechanism may be facilitated.

[0120] Figure 25D shows an example graph of the output of a torque or force sensor associated with drive output 208 during the docking and alignment process shown in Figures 25A-C. In the illustrated embodiment, the graph shows measured torque, although this need not be the case in all embodiments. For example, the graph could represent measured force or torque, or the output of a sensor indicative of torque or force.

[0121] As shown in Fig. 25D, initially, the measured torque τ is substantially zero. This may represent a condition in which the medical instrument is not in contact with the instrument drive mechanism. In this condition, there is no contact with the drive output 208 such that the torque sensor associated with the drive output 208 does not measure torque. As shown, the measured torque may begin to rise upon contact with the instrument drive mechanism during docking as the misaligned drive output 208 may begin to contact the drive input 228.

[0122] The state shown in FIG. 25A can be represented by the time t a In this case, the torque τ is increasing, but the threshold τ thresh In some embodiments, the measured torque τ is less than a threshold τ thresh Although the threshold τ remains below the threshold τ, rotation of the drive output 208 is not triggered. threshmay be selected to take noise into account and adjust the sensitivity of the system.

[0123] Time t a From the above, the measured torque τ is thresh The measured torque τ can continue to increase beyond the threshold τ thresh may be triggered to rotate R of the drive output 208. For example, at time t b may indicate the stage shown in FIG. 25B , where, as described above, the drive output 208 is still misaligned with the drive input 228, the measured torque τ is still present, and the drive output 208 is undergoing rotation R to align the drive output 208 with the drive input 228.

[0124] FIG. 25D shows time t b As shown from the above, the measured torque τ is thresh The torque continues to decrease until it falls below the threshold τ thresh When the drive output 208 and the drive input 228 are below the time t c 25C, which can show that the rotation R can be stopped. c can correspond to a suitable match, for example, as shown in FIG. 25C.

[0125] Figure 26 is a block diagram illustrating an embodiment of a medical system 300 configured to align a drive input 318 of a medical instrument 314 with a drive output 312 of an instrument drive mechanism 306. In some embodiments, the alignment may occur automatically based on the output of a torque or force sensor 308 associated with the drive output 312 in a manner similar to that described with reference to Figures 25A-25D and in more detail below with reference to Figure 27.

[0126] 26, the system 300 may include one or more processors 302 and one or more computer readable media or memories 304 in communication with the processor 302. The memory 304 may be configured with instructions that configure the processor 302 to perform various features. For example, the memory 304 may be configured with instructions that cause the processor 302 to perform the automatic alignment and docking mechanisms described throughout the application.

[0127] The system 300 also includes an instrument drive mechanism 306. Exemplary instrument drive mechanisms are described above with reference to, for example, Figures 15, 16, 21A and 21B. In some embodiments, the instrument drive mechanism 306 is positioned on a distal end of a robotic arm or other instrument positioning device. The instrument drive mechanism 306 may be configured to dock with a medical instrument 314. In the illustrated embodiment, the instrument drive mechanism 306 includes a torque sensor 308, a motor 310 and a drive output 312. The instrument drive mechanism 306 may also include additional mechanisms (e.g., a proximity sensor, a communication module, etc.) not shown in Figure 26.

[0128] As previously mentioned, the drive output 312 may be configured to engage a corresponding drive input 318 on the medical instrument 314. The drive output 312 may be driven by the motor 310. The motor 310 may be configured to rotate the drive output 312, for example, in a clockwise and counterclockwise direction. The drive output 312 may be configured to transfer rotational motion of the motor 310 to the drive input 318 of the medical instrument 314. As such, the drive output 312 may include any structure suitable for transferring rotational motion, such as, for example, a gear and socket.

[0129] As shown in FIG. 26 , the instrument drive mechanism 306 may also include a sensor 308, such as the illustrated torque sensor 308. As previously mentioned, other types of sensors, such as force sensors, may also be used. The torque sensor 308 may be associated with the drive output 312. For example, the torque sensor 308 may provide an output signal indicative of the torque or force applied to the drive output 312. In some embodiments, the torque sensor 308 may include one or more strain gauges. The torque sensor may be positioned between the housing of the instrument drive mechanism 306 and the motor 310. In some embodiments, the torque sensor 308 is bi-directional. That is, in some embodiments, the torque sensor 308 may be configured to measure torque in both clockwise and counterclockwise directions. The output signal of the torque sensor 308 may indicate the direction of the torque applied to the drive output 312.

