Instrument Roll Control

Abstract

The medical instrument includes an elongate shaft defining a roll axis and a handle coupled to the elongate shaft, the handle including a robotic drive input operable to rotate the elongate shaft relative to the handle about the roll axis, and a lockout mechanism movable between an engaged position, where the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, where the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 150,318, filed February 17, 2021, and entitled "INSTRUMENT ROLL CONTROL," the disclosure of which is incorporated herein by reference in its entirety. [Background technology]

[0002] Certain robotic medical procedures may involve the use of shaft-type instruments, such as endoscopes, that can be inserted into a patient through an orifice (e.g., a natural orifice) and advanced to a target anatomical site. Such medical instruments may be manually rotatable such that the instrument shaft rolls about its axis. [Brief explanation of the drawings]

[0003] Various embodiments are depicted in the accompanying drawings for illustrative purposes and should not be construed as limiting the scope of the present invention in any way. In addition, various features of different disclosed embodiments may be combined to form further embodiments that are part of this disclosure. Throughout the drawings, reference numerals may be reused to indicate correspondence between referenced elements. [Figure 1] 1 illustrates an embodiment of a robotic medical system including a shaft-type instrument coupled to a robotic end effector, according to one or more embodiments. [Figure 2] 1 illustrates a robotic system arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. [Figure 3] 1 illustrates a pedestal-based robotic system according to one or more embodiments. [Figure 4-1] 4 illustrates medical system components that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. [Figure 4-2]4 illustrates medical system components that may be implemented in any of the medical systems of FIGS. 1-3, according to one or more embodiments. [Figure 5] 1 illustrates a shaft-type instrument disposed within a portion of a patient's urinary system, according to one or more embodiments. [Figure 6] FIG. 1 illustrates an exploded view of an instrument manipulator assembly associated with a robotic arm, according to one or more embodiments. [Figure 7A] FIG. 1 illustrates a cutaway perspective view of an instrument handle according to one or more embodiments. [Figure 7B] FIG. 1 illustrates a cutaway perspective view of an instrument handle according to one or more embodiments. [Figure 8] FIG. 1 illustrates a cutaway view of an instrument handle, according to one or more embodiments. [Figure 9] FIG. 1 illustrates a cutaway view of an instrument handle, according to one or more embodiments. [Figure 10] 10-1, 10-2, and 10-3 show perspective views of a roll axis assembly according to one or more embodiments. [Figure 10-4] 10-1, 10-2, and 10-3 show exploded views of the roll axis assembly according to one or more embodiments. [Figure 11A] FIG. 1 illustrates a perspective view of certain instrument handle components including a shaft catch in a locked position, according to one or more embodiments. [Figure 11B] FIG. 1 illustrates a perspective view of certain instrument handle components including a shaft catch in a locked position, according to one or more embodiments. [Figure 11C] FIG. 1 illustrates a perspective view of certain instrument handle components including a shaft catch in a locked position, according to one or more embodiments. [Figure 12A] FIG. 1 illustrates a perspective view of certain instrument handle components, including a shaft catch, in an unlocked position, according to one or more embodiments. [Figure 12B]FIG. 1 illustrates a perspective view of certain instrument handle components, including a shaft catch, in an unlocked position, according to one or more embodiments. [Figure 12C] FIG. 1 illustrates a perspective view of certain instrument handle components, including a shaft catch, in an unlocked position, according to one or more embodiments. [Figure 13-1] FIG. 1 illustrates a perspective view of certain instrument handle components, including an axle catch, according to one or more embodiments. [Figure 13-2] FIG. 1 illustrates a perspective view of certain instrument handle components, including an axle catch, according to one or more embodiments. [Figure 14-1] 10A-10C illustrate a roll lock feature for an instrument in an unlocked and locked configuration / state, respectively, according to one or more embodiments. [Figure 14-2] 10A-10C illustrate a roll lock feature for an instrument in an unlocked and locked configuration / state, respectively, according to one or more embodiments. [Figure 15-1] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 15-2] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 15-3] 1 provides a flow diagram for a process for rolling an instrument shaft, according to one or more embodiments. [Figure 16-1] 15-1, 15-2, and 15-3, respectively, illustrate specific images corresponding to various blocks, states, and / or operations associated with the processes in accordance with one or more embodiments. [Figure 16-2] 15-1, 15-2, and 15-3, respectively, illustrate specific images corresponding to various blocks, states, and / or operations associated with the processes in accordance with one or more embodiments. [Figure 16-3]15-1, 15-2, and 15-3, respectively, illustrate specific images corresponding to various blocks, states, and / or operations associated with the processes in accordance with one or more embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0004] The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed invention. While certain preferred embodiments and examples are disclosed below, the inventive subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as to modifications and equivalents thereof. Accordingly, the scope of claims that may arise from this specification is not limited by any of the specific embodiments described below. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable order and are not necessarily limited to any particular disclosed order. Various operations may be described sequentially as multiple separate operations in a manner that may be helpful in understanding a particular embodiment; however, the order of description should not be construed to imply that these operations are order-dependent. Furthermore, structures, systems, and / or devices described herein may be embodied as integrated or separate components. For purposes of comparing various embodiments, certain aspects and advantages of these embodiments will be described. Not necessarily all such aspects or advantages are achieved by any particular embodiment. Thus, for example, various embodiments may be performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or suggested herein.

[0005] While certain spatially relative terms, such as “outer,” “inner,” “superior,” “lower,” “below,” “upper,” “vertical,” “horizontal,” “top,” “bottom,” “lateral,” and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another, it should be understood that these terms are used herein for ease of description to describe positional relationships between elements / structures, such as with respect to the illustrated orientation of the drawings. It should be understood that spatially relative terms are intended to encompass different orientations of elements / structures during use or operation in addition to the orientation shown in the drawings. For example, an element / structure described as being “above” another element / structure may represent a position below or to the side of such other element / structure, relative to the intended patient or alternative orientations of the element / structure, and vice versa. It should be understood that spatially relative terms, including those listed above, may be understood with respect to the illustrated orientation of each of the referenced figures.

[0006] Certain reference numbers are reused across different figures within a set of figures of this disclosure for convenience of devices, components, systems, features, and / or modules having characteristics that may be similar in one or more respects. However, with respect to any of the embodiments disclosed herein, the reuse of a common reference number in a figure does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, one skilled in the art may be informed by context as to the extent to which the use of a common reference number may imply similarity between the referenced subject matter. The use of a particular reference number in the context of the description of a particular figure may be understood to relate to the identified device, component, aspect, feature, module, or system in that particular figure, and not necessarily to any device, component, aspect, feature, module, or system identified by the same reference number in another figure. Furthermore, aspects of separate figures identified with a common reference number may be construed as sharing characteristics or as being entirely independent of one another. In some contexts, features associated with separate figures identified by a common reference number are unrelated and / or similar, at least with respect to certain aspects.

[0007] The present disclosure provides systems, devices, and methods for implementing and controlling the roll of an instrument shaft, such as a medical endoscope. With respect to the medical instruments described in this disclosure, the term "instrument" is used according to its broad and ordinary meaning and may refer to any type of tool, device, assembly, system, subsystem, apparatus, component, etc. In some contexts herein, the term "device" may be used substantially interchangeably with the term "instrument." Furthermore, the term "shaft" is used herein according to its broad and ordinary meaning and may refer to any type of elongated cylinder, tube, scope (e.g., endoscope), prism (e.g., rectangular, oval, elliptical, or oval prism), wire, or the like, regardless of cross-sectional shape. It should be understood that any reference herein to a "shaft" or "instrument shaft" may be understood to refer to an endoscope.

[0008] medical treatment While certain aspects of the present disclosure are described in detail herein in the context of renal, urinary, and / or nephrological procedures, such as kidney stone removal / treatment procedures, it should be understood that such context is provided for convenience and clarity, and that the robotic and manual instrument shaft roll concepts disclosed herein are applicable to any suitable medical procedure, such as robotic bronchoscopy. However, as noted, a description of the anatomy of the renal / urinary system and related medical problems and procedures is presented below to aid in the explanation of the inventive concepts disclosed herein.

[0009] In certain medical procedures, such as ureteroscopy procedures, an elongated medical instrument accessing the treatment site through an access sheath can be used to remove debris, such as kidney stones and stone fragments or other waste or contaminants, from the treatment site. Kidney stone disease, also known as urolithiasis, is a medical condition involving the formation of solid pieces of material in the urinary tract, referred to as "kidney stones," "urinary stones," "nephrolithiasis," or "nephrolithiasis." Urinary stones can form and / or be found in the kidneys, ureters, and bladder (referred to as "bladder stones"). Such urinary stones can form as a result of the concentration of minerals in urine, and if they reach a size sufficient to obstruct urine flow through the ureter or urethra, they can cause significant abdominal pain. Urinary stones can be formed from calcium, magnesium, ammonia, uric acid, cystine, and / or other compounds, or combinations thereof.

[0010] Several methods can be used to treat patients with kidney stones, including observation, medical treatment (such as expulsion therapy), non-invasive treatment (such as extracorporeal shock wave lithotripsy (ESWL)), minimally invasive or surgical treatment (such as ureteroscopy and percutaneous nephrolithotomy (PCNL)), etc. In some approaches (e.g., ureteroscopy and PCNL), a physician gains access to the stone, the stone is broken up into smaller pieces or fragments, and the smaller stone fragments / particles are extracted from within the kidney using a basket device and / or suction.

[0011] In some procedures, a surgeon may insert an endoscope (e.g., a ureteroscope) through the urethra and into the urinary tract to remove urinary stones from the bladder and ureters. Typically, the ureteroscope includes a camera at its distal end configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotripsy device configured to capture or fragment ureteral stones or allow them to be placed within the working channel of the ureteroscope. During a ureteroscopic procedure, one physician / technologist may control the position of the ureteroscope, while another physician / technologist may control the lithotripsy device.

[0012] In some procedures, such as those for removing relatively large stones / fragments, physicians may use percutaneous nephrolithotomy ("PCNL") techniques, which involve inserting a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site in order to break up and / or remove the stone. The percutaneous access devices (e.g., nephroscopes, sheaths, sheath assemblies, and / or catheters) (and / or direct entry endoscopes) used to provide an access channel to the target anatomical site may include one or more fluid channels for providing irrigation fluid flow to the target site and / or for aspirating fluid from the target site (e.g., through passive outflow and / or active suction).

[0013] In ureteroscopic procedures, physicians may perform procedures to break up relatively large kidney stones into relatively smaller fragments to facilitate their removal. For example, certain instruments may be utilized to break up the stone into smaller fragments, such as by laser treatment or other application of a cleaving force to the kidney stone. According to some procedures, a basket device / system may be used to capture and extract the relatively smaller stone fragments from the treatment site and out of the patient. Generally, when a stone is captured, the surgeon may wish to quickly extract the stone through the ureteral access sheath before opening the basket to deposit / drop the stone into a specimen collection structure or area, after which the basket can be closed and reinserted through the access sheath (e.g., into the working channel of the endoscope / ureteroscope) to extract any remaining stone or stone fragments.