[0130] As shown, the torque sensor 308 and the motor 310 may be communicatively coupled to the processor 302, for example, to allow an output signal of the torque sensor 308 to be used by the processor 302 and may further allow the processor 302 to control the motor 310. In some embodiments, the processor 302 controls the motor 310 based on the output signal of the torque sensor 308 to implement the automatic alignment and docking mechanisms described herein.

[0131] FIG 26 illustrates that the system 300 may also include a medical instrument 314. Exemplary medical instruments 314 have been described above with reference to, for example, FIGS. 1, 3-5, 8, 9, 16-18, 22A and 22B. The medical instrument 314 may include an instrument base or handle 316 and an elongate shaft 320. The instrument handle 316 may be configured to dock with the instrument drive mechanism 306. The elongate shaft 320 may extend from the instrument handle 316. In some embodiments, the elongate shaft 320 may be configured for insertion into a patient's body (e.g., laparoscopic or endoscopic) during a medical procedure.

[0132] The instrument handle 316 can include a drive input 318 configured to engage with the drive output 312 of the instrument drive mechanism 306. In some embodiments, the drive input 318 is associated with one or more pull wires 322 that can perform various functions with the medical instrument 314. For example, in some embodiments, actuating the pull wires 322 articulates the elongate shaft 320 or operates a tool positioned at the distal end of the elongate shaft 320. In some embodiments, the pull wires 322 are actuated by rotating the drive input 318. As described above, the drive input 318 can be configured to engage the drive output 312 such that rotational motion from the motor 310 can be transferred through the drive output 312 to the drive input 318 to actuate the pull wires 322. In some embodiments, the pull wires 322 can be pre-tensioned.

[0133] In some embodiments, the medical instrument 314 includes a pre-tensioned pull wire, i.e., in some embodiments, any rotation of the drive input 318 causes actuation of the pull wire. In such embodiments, inadvertent or unintended rotation of the drive input 318 may be undesirable, as such rotation may cause inadvertent or unintended articulation of the medical instrument.

[0134] In some embodiments, the system 300 is configured to implement a matching process to automatically match the drive output 312 and the drive input 318 to facilitate docking.

[0135] 27 is a flow chart illustrating an exemplary method 400 of alignment of a drive output of an instrument drive mechanism with a drive input of a medical instrument. In some embodiments, the method 400 can be implemented on the system 300 of FIG. 26, as well as other medical systems described herein.

[0136] Method 400 begins at block 402 where a torque signal is received from a torque sensor associated with a drive output of an instrument drive mechanism. In some embodiments, the torque signal may indicate a direction of torque imparted to the drive output. The torque, in some embodiments, may be caused by a misalignment between the drive output and the drive input, as described above. In some embodiments, method 400 may use a signal indicative of force rather than torque.

[0137] Method 400 then moves to block 404, where a motor associated with the drive output is activated to rotate the drive output in response to a torque signal (received at block 402) that exceeds a threshold. The threshold may be configured to adjust the sensitivity of the system and / or to account for noise in the signal. In some embodiments, the threshold may be configured based on the medical instrument. For example, a stiffer medical instrument may include a higher threshold than a more flexible medical instrument. In some embodiments, threshold information is stored with each instrument (in some embodiments, within the instrument itself) and retrieved for use in method 400.

[0138] In some embodiments, the rotation is configured to align the drive output with the drive input. In some embodiments, the drive output is rotated in the same direction as the torque applied to the drive output. For example, if the torque is in a clockwise direction, the drive input may be rotated in a clockwise direction. In some embodiments, the drive output is configured to rotate in a direction opposite to the direction of the torque.

[0139] In some embodiments, the rotation speed may be proportional to the magnitude of the torque measured in block 402. For example, the greater the torque, the greater the rotation speed. The torque may be related to the degree of misalignment, so that when the drive output and drive input are significantly out of alignment, the rotation may be faster and as the drive output and drive input rotate to align, the rotation may slow down. In other embodiments, the rotation speed may be constant.

[0140] The method 400 then moves to block 406 where the motor is stopped to cause the motor to stop rotating the drive output in response to the torque signal falling below a threshold. A torque signal falling below a threshold may indicate proper matching between the drive output and the drive input.

[0141] In some embodiments, method 400 is performed during an instrument docking or instrument loading state. For example, method 400 may be performed in some embodiments while docking a medical instrument to an instrument drive mechanism. In some embodiments, the system determines whether to be automatic based on, for example, proximity sensors in the instrument drive mechanism and medical instrument, or manual based on user input. In some embodiments, once docking is complete, the system exits the instrument loading state and no longer performs method 400.

[0142] In some embodiments, the method 400 may be performed for each drive output of the tool drive mechanism and may therefore be used to match multiple drive outputs with multiple drive inputs.