[0014] Robotic-assisted ureteroscopic procedures may be performed in connection with various medical procedures, such as kidney stone removal procedures, where robotic tools may enable physicians / urologists to perform endoscopic target access as well as percutaneous access / treatment. Advantageously, aspects of the present disclosure relate to systems, devices, and methods for robotically controlling the axial rotation / roll of an endoscope / ureteroscope to improve the efficiency and effectiveness of the procedure.

[0015] medical system FIG. 1 illustrates an example medical system 100 for performing various medical procedures in accordance with aspects of the present disclosure. The medical system 100 may be used, for example, in endoscopic (e.g., ureteroscopic) procedures. As mentioned and described above, certain ureteroscopic procedures involve the treatment / removal of kidney stones. In some implementations, kidney stone treatment can benefit from the assistance of certain robotic techniques / devices. Robotic medical solutions can provide relatively greater precision, greater control, and / or better hand-eye coordination for certain instruments compared to strictly manual procedures. For example, robotically assisted ureteroscopic access to the kidney with some procedures can advantageously enable a urologist to independently perform both endoscope control and basket control.

[0016] While the system 100 of FIG. 1 is presented in the context of a ureteroscopic procedure, it should be understood that the principles disclosed herein can be implemented in any type of endoscopic procedure. Furthermore, some of the examples described herein relate to object removal procedures involving the removal of kidney stones from a kidney. However, the present disclosure is not limited to kidney stone removal alone. For example, the following description is also applicable to other surgical or medical procedures involving the removal of objects from a patient, including any object that can be removed from a treatment site or patient cavity (e.g., esophagus, ureter, intestine, eye, etc.) via percutaneous and / or endoscopic access, such as gallbladder stone removal, lung (pulmonary / transthoracic) tumor biopsy, or cataract extraction.

[0017] The medical system 100 includes a robotic system 10 (e.g., a mobile robotic cart) configured to engage and / or control a medical instrument 19 (e.g., a ureteroscope) including a proximal handle 31 and a shaft 40 coupled at its proximal portion to the handle 31, to perform a direct entry procedure on a patient 7. The term "direct entry" is used herein according to its broad and ordinary meaning and may refer to any entry of instrumentation through a natural or artificial opening in a patient's body. For example, with reference to FIG. 1 , direct entry of the scope / shaft 40 into the urinary tract of a patient 7 may occur via the urethra 65.

[0018] It should be understood that the direct entry instrument 19 may be any type of shaft-based medical instrument, including an endoscope (e.g., a ureteroscope), a catheter (e.g., a steerable or non-steerable catheter), a nephroscope, a laparoscope, or other type of medical instrument. The embodiments of the present disclosure relating to a ureteroscopic procedure for removing a kidney stone through a ureteral access sheath (e.g., ureteral access sheath 90) are also applicable to solutions for removing objects through percutaneous access, such as through a percutaneous access sheath. For example, an instrument may access the kidney percutaneously, e.g., through a percutaneous access sheath, to capture and remove a kidney stone. The term “percutaneous access” is used herein in accordance with its broad and ordinary meaning and may refer to entry, such as by puncture and / or small incision, of an instrument through a patient's skin and any other body layers necessary to reach a target anatomical location associated with the procedure (e.g., the calyceal rete of the kidney 70).

[0019] The medical system 100 includes a control system 50 configured to interface with the robotic system 10 to provide information regarding the procedure and / or perform various other operations. For example, the control system 50 may include one or more displays 56 configured to present specific information to assist the physician 5 and / or other technicians or individuals. The medical system 100 may include a platform 15 configured to hold a patient 7. The system 100 may further include an electromagnetic (EM) field generator 18, which may be carried by one or more of the robotic arms 12 of the robotic system 10 or may be a stand-alone device. While the various robotic arms 12 are shown in different positions and coupled to various tools / devices, it should be understood that such configurations are shown for convenience and illustrative purposes, and that such robotic arms may have different configurations over time and / or at different points during a medical procedure. Additionally, robotic arm 12 may be coupled to devices / instruments different from those shown in FIG. 1 , and in some cases or periods, one or more of the arms may not be utilized or coupled to a medical instrument (e.g., an instrument manipulator / coupler). The roll of shaft 40 may be controlled robotically and / or manually, such as through the movement of an end effector associated with robotic arm 12 a, and such movement may be controlled by control system 50 and / or robotic system 10. The term “end effector” is used herein according to its broad and ordinary meaning and may refer to any type of robotic manipulator device, component, and / or assembly. In the case where an adapter, such as a sterile adapter, is coupled to a robotic end effector or other robotic manipulator, the term “end effector” may refer to the adapter (e.g., the sterile adapter) or any other robotic manipulator device, component, or assembly associated with and / or coupled to the end effector.In some contexts, the combination of a robotic end effector and an adapter may be referred to as an instrument manipulator assembly, and such an assembly may or may not also include a medical instrument (or instrument handle / base) physically coupled to the adapter and / or end effector. The terms "robotic manipulator" and "robotic manipulator assembly" are used according to their broad and ordinary meanings and may collectively or individually refer to a robotic end effector and / or a sterile adapter or other adapter component coupled to the end effector. For example, "robotic manipulator" or "robotic manipulator assembly" may refer to an instrument device manipulator (IDM) that includes one or more drive outputs, whether embodied in a robotic end effector, a sterile adapter, and / or other components.

[0020] In an exemplary use case, if a patient 7 has a kidney stone (or stone fragments) 180 located in a kidney 70, a physician may perform a procedure to remove the stone 180 through the ureter (63, 60, 65). In some embodiments, the physician 5 can interact with the control system 50 and / or the robotic system 10 to cause / control the robotic system 10 to advance and navigate a medical instrument shaft 40 (e.g., a scope) from the urethra 65, through the bladder 60, up the ureter 63, and into the renal pelvis 71 and / or calyx rete of the kidney 70 where the stone 180 is located. The physician 5 can further interact with the control system 50 and / or the robotic system 10 to cause / control the advancement of a basket device 30 through the working channel of the instrument shaft 40, the basket device 30 being configured to facilitate capture and removal of the kidney stone or stone fragments. The control system 50 may provide information associated with the medical instrument 40 and / or other instruments of the system 100, such as real-time endoscopic images captured therewith, via the display 56 to assist the physician 5 in navigating / controlling such instruments.

[0021] Renal anatomy is described herein for reference with respect to specific medical procedures related to aspects of the inventive concept. Kidneys 70, shown generally in a typical anatomical location in FIG. 1 , generally comprise two bean-shaped organs located on the left and right sides, respectively, within the retroperitoneal space. In an adult human, the kidneys generally measure approximately 11 cm in height / length. The kidneys receive blood from paired renal arteries 69, and blood leaves the kidneys via paired renal veins 67. Each kidney 70 is fluidly connected to a respective ureter 63, which generally comprises a tube that carries urine drained from the kidney 70 to the bladder 60.

[0022] The kidneys 70 typically lie relatively high within the abdominal cavity, in a retroperitoneal position at a slight oblique angle. Asymmetry within the abdominal cavity, generally caused by the position of the liver, typically causes the right kidney to be slightly lower and smaller than the left, and slightly more centrally located than the left kidney (as shown in detail in FIG. 1 ). Above each kidney is an adrenal gland (not shown). The upper portion of the kidney 70 is partially protected by the 11th and 12th ribs (not shown). Each kidney, along with its adrenal gland, is generally surrounded by two layers of fat: perirenal fat, which resides between the renal fascia and the renal capsule, and pararenal fat, which resides above the renal fascia.

[0023] The kidneys 70 are responsible for regulating the volume of various body fluid compartments, fluid osmolality, acid-base balance, various electrolyte concentrations, and the removal of toxins. The kidneys 70 provide a filtration function by secreting certain substances and reabsorbing others. Examples of substances secreted in urine are hydrogen, ammonium, potassium, and uric acid. In addition, the kidneys also perform various other functions, such as hormone synthesis.

[0024] The recessed area on the concave border of the kidney 70 is the renal hilum 181, where the renal artery 69 (not shown in the detailed view of the kidney 70) enters the kidney 70 and where the renal vein 67 (not shown in the detailed view) and ureter 63 exit. The kidney 70 is surrounded by a tough fibrous tissue, the renal capsule 74, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (back) surface is the transversalis fascia.

[0025] The functional matrix, or parenchyma, of the kidney 70 is divided into two major structures: the outer renal cortex 77 and the inner renal medulla 187. These structures each take the form of multiple roughly conical renal lobes containing a renal cortex surrounding a portion of the medulla called the renal pyramids 72. Between the renal pyramids 72 are processes of the cortex called the renal columns 73. The urine-producing functional structure of the kidney, the nephron (not shown in detail in FIG. 1 ), spans the cortex 77 and medulla 187. The initial filtering portion of the nephron is the renal corpuscle, located in the cortex, followed by the renal duct, which enters the cortex deep into the medullary pyramid. The medullary ray, part of the renal cortex, is a collection of tubules that drain into a single collecting duct.

[0026] The tip / apex, or papilla 79, of each renal pyramid drains urine into a respective minor calyx 75, which drains into a major calyx 76, which drains into the renal pelvis 71, where it empties into the ureter 63. The manifold-shaped collection of minor and major calyxes may be referred to herein as the kidney's "calyx network." At the renal hilum 181, the ureter 63 and renal vein 67 exit the kidney, and the renal artery 69 enters. Hilar fat and lymphatic tissue, along with lymph nodes, surround these structures. The hilar fat is adjacent to a fat-filled cavity called the renal sinus. The renal sinus collectively contains the renal pelvis 71 and calyxes 75, 76 and separates these structures from the renal medullary tissue. The funnel-shaped / tubular anatomical structure associated with the calyx may be referred to as the infundibulum. That is, the infundibulum generally marks the end of the calyx, where the papilla is exposed within the calyx.

[0027] With further reference to the medical system 100, a medical instrument shaft 40 (e.g., a scope, direct entry instrument, etc.) may be advanced through the urinary tract and into the kidney 70. Specifically, a ureteral access sheath 190 may be disposed within the urinary tract to an area near the kidney 70. The shaft 40 may be passed through the ureteral access sheath 190 to access the internal anatomical structure of the kidney 70, as shown. Upon reaching the site of the kidney stone 180 (e.g., within the target calyx 75 of the kidney 70 where the stone 180 is accessible), the medical instrument 19 and / or its shaft 40 may be used to guide / direct the basket device 30 to the target location. Once the stone 180 is captured within the distal basket portion 35 of the basket device 30 / assembly, the kidney stone 180 may be extracted from the patient 7 using the utilized ureteral access pathway.

[0028] Various scope / shaft-type instruments disclosed herein, such as shaft 40 of system 100, can be configured to navigate within the human anatomy, such as within natural orifices or lumens of the human anatomy. The terms “scope” and “endoscope” are used herein according to their broad and ordinary meaning and may refer to any type of elongated (e.g., shaft-type) medical instrument having imaging, viewing, and / or capturing capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space in the body. Scopes can include, for example, ureteroscopes (e.g., for accessing the urinary tract), laparoscopes, nephroscopes (e.g., for accessing the kidneys), bronchoscopes (e.g., for accessing the airways such as the bronchi), colonoscopes (e.g., for accessing the colon), arthroscopes (e.g., for accessing joints), cystoscopes (e.g., for accessing the bladder), colonoscopes (e.g., for accessing the colon and / or rectum), borescopes, etc. The scope / endoscope, in some cases, may comprise at least a portion of a rigid and / or flexible tube and may be sized to be passed through an outer sheath, catheter, introducer, or other luminal device, or may be used without such a device.