[0143] 28A-D illustrate an exemplary homing process using the drive output 208 and drive input 228 described above. In some embodiments, the homing process is completed after the medical instrument is docked to the instrument drive mechanism. The homing process may be used to estimate or determine the size of the gap g between the teeth 209 of the drive output 208 and the grooves 229 of the drive input 228. The gap g may represent a clearance or tolerance between the drive output 208 and the drive input 228. It may be desirable to calculate the size of the gap g so that the gap g can be taken into account while controlling the robotic medical instrument, as described below.

[0144] FIG. 28A shows the drive output 208 engaged with the drive input 228. As shown, the teeth 209 of the drive output 208 are received within the grooves 229 of the drive input 228. For tolerance and clearance reasons, a gap g may exist between the teeth 209 and the grooves 229. The gap g may facilitate docking and mating between the drive output 208 and the drive input 228. As shown, the gap g may exist on one or both sides of the teeth 209. For example, the entire gap g may be on a first side, the entire gap g may be on a second side, or a portion of the gap g may be on the first side and another portion of the gap g may be on the second side of the teeth 209. Due to the gap g, it may be possible to rotate the drive output 208 without causing a corresponding rotation of the drive output 208. For example, the drive output 208 must rotate until the walls of the teeth 209 contact the walls of the grooves 229 before the drive output 208 begins to rotate. It may therefore be desirable to determine or estimate the size of the gap g so that this distance can be taken into account. The gap may also be referred to as backlash. It may be desirable to account for backlash when switching rotation directions. For example, after rotating in a clockwise direction, a counterclockwise rotation through the distance of the gap g is required before a counterclockwise rotation will cause actuation of the medical device.

[0145] 28B illustrates that as part of the homing process to determine the size of the gap g, the drive output 208 can be rotated in a first direction to a first rotational position. In the illustrated example, the drive output 208 is rotated in a counterclockwise direction with a rotation R until a torque τ is measured in the same direction as the rotation R. The torque τ can be caused by the teeth 209 contacting the grooves 229. In this manner, the process can determine a rotational position where the teeth 209 contact the grooves 229 when rotated in the first direction.

[0146] As shown in Figure 28C, the drive output 208 may then be rotated in a second direction to a second rotational position. In the illustrated example, the drive output 208 then rotates the rotation R in a clockwise direction until a torque τ is measured in the same direction as the rotation R. Again, the torque τ may be caused by the teeth 209 contacting the grooves 229. In this manner, the process may determine the rotational position at which the teeth 209 contact the grooves 229 when rotated in the second direction.

[0147] The rotational distance between the first rotational position (shown in FIG. 28B) and the second rotational position (shown in FIG. 28C) can then be determined and used as the gap g, since the drive output 208 is homed by locating each sidewall of the groove 229 of the drive input 228. The rotational distance can then be used to account for backlash in the system when changing rotational direction.

[0148] FIG. 28D illustrates an example graph of the output of a torque sensor associated with the drive output during the homing process illustrated in FIGS. 28A-C. As previously discussed, the graph may represent an output signal indicative of force or torque. As illustrated, a At time t b In FIG. 28B, the torque τ is greater than or equal to the torque threshold + τ thresh At time t c 28C), the torque τ is below a threshold −τ thresh In the graph, the positive and negative torque thresholds τ thresh indicates the limit of the opposite rotation direction.

[0149] Fig. 29 is a flow chart illustrating an exemplary homing method 500 for a medical system. The medical system may be, for example, the medical system 300 of Fig. 26, as well as other medical systems described herein. The homing method 500 may be used to determine or estimate a clearance between a drive input and a drive output, as described with reference to Fig. 28A, so that the clearance can be taken into account during further use of the medical system.

[0150] The method 500 begins at block 502 where a motor associated with a drive output of an instrument drive mechanism is activated to rotate the drive output in a first direction until a torque signal measured by a torque sensor associated with the drive output exceeds a threshold value. In some embodiments, a torque signal that exceeds a threshold value can be indicative of the drive output contacting the drive input, for example, as shown in FIG.

[0151] The method 500 then moves to block 504 where the motor rotates the drive output in a second direction to a second rotational position where the torque signal measured by the torque sensor exceeds a threshold value. In some embodiments, a torque signal that exceeds a threshold value can be indicative of the drive output contacting the drive input in an opposite direction, for example as shown in FIG.

[0152] Finally, in block 506, the method 500 determines a rotational distance between the first rotational position (FIG. 28B) and the second rotational position (FIG. 28C). The rotational distance may represent a gap or clearance between the drive output and the drive input.

[0153] In some embodiments, once the method 500 determines the gap, the gap is taken into account for future commanded movements. For example, rotation of a drive output is used to control a medical instrument. However, when the rotation of the drive output changes direction, the drive output must rotate back through the gap distance before contacting the drive input in the opposite direction.

[0154] 30 shows an example of a robotic medical system 600 during docking of a medical instrument to an instrument drive mechanism. In the illustrated embodiment, the system 600 includes an instrument drive mechanism 602 and a robotic medical instrument 610. The robotic medical instrument 610 includes an instrument base or handle 612 and an elongate shaft 614. The elongate shaft 614 can be configured to articulate. In some embodiments, the elongate shaft includes one or more pull wires that are actuable to cause articulation of the elongate shaft 614. In some embodiments, the pull wires are pre-tensioned pull wires.

[0155] The robotic medical instrument 610 may be configured to dock to the instrument drive mechanism 602 such that the instrument drive mechanism 602 can drive the robotic medical instrument 610. As shown, the instrument drive mechanism 602 includes an instrument drive output 604. The instrument drive output 604 may be configured to engage with a corresponding instrument drive input 616 on the base or handle 612 of the robotic medical instrument 610. As mentioned above, alignment between the drive output 604 and the drive input 610 can facilitate docking.

[0156] In the illustrative example of FIG. 30 , the instrument drive mechanism 600 includes a sensor 606. The sensor 606 may be configured to determine when the robotic medical instrument 610 is within a threshold load distance D of the instrument drive mechanism 602. In some embodiments, the sensor 606 is a proximity sensor, a magnetic sensor, an RFID reader, or any other type of suitable sensor for determining when the robotic medical instrument is within the distance D of the instrument drive mechanism 602. In some embodiments, the instrument drive mechanism includes a corresponding sensor 618 that can be read by the sensor 606 of the instrument drive mechanism 602. For example, the sensor 618 may be a magnet or an RFID tag that can be read by the sensor 606 when within the distance D. In some embodiments, the distance D is at least 20 cm, at least 15 cm, at least 10 cm, at least 5 cm, or at least 1 cm. In some embodiments, the distance D is 20 cm or less, 15 cm or less, 10 cm or less, 5 cm or less, or 1 cm or less.

[0157] In the illustrated embodiment, when the robotic medical instrument 610 is brought within distance D of the instrument drive mechanism 602, the motor of the instrument drive mechanism 602 can begin to drive an oscillation of the drive output 604. For example, the oscillation of the drive output can include rotation of the drive output back and forth in clockwise and counterclockwise directions (as illustrated in FIG. 30 by the arrows) through a rotational range of at least 30 degrees, at least 20 degrees, at least 15 degrees, at least 10 degrees, at least 5 degrees, at least 3 degrees, or at least 1 degree. In some embodiments, the oscillation is a rotational range of 30 degrees or less, 20 degrees or less, 15 degrees or less, 10 degrees or less, 5 degrees or less, 3 degrees or less, or 1 degree or less.

[0158] In some embodiments, the motor driving the drive output can be placed in admittance mode when the instrument drive mechanism 602 is within a threshold docking distance D of the robotic medical instrument. For example, the motor may be in admittance mode while the drive output 604 is vibrating.

[0159] The oscillation of the drive output 604 can facilitate matching between the drive output and the drive input 616, thereby allowing the medical instrument 610 to dock to the instrument drive mechanism 602. In some embodiments, the system can determine that the robotic medical instrument has docked to the instrument drive mechanism based on the output of the sensor, and stop causing oscillation of the drive output when the robotic medical instrument is docked.

[0160] 31 is a flow chart illustrating an example alignment method 700 for a robotic medical system. Method 700 may begin at block 702. In block 702, method 700 includes determining that the robotic medical instrument is within a threshold load distance of the instrument drive mechanism based on an output of a sensor on the instrument drive mechanism. This can be done with a sensor as described above. In block 704, method 700 includes placing a motor associated with a drive input in an admittance mode. In block 706, method 700 includes activating a motor associated with a drive output of the instrument drive mechanism to oscillate the drive output to facilitate alignment of the drive output and the corresponding drive input when the robotic medical instrument is within the threshold load distance of the instrument drive mechanism.

[0161] In some embodiments, the systems and techniques for medical instrument docking described above can be viewed as admittance control of the interface of the instrument drive mechanism with the input force / torque resulting from misalignment between the drive gear and the socket.