[0029] FIG. 2 illustrates a cart-based robotic system 101 arranged for diagnostic and / or therapeutic bronchoscopy, according to one or more embodiments. During bronchoscopy, the arm 12 of the robotic system 10 can be configured to drive a medical instrument shaft 52, such as a steerable endoscope, which may be a procedure-specific bronchoscope for bronchoscopy, through a natural orifice access point (e.g., the mouth of a patient 7 positioned on a table 15 in this example) to deliver diagnostic and / or therapeutic tools. As shown, the robotic system 10 (e.g., a cart) can be positioned adjacent to the patient's upper torso to provide access to the access point. Similarly, the robotic arm 12 can be actuated to position the bronchoscope / shaft 52 relative to the access point. The arrangement in FIG. 2 can also be utilized when gastrointestinal (GI) procedures are performed using a gastroscope, an endoscope specialized for GI procedures.

[0030] Once the robotic system 10 is properly positioned, the robotic arms 12 can insert the steerable endoscope 52 into the patient robotically, manually, or a combination thereof. The steerable endoscope 52 can include at least two telescoping parts, such as an inner leader section and an outer sheath section, each coupled to a separate instrument feeder from a set of instrument feeders and / or instrument handles 111, with each instrument feeder / handle coupled to the distal end of a respective robotic arm 12. This linear arrangement of feeders / handles 111 can create a “virtual rail” 103 that can be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or positions. One or more of the instrument feeders / handles 111 can be configured to implement a robotic roll of the shaft and can be configured according to one or more embodiments disclosed herein for such purpose.

[0031] After insertion, the endoscope 52 can be directed downstream of the patient's trachea and lungs using precise commands from the robotic system 10 until it reaches the target surgical site. For example, the endoscope 52 can be directed to deliver a biopsy needle to a target, such as a lesion or nodule, within the patient's lung. The needle can be deployed through the working channel along the length of the endoscope to obtain a tissue sample that can be analyzed by a pathologist. Depending on the pathology results, additional tools can be deployed through the endoscope's working channel for further biopsies. For example, when a nodule is identified as malignant, the endoscope 52 can deliver tools endoscopically to remove potentially cancerous tissue. In some cases, diagnostic and therapeutic treatments can be delivered in separate procedures. In these situations, the endoscope 52 can also be used to deliver fiducials to "mark" the location of the targeted nodule. In other cases, diagnostic and therapeutic treatments can be delivered during the same procedure.

[0032] In system 101, patient introducer 102 is attached to patient 7 via a port (not shown, e.g., surgical tubing). The curvature of introducer 102 may allow robotic system 10 to manipulate instruments 52 from positions that are not directly axially aligned with the patient access port, thereby allowing greater flexibility in placement of robotic system 10 within a room. Furthermore, the curvature of introducer 102 may allow robotic arm 12 of robotic system 10 to be substantially horizontally aligned with patient introducer 102, which may facilitate manual movement of robotic arm 12 as needed. Control system 50 and / or robotic cart 10 may include control circuitry configured to implement scope roll control as described herein.

[0033] 3 illustrates a pedestal-based robotic system 104 in accordance with one or more embodiments of the present disclosure. The system 104 incorporates the robotic components 105 into a pedestal / platform 147, thereby allowing for a reduced amount of capital equipment in the operating room compared to some cart-based robotic systems, which in some cases may allow for greater access to the patient 7. Similar to cart-based systems, the instrument device manipulator assembly associated with the robotic arm 212 of the system 104 may generally comprise an instrument and / or instrument feeder designed to manipulate an elongated medical instrument / shaft, such as a catheter 48, along a virtual rail or path.

[0034] As shown, the robotic table system 104 can include a column 144 coupled to one or more carriages 141 (e.g., a ring-shaped movable structure) from which one or more robotic arms 212 can emanate. The carriage 141 can translate along a vertical column interface over at least a portion of the length of the column 144 to provide different vantage points from which the robotic arms 212 can be positioned to reach the patient 7. In some embodiments, the carriage 141 can rotate about the column 144 using a mechanical motor positioned within the column 144 to allow the robotic arms 212 to access multiple sides of the table 104. The rotation and / or translation of the carriage 141 can enable the system 104 to position medical instruments, such as endoscopes and catheters, to different access points on the patient. By providing vertical adjustment, the robotic arms 212 can advantageously be configured to be compactly stored beneath a platform 147 of the table system 104 and then elevated during a procedure.

[0035] The robotic arm 212 may be mounted to the carriage 141 through one or more arm mounts 145, which may comprise a series of joints that may rotate independently and / or extend telescopically to provide additional configurability for the robotic arm 212. A column 144 structurally provides support for the base platform 147 and a path for vertical translation of the carriage 141. The column 144 may also transmit power and control signals to the carriage 141 and / or the robotic arm 212 mounted thereon. The system 104 may include specific control circuitry configured to control the drive and / or roll of the instrument shaft 240 using an instrument feeder 211, which may be coupled to an end effector of one of the arms 212, and the instrument feeder 211 is controlled to automatically modify the axial drive speed with respect to the elongated instrument (e.g., endoscope) 48 based on a determined position of the distal end of the instrument 48. For example, when the distal end of the instrument 48 is positioned at a predetermined automatic pause location, the instrument feeder 211 may be controlled / driven to automatically pause / stop axial retraction to allow specimen collection, as described in detail herein.