[0162] 3. Implementation system and terminology. Implementations disclosed herein provide systems, methods, and devices for docking a medical instrument, and in some embodiments a robotic medical instrument, which may include one or more pre-tensioned pull wires, to an instrument drive mechanism. The systems, methods, and devices may facilitate matching a drive output on the instrument drive mechanism with a drive input on the medical instrument.

[0163] It should be noted that, as used herein, the terms "couple," "connecting," "coupled," or other variations of word combinations may indicate either an indirect connection or a direct connection. For example, when a first component is "coupled" to a second component, the first component may be either indirectly connected to the second component through another component, or directly connected to the second component.

[0164] Phrases referring to certain computer-implemented processes and functions described herein may be stored as a processor-readable medium or one or more instructions on a computer-readable medium. The term "computer-readable medium" refers to any available medium that can be accessed by a computer or processor. By way of example, and not limitation, such media may include random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, compact disk read-only memory (CD-ROM), or other optical disk storage, magnetic disk storage, or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that computer-readable media may be tangible and non-transitory. As used herein, the term "code" may refer to software, instructions, code, or data that is executable by a computing device or processor.

[0165] The methods disclosed herein include one or more steps or acts for achieving the described method. Method steps and / or acts may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or acts is required for the proper operation of the described method, the order and / or use of specific steps and / or acts may be modified without departing from the scope of the claims.

[0166] As used herein, the term "plurality" refers to two or more. For example, a plurality of components refers to two or more components. The term "determining" encompasses a wide variety of acts, and thus "determining" can include calculating, computing, processing, calculating, examining, looking (e.g., looking at a table, database, or another data structure), ascertaining, and the like. "Determining" can also include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), and the like. "Determining" can also include resolving, selecting, choosing, establishing, and the like.

[0167] The phrase "based on" does not mean "based only on," unless expressly specified otherwise. In other words, the phrase "based on" describes both "based only on" and "based at least on."

[0168] The foregoing description of the disclosed implementations is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these implementations will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other implementations without departing from the scope of the present invention. For example, those skilled in the art will understand that many corresponding alternative and equivalent structural details may be used, such as equivalent methods of fastening, attaching, coupling, or engaging tool components, equivalent mechanisms for producing specific actuation motions, and equivalent mechanisms for delivering electrical energy. Thus, the present invention is not intended to be limited to the implementations shown herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

[0169] [Embodiment] (1) A robotic medical system, comprising: 1. An instrument drive mechanism comprising: a drive output configured to rotate and engage a corresponding drive input on a handle of a robotic medical instrument, the robotic medical instrument comprising a pre-tensioned pull wire actuated by the drive input; a motor associated with the drive output and configured to rotate the drive output; a torque sensor associated with the drive output and configured to measure a torque imparted to the drive output; and and at least one computer-readable memory in communication with at least one processor storing computer-executable instructions for causing the at least one processor to activate the motor associated with the drive output to rotate the drive output in response to a torque signal from the torque sensor associated with the drive output. (2) The system of claim 1, wherein the instructions cause the processor to rotate the drive output to align the drive output with the corresponding drive output. (3) The system of claim 1, wherein the instructions cause the processor to start the motor in response to the torque signal exceeding a threshold. (4) The system of claim 3, wherein the instructions cause the processor to stop the motor in response to the torque signal falling below the threshold. (5) The system of embodiment 1, wherein the torque signal indicates a direction of torque applied on the drive output, and the instructions cause the processor to start the motor to rotate in the same direction as the direction of the applied torque.

[0170] (6) The system of claim 1, wherein the rotational speed of the motor is proportional to a measured torque determined based on the torque signal. (7) The system of embodiment 1, wherein the rotational speed of the motor is constant. (8) The system of embodiment 1, wherein the drive output is a gear and the drive input is a socket. (9) The system of embodiment 1, wherein the drive output is a socket and the drive input is a gear. (10) The system of embodiment 1, wherein the instructions cause the processor to activate the motor associated with the drive output to rotate the drive output in response to the torque signal when the system is in a load implement state.

[0171] (11) The system of embodiment 1, wherein the torque sensor includes a strain gauge. (12) The system of claim 11, wherein the strain gauge is positioned between a housing of the instrument drive mechanism and the motor. (13) The system of claim 1, wherein the torque sensor is bidirectional. (14) A computer-readable medium, comprising: At least one processor has receiving a torque signal from a torque sensor associated with a drive output of the tool drive mechanism; activating a motor associated with the drive output to rotate the drive output in response to the torque signal from the torque sensor exceeding a threshold value; 11. A computer-readable medium comprising: instructions configured to cause the motor to stop rotating the drive output in response to the torque signal from the torque sensor falling below the threshold, such that the motor is stopped. (15) The computer-readable medium of claim 14, wherein the instructions are configured to cause at least one processor to rotate the drive output to align the drive output with a drive input or a robotic medical instrument, the robotic medical instrument including at least one pre-tensioned pull wire associated with the drive input.

[0172] (16) The computer-readable medium of claim 14, wherein the torque signal indicates a direction of torque applied on the drive output, and the instructions cause the at least one processor to start the motor to rotate in the same direction as the direction of the applied torque. (17) The computer-readable medium of claim 14, wherein the instructions are configured to cause the motor to rotate the drive output at a rotational speed proportional to a measured torque determined based on the torque signal. (18) The computer-readable medium of claim 14, wherein the instructions are configured to cause the motor to rotate the drive output at a constant rotational speed. (19) The computer-readable medium of claim 14, wherein the instructions cause the at least one processor to activate the motor associated with the drive output to rotate the drive output in response to the torque signal when the system is in a load implement state. (20) A method for matching a drive input of a robotic medical instrument and a drive output of an instrument drive mechanism, comprising: receiving a torque signal from a torque sensor associated with the drive output of the tool drive mechanism, the torque signal being indicative of a torque applied to the drive output; comparing the torque signal to a threshold; activating a motor of the tool drive mechanism associated with the drive output to rotate the drive output in response to the torque signal exceeding the threshold; and in response to the torque signal from the torque sensor falling below the threshold, stopping the motor such that the motor stops rotating the drive output.

[0173] (21) The method of embodiment 20, wherein the drive output is rotated to align the drive output with the drive input of the robotic medical instrument. (22) The method of embodiment 21, wherein the robotic medical instrument includes at least one pre-tensioned pull wire associated with the drive input. 23. The method of claim 20, wherein the torque signal indicates a direction of torque applied on the drive output, and the method includes starting the motor to rotate in the same direction as the direction of the applied torque. (24) The method of claim 20, wherein the rotational speed of the motor is proportional to a measured torque determined based on the torque signal. (25) The method of claim 20, wherein the rotational speed of the motor is constant.

[0174] 26. The method of claim 20, wherein the drive output is a gear and the drive input is a socket. (27) The method of claim 20, wherein the drive output is a socket and the drive input is a gear. (28) The method of claim 20, wherein the starting and stopping steps occur when the device is in a loaded state. (29) A robotic medical system, comprising: 1. An instrument drive mechanism comprising: a drive output configured to rotate and engage a drive input on a handle of a robotic medical instrument, the robotic medical instrument comprising a pull wire associated with the drive input; a motor associated with the drive output and configured to rotate the drive output; a torque sensor associated with the drive output and configured to measure a torque imparted to the drive output; and at least one computer-readable memory in communication with the at least one processor, the memory having computer-executable instructions stored in the at least one computer-readable memory, the computer-executable instructions causing the at least one processor to: actuating the motor associated with the drive output to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by the torque sensor associated with the drive output exceeds a threshold; causing the motor to rotate the drive output in a second direction to a second rotational position at which the torque signal measured by the torque sensor exceeds the threshold; and at least one computer readable memory that causes a rotational distance between the first rotational position and the second rotational position to be determined. (30) The system of claim 29, wherein the rotational distance indicates a gap between the drive output and the drive input.

[0175] (31) The system of claim 29, wherein the torque signal exceeding the threshold indicates the drive output contacting the drive input. (32) The system of claim 29, wherein the instructions cause the at least one processor to rotate the drive output to articulate an elongate shaft of the medical instrument, the rotation being based at least in part on the determined rotation distance. (33) The system of embodiment 29, wherein the drive output is a gear and the drive input is a socket. (34) The system of embodiment 29, wherein the drive output is a socket and the drive input is a gear. (35) The system of claim 29, wherein the instructions cause the processor to start the motor associated with the drive output and rotate the drive output to align the drive output with the drive input in response to the torque signal when the system is in a homing state.

[0176] (36) The system of embodiment 35, wherein the system enters the homing state after the medical instrument is docked to the instrument drive mechanism. (37) The system of embodiment 29, wherein the torque sensor includes a strain gauge. (38) The system of embodiment 37, wherein the strain gauge is positioned between a housing of the instrument drive mechanism and the motor. (39) The system of embodiment 29, wherein the torque sensor is bidirectional. (40) A computer-readable medium, comprising: At least one processor has actuating a motor associated with a drive output of the tool drive mechanism to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by a torque sensor associated with the drive output exceeds a threshold; causing the motor to rotate the drive output in a second direction to a second rotational position at which the torque signal measured by the torque sensor exceeds the threshold; A computer-readable medium comprising instructions configured to cause a rotational distance between the first rotational position and the second rotational position to be determined.