[0036] 1-3 and 4-1 , which illustrate an exemplary embodiment of a control system for any of FIGS. 1-3 , an associated control system 50 can be configured to provide various functions to assist in the performance of a medical procedure. In some embodiments, the control system 50 can be coupled to the robotic system 10 and operate in cooperation with the robotic system 10 to perform a medical procedure on a patient 7. For example, the control system 50 can communicate with the robotic system 10 via a wireless or wired connection (e.g., to control the robotic system 10). Additionally, in some embodiments, the control system 50 can communicate with the robotic system 10 to receive position data therefrom regarding the position of the distal end of the scope 40, the access sheath 90, or the basket device 30. Such position data regarding the position of the scope 40, the access sheath 90, or the basket device 30 can be derived using one or more electromagnetic sensors associated with the respective components, scope image processing capabilities, and / or based at least in part on robotic system data (e.g., arm position data, known parameters / dimensions of various system components, etc.). Additionally, in some embodiments, the control system 50 may communicate with the table 15 to position the table 15 in a particular orientation or otherwise control the table 15. In some embodiments, the control system 50 may communicate with the EM field generator 18 to control the generation of the EM field around the patient 7 and / or in the area of the instrument feeder 11.

[0037] FIG. 4-1 further illustrates an exemplary embodiment of the robotic system of any of FIGS. 1-3. The robotic system 10 can be configured to at least partially facilitate the performance of a medical procedure. The robotic system 10 can be arranged in various ways depending on the particular procedure. The robotic system 10 can include, for example, one or more robotic arms 12 configured to engage and / or control a scope 40 and / or basket device / system 30 to perform one or more aspects of the procedure. As shown, each robotic arm 12 can include multiple arm segments 23 coupled to joints 24 that can provide multiple degrees of movement / freedom. In the example of FIG. 1, the robotic system 10 is positioned adjacent a patient's leg, and the robotic arm 12 is actuated to engage and position the scope 40 for access into an access opening, such as the urethra 65 of the patient 7. Once the robotic system 10 is properly positioned, the scope 40 can be inserted into the patient 7 robotically using the robotic arm 12, manually by the physician 5, or a combination thereof. 1 , a scope-driver / feeder instrument coupler 11 (i.e., an instrument device manipulator (IDM)) can be attached to the distal end effector 22 of one of the arms 12b to facilitate robotic control / advancement of the scope 40. Another of the arms 12a can be associated with an instrument coupler / manipulator 19 configured to facilitate advancement and operation of a basket device 30. The instrument coupler 19 can further provide a handle 31 for the scope 40, which is physically coupled to the handle 31 at the proximal end of the scope 40. The scope 40 can include one or more working channels through which additional tools, such as a lithotriptor, basket device, forceps, etc., can be introduced into the treatment site.

[0038] The robotic system 10 may be coupled to any component of the medical system 100, such as the control system 50, the platform 15, the EM field generator 18, the scope 40, the basket system 30, and / or any type of percutaneous access instrument (e.g., needle, catheter, nephroscope, etc.). In some embodiments, the robotic system 10 is communicatively coupled to the control system 50. For example, the robotic system 10 may be configured to receive control signals from the control system 50 to perform specific operations, such as positioning one or more of the robotic arms 12 in a particular manner, manipulating the scope 40, or manipulating the basket system 30. In response, the robotic system 10 may control components of the robotic system 10 to perform the operations using specific control circuits 211, actuators 217, and / or other components of the robotic system 10. For example, the control circuit 211 may control the roll of the shaft / scope 40 by actuating the drive output 402 of the end effector 22 coupled to the instrument handle 31. In some embodiments, the robotic system 10 and / or control system 50 are configured to receive images and / or image data from the scope 40 representing the internal anatomical structure of the patient 7 and / or portions of the access sheath or other device components.

[0039] The robotic system 10 generally includes an elongated support structure 14 (also referred to as a "column"), a robotic system base 25, and a console 13 at the top of the column 14. The column 14 may include one or more arm supports 17 (also referred to as a "carriage") for supporting the deployment of one or more robotic arms 12 (three are shown in FIG. 1). The arm supports 17 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arms 12 for more desired positioning relative to the patient.

[0040] The arm support 17 can be configured to translate vertically along the column 14. In some embodiments, the arm support 17 can connect to the column 14 through slots 20 positioned on either side of the column 14 to guide the vertical translation of the arm support 17. The slots 20 accommodate vertical translation interfaces for positioning and holding the arm support 17 at various vertical heights relative to the robotic system base 25. The vertical translation of the arm support 17 allows the robotic system 10 to adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, individually configurable arm mounts on the arm support 17 can allow the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0041] The robotic arm 12 may generally comprise a robotic arm base 21 and an end effector 22 separated by a series of articulated arm segments 23 connected by a series of joints 24, each joint comprising one or more independent actuators 217. Each actuator may comprise an independently controllable motor. Each independently controllable joint 24 may provide or represent an independent degree of freedom available to the robotic arm. In some embodiments, each of the arms 12 has seven joints, thus providing seven degrees of freedom, including a “redundant” degree of freedom. The redundant degrees of freedom allow the robotic arm 12 to position its respective end effector 22 at a specific position, orientation, and trajectory in space using various link positions and joint angles. This allows the system to position and orient medical instruments from a desired location in space, while also allowing the physician to move the arm joints to a clinically convenient position away from the patient to create greater access while avoiding arm collisions.

[0042] The robotic system base 25 balances the weight of the column 14, arm support 17, and arm 12 on the floor. Thus, the robotic system base 25 can house certain relatively heavier components, such as electronics, motors, power supplies, and components that selectively enable movement or immobilize the robotic system. For example, the robotic system base 25 can include casters 28 in the form of wheels that allow the robotic system to be easily moved around the operating room before a procedure. After reaching the appropriate position, the casters 28 can be locked using wheel locks to hold the robotic system 10 in place during a procedure.

[0043] When positioned at the top of the column 14, the console 13 can provide both a user interface for receiving user input and a display screen 16 (or dual-purpose device, e.g., a touchscreen) for providing both pre- and intra-operative data to the physician / user. Potential pre-operative data on the console / display 16 or display 56 can include pre-operative planning, navigation and mapping data derived from a pre-operative computerized tomography (CT) scan, and / or notes from a pre-operative patient interview. Intra-operative data on the display can also include vital patient statistics such as respiration, heart rate, and / or pulse, along with optical information provided by tools, sensor information from sensors, and coordinate information. The console 13 can be positioned and tilted to allow a physician to access the console from the side of the column 14 opposite the arm support 17. From this position, the physician can view the console 13, the robotic arm 12, and the patient while operating the console 13 from behind the robotic system 10. As shown, the console 13 may also include a handle 27 to assist in manipulating and stabilizing the robotic system 10 .

[0044] Each end effector 22 of the robotic arm 12 may include or be configured to couple to an instrument device manipulator (IDM) 29, which in some cases may be attached using a sterile adapter component. The combination of the end effector 22 and associated IDM, as well as any intervening articulations or couplers (e.g., sterile adapters), may be referred to as a manipulator assembly 111. In some embodiments, the IDM 29 may be removed and replaced with a different type of IDM; for example, a first type of IDM / instrument 11 may be configured to manipulate the endoscope / shaft, and a second type of IDM / instrument 19 may be associated with the shaft (e.g., coupled to a proximal portion thereof) and configured to roll and / or articulate the shaft and / or manipulate a basket device. Another type of IDM / instrument may be configured to hold the electromagnetic field generator 18. The IDM may provide a power and control interface. For example, the interface may include connectors for transmitting pneumatic pressure, power, electrical signals, and / or optical signals from the robotic arm 12 to the IDM. The IDM 29 may be configured to manipulate a medical instrument (e.g., a surgical tool / instrument), such as a scope 40, using techniques including, for example, direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, and the like. In some embodiments, the device manipulator 29 may be attached to a respective one of the robotic arms 12, which are configured to insert or retract each associated medical instrument into or from a treatment site.

[0045] As noted above, system 100 may include specific control circuits configured to perform specific functions described herein, including control circuitry 211 of robotic system 10 and control circuitry 251 of control system 50. That is, the control circuitry of systems 100, 101, and 104 may be part of robotic system 10, control system 50, or some combination thereof. Accordingly, all references herein to control circuits may refer to circuitry embodied in a robotic system, a control system, or any other component of a medical system, such as medical systems 100, 101, and 104 shown in FIGS. 1-3, respectively. The term “control circuitry” is used herein according to its broad and ordinary meaning and may refer to any collection of processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connectivity circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any devices that manipulate signals (analog and / or digital) based on hard-coded and / or operational instructions in the circuitry. Control circuitry referred to herein may further include one or more circuit boards (e.g., printed circuit boards), conductive traces and vias, and / or mounting pads, connectors, and / or components. Control circuitry referred to herein may further comprise one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuitry of a device. Such data storage devices may comprise read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information.It should be noted that in embodiments in which the control circuitry comprises hardware and / or software state machines, analog circuits, digital circuits, and / or logic circuits, the data storage devices / registers that store any associated operational instructions may be embedded within or external to the circuitry that comprises the state machines, analog circuits, digital circuits, and / or logic circuits.

[0046] The control circuits 211, 251 may include computer-readable media configured to store and / or store hard-coded and / or operational instructions corresponding to at least some of the steps and / or functions illustrated in one or more of the present figures and / or described herein. Such computer-readable media may, in some cases, be included in an article of manufacture. The control circuits 211 / 251 may be maintained / distributed entirely locally or may be at least partially remotely located (e.g., indirectly communicatively coupled via a local area network and / or wide area network). Either of the control circuits 211, 251 may be configured to perform any aspect of the various processes disclosed herein, including the processes shown in Figures 15-1 and 15-2, as described below.

[0047] With respect to robotic system 10, at least a portion of control circuitry 211 may be integrated with base 25, column 14, and / or console 13 of robotic system 10, and / or another system communicatively coupled to robotic system 10. With respect to control system 50, at least a portion of control circuitry 251 may be integrated with console base 51 and / or display unit 56 of control system 50. It should be understood that any description herein of functional control circuitry or related functionality may also be understood to be embodied at least in part in robotic system 10, control system 50, or any combination thereof, and / or in one or more other local or remote systems / devices, such as control circuitry associated with the handle / base of a shaft-type instrument (e.g., an endoscope) according to any of the disclosed embodiments.

[0048] With further reference to FIG. 4-1 , the control system 50 can include various I / O components 258 configured to assist the physician 5 or others in performing a medical procedure. For example, the input / output (I / O) components 258 can be configured to allow user input to control / navigate the scope 40 and / or basket system within the patient 7. In some embodiments, for example, the physician 5 can provide input to the control system 50 and / or the robotic system 10, and in response to such input, can send control signals to the robotic system 10 to operate the scope 40 and / or the catheter basket system 30. The control system 50 can include one or more display devices 56 to provide various information regarding the procedure. For example, the display 56 can provide information regarding the scope 40 and / or the basket system 30. For example, the control system 50 can receive real-time images captured by the scope 40 and display the real-time images via the display 56. Additionally or alternatively, control system 50 may receive signals (e.g., analog, digital, electrical, acoustic / sonic, pneumatic, tactile, hydraulic, etc.) from medical monitors and / or sensors associated with patient 7, and display 56 may present information regarding the health or environment of patient 7. Such information may include, for example, information displayed via the medical monitor, such as heart rate (e.g., ECG, HRV, etc.), blood pressure / blood velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, brain waves (e.g., EEG), environmental and / or local or core body temperature information.