[0177] (41) The computer-readable medium of claim 40, wherein the rotational distance indicates a clearance between the drive output and a drive input of a robotic medical instrument docked to the instrument drive mechanism. (42) The computer-readable medium of claim 40, wherein the torque signal exceeding the threshold is indicative of the drive output contacting the drive input. (43) The computer-readable medium of claim 40, wherein the instructions cause the at least one processor to rotate the drive output to articulate an elongate shaft of the medical instrument, the rotation being based at least in part on the determined rotation distance. (44) The computer-readable medium of claim 40, wherein the instructions cause the at least one processor to actuate the motor associated with the drive output in response to the torque signal when the system is in a homing state to rotate the drive output to align the drive output with the drive input. (45) The computer-readable medium of claim 44, wherein the system enters the homing state after the medical instrument is docked to the instrument drive mechanism.

[0178] (46) A method comprising the steps of: actuating a motor associated with a drive output of the tool drive mechanism to rotate the drive output in a first direction to a first rotational position at which a torque signal measured by a torque sensor associated with the drive output exceeds a threshold; causing the motor to rotate the drive output in a second direction to a second rotational position at which the torque signal measured by the torque sensor exceeds the threshold; determining a rotational distance between the first rotational position and the second rotational position. (47) The method of claim 46, wherein the rotational distance indicates a clearance between the drive output and a drive input of a robotic medical instrument docked to the instrument drive mechanism. (48) The method of claim 47, wherein the torque signal exceeding the threshold indicates the drive output contacting the drive input. (49) The method of claim 48, further comprising rotating the drive output to articulate an elongate shaft of the medical instrument, the rotation being based at least in part on the determined rotation distance. (50) A robotic medical system, comprising: 1. An instrument drive mechanism comprising: a drive output configured to rotate and engage a corresponding drive input on a handle of a robotic medical instrument, the robotic medical instrument comprising a pre-tensioned pull wire actuated by the drive input; a motor associated with the drive output and configured to rotate the drive output; a sensor configured to detect when the handle of the robotic medical instrument is within a threshold load distance from the instrument drive mechanism; at least one computer-readable memory in communication with the at least one processor, the memory having computer-executable instructions stored in the at least one computer-readable memory, the computer-executable instructions causing the at least one processor to: determining, based on an output of the sensor, that the robotic medical instrument is within the threshold load distance of the instrument drive mechanism; and a computer readable memory for activating the motor associated with the drive output to vibrate the drive output to promote matching of the drive output and the corresponding drive input.

[0179] (51) The system of embodiment 50, wherein the instructions further configure the processor to place the motor in an admittance mode where the robotic medical instrument is within the threshold load distance of the instrument drive mechanism. (52) The system of embodiment 50, wherein the sensor is a proximity sensor. (53) The system described in embodiment 50, wherein the sensor is a magnetic sensor. (54) The system of embodiment 50, wherein the sensor is an RFID reader. (55) The system of embodiment 50, wherein the oscillation of the drive output includes rotation of the drive output back and forth in clockwise and counterclockwise directions over a rotational range of at least 30 degrees, at least 20 degrees, at least 15 degrees, at least 10 degrees, at least 5 degrees, at least 3 degrees, or at least 1 degree.

[0180] (56) The system of embodiment 50, wherein the oscillation of the drive output includes rotation of the drive output back and forth in clockwise and counterclockwise directions over a rotational range of 30 degrees or less, 20 degrees or less, 15 degrees or less, 10 degrees or less, 5 degrees or less, 3 degrees or less, or 1 degree or less. (57) The said order: determining that the robotic medical instrument is docked to the instrument drive mechanism based on an output of the sensor; 51. The system of embodiment 50, further configured to: stop causing vibration of the drive output when the robotic medical instrument is docked. (58) The system of embodiment 50, wherein the threshold loading distance is at least 20 cm, at least 15 cm, at least 10 cm, at least 5 cm, or at least 1 cm. (59) The system of embodiment 50, wherein the threshold loading distance is 20 cm or less, 15 cm or less, 10 cm or less, 5 cm or less, or 1 cm or less. (60) A method comprising the steps of: determining, based on an output of a sensor on an instrument drive mechanism, that a robotic medical instrument is within a threshold load distance of the instrument drive mechanism; and activating a motor associated with a drive output of the instrument drive mechanism to oscillate the drive output to facilitate alignment of the drive output and the corresponding drive input when the robotic medical instrument is within the threshold load distance of the instrument drive mechanism.

[0181] (61) The method of embodiment 60, further comprising placing the motor in an admittance mode in which the robotic medical instrument is within the threshold load distance of the instrument drive mechanism. (62) The method of embodiment 60, wherein the sensor is a proximity sensor. (63) The method of embodiment 60, wherein the sensor is a magnetic sensor. (64) The method of embodiment 60, wherein the sensor is an RFID reader. (65) The method of embodiment 60, wherein the oscillation of the drive output comprises rotation of the drive output back and forth in clockwise and counterclockwise directions over a rotational range of at least 30 degrees, at least 20 degrees, at least 15 degrees, at least 10 degrees, at least 5 degrees, at least 3 degrees, or at least 1 degree.

[0182] (66) The method of embodiment 60, wherein the oscillation of the drive output includes rotation of the drive output back and forth in clockwise and counterclockwise directions over a rotational range of 60 degrees or less, 20 degrees or less, 15 degrees or less, 10 degrees or less, 5 degrees or less, 3 degrees or less, or 1 degree or less. (67) determining, based on an output of the sensor, that the robotic medical instrument is docked to the instrument drive mechanism; 61. The method of embodiment 60, further comprising ceasing vibration of the drive output when the robotic medical instrument is docked. (68) The method of embodiment 60, wherein the threshold loading distance is at least 20 cm, at least 15 cm, at least 10 cm, at least 5 cm, or at least 1 cm. (69) The method of embodiment 60, wherein the threshold loading distance is 20 cm or less, 15 cm or less, 10 cm or less, 5 cm or less, or 1 cm or less.

Claims

1. 1. A robotic medical system, comprising:

1. An instrument drive mechanism comprising: a drive output configured to rotate and engage a corresponding drive input on a handle of a robotic medical instrument, the robotic medical instrument comprising a pre-tensioned pull wire secured by the drive input; a motor associated with the drive output and configured to rotate the drive output; a torque sensor associated with the drive output and configured to measure a torque imparted to the drive output; and At least one processor; at least one computer readable memory in communication with the at least one processor storing computer executable instructions for: activating the motor associated with the drive output during docking of the handle of the robotic medical instrument to the instrument drive mechanism to rotate the drive output in response to a torque signal from the torque sensor associated with the drive output indicative of a magnitude of the torque applied to the drive output; The computer executable instructions cause the at least one processor to start the motor in response to the torque signal exceeding a threshold; the instrument drive mechanism comprises an instrument driver shaft and a rotation assembly; the drive output is housed in the rotating assembly; The system, wherein the handle of the robotic medical instrument, when coupled to the rotating assembly, rotates with the rotating assembly about the instrument driver axis.

2. The system of claim 1 , wherein the computer executable instructions cause the at least one processor to rotate the drive outputs to align the drive outputs with the corresponding drive inputs.

3. The system of claim 1 , wherein the computer executable instructions cause the at least one processor to start or stop the motor in response to the torque signal.

4. the drive output is configured to transfer rotational motion of the motor to the drive input; 2. The system of claim 1, wherein the torque signal further indicates a direction of the torque applied on the drive output, and the computer executable instructions cause the at least one processor to activate the motor to rotate the drive output in the same direction as the direction of the applied torque.

5. 1. A method for matching a drive output of an instrument drive mechanism with a drive input of a robotic medical instrument, comprising: During docking of the robotic medical instrument handle to the instrument drive mechanism, the method includes: receiving a torque signal from a torque sensor associated with the drive output of the tool drive mechanism, the torque signal indicative of a magnitude of torque applied to the drive output; comparing the torque signal to a threshold; activating a motor of the tool drive mechanism associated with the drive output to rotate the drive output in response to the torque signal exceeding the threshold; and in response to the torque signal from the torque sensor falling below the threshold, stopping the motor to cease rotating the drive output. the instrument drive mechanism comprises an instrument driver shaft and a rotation assembly; the drive output is housed in the rotating assembly; The method, wherein the handle of the robotic medical instrument, when coupled to the rotating assembly, rotates with the rotating assembly about the instrument driver axis.

6. The method of claim 5 , wherein the drive output is rotated to align the drive output with the drive input of the robotic medical instrument.

7. the drive output is configured to transfer rotational motion of the motor to the drive input; 7. The method of claim 6, wherein the torque signal further indicates a direction of the torque applied on the drive output, the method including actuating the motor to rotate the drive output in the same direction as the direction of the applied torque.

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