[0049] The various components of system 100 can be communicatively coupled to one another over a network, which can include wireless and / or wired networks. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), cellular networks, the Internet, personal area networks (PANs), body area networks (BANs), etc. For example, the various communication interfaces of the system of FIG. 4-1 can be configured to communicate with one or more devices / sensors / systems, such as over wireless and / or wired network connections. In some embodiments, the various communication interfaces can implement wireless technologies such as Bluetooth, Wi-Fi, near field communication (NFC), etc. Furthermore, in some embodiments, the various components of system 100 can be connected for data communication, fluid exchange, power exchange, etc. via one or more supporting cables, conduits, etc.

[0050] The control system 50 and / or the robotic system 10 may include specific user controls (e.g., controls 55), which may comprise any type of user input (and / or output) device or device interface, such as one or more buttons, keys, joysticks, handheld controllers (e.g., video game-style controllers), computer mice, trackpads, trackballs, control pads, and / or sensors (e.g., motion sensors or cameras) that capture hand and finger gestures, touchscreens, and / or interfaces / connectors therefor. Such user controls are communicatively and / or physically coupled to respective control circuits. In some embodiments, a user may engage the user controls 55 to command robot shaft rotation / roll as described herein.

[0051] FIG. 4-2 illustrates medical system components including a scope 519 and basket 30 device / assembly 519 that can be implemented in any of the medical systems of FIGS. 1-3 according to one or more embodiments. In some embodiments, the scope assembly 519 includes a handle or base 31 coupled to an endoscope 40. For example, the endoscope (i.e., "scope" or "shaft") can include an elongated shaft that includes one or more lights 49 and one or more cameras or other imaging devices 48. The scope 40 can further include one or more working channels 44 that can run the length of the scope 40. In some embodiments, such channels can be utilized to provide access for elongated basket wires / tines through the scope 40.

[0052] The basket assembly 30 can include a basket 35 formed from one or more wire tines 36. For example, the basket system 30 can include four wire tines disposed along its length within a basket sheath 37, with the tines protruding from the distal end of the sheath 37 to form the basket shape 35. The tines 36 extend further from the proximal end of the sheath 37. The tines 36 can be configured to be slidable within the basket sheath 37 with some frictional resistance. The tines 36 and sheath 37 can be coupled to respective actuators 195 of the basket cartridge component 32. The basket cartridge 32 can be physically and / or communicatively coupled to a handle portion / component 31 of the scope assembly 519. The handle component 31 can be configured to be used to assist in basket and / or scope control, either manually or through robotic control.

[0053] The scope assembly 519 may be powered through a power interface 79 and / or controlled through a control interface 78, each or both of which may interface with a robotic arm / component of the robotic system 10. The scope assembly 519 may further include one or more sensors 72, such as pressure and / or other force reading sensors, which may be configured to generate signals indicative of forces experienced at / by one or more of the actuators 195 and / or other couplings of the scope / basket system 519.

[0054] The scope assembly 519 includes a specific mechanism for rolling the shaft 40 about its axis (e.g., rolling about the shaft axis at its base / proximal end). For example, the shaft 40 may be associated with a roll gear component 45 at its proximal portion. Such roll gear 45 may have one or more teeth or other features configured to mesh with or engage with an actuator component associated with the handle 31 of the scope assembly 519. The scope assembly shaft 40 may be rolled / rotated by actuating the roll gear 45 using one or more actuator components (e.g., gears, belts, shafts, etc.) associated with the handle 31. In some embodiments, the scope / shaft 40 includes a strain relief component 43, which may include a rubber cone or other feature / material configured to reduce strain on the proximal portion / end of the shaft from bending of the shaft and / or reduce the bend angle at the proximal portion of the shaft.

[0055] The roll gear 45 of the shaft 40 may be at least partially disposed within the housing 80 of the handle 31. Additionally, additional components configured to cause the roll gear 45 and the shaft 40 to roll / rotate may be at least partially disposed within the housing 80. In some embodiments, the handle 31 is associated with an externally accessible / actuable roll axis 85, which may include a drive input configured to rotate about an axis when engaged with a drive output of a robot end effector and / or an adapter associated therewith. In some embodiments, the roll axis 85 has an axis that is transverse, orthogonal, and / or perpendicular to the axis of the roll gear 45 and / or the shaft 40. Accordingly, the handle 31 may further include an angle conversion gear 89, which may be configured to transfer / convert the rotation of the roll axis 85 to an axis that is parallel to the axis of the roll gear 45. The angle conversion gear 89 may be, for example, a bevel gear that meshingly engages the roll axis 85 or the roll gear 45. The rotation / roll transmission 83 may be configured to transfer the rotation of the roll shaft 85 to the rotation of the roll gear 45 through some type of direct or indirect physical coupling between the roll shaft 85 and the roll gear 45. For example, the roll transmission 83 may comprise one or more belts, cables, rods, etc. In some embodiments, the roll shaft 85 is accessible through an opening in the underside of the handle 31.

[0056] The scope assembly may further include a roll axis catch or locking means / mechanism 90, which may comprise structure configured to operate to either a locked configuration in which its key component 95 is engaged with a mating feature on the roll axis 85, or an unlocked position in which the key component 95 is not engaged with a mating feature on the roll axis 85. The roll axis catch 90 may further include an actuator component 91, which may be integral with the body of the roll axis 90 and / or the key feature 95. The actuator 91 may be accessible through an opening or other access 81 in the housing 80, which allows actuation of the roll axis catch actuator 91 from outside the handle 31 and / or housing 80. The various components of the scope assembly 519 are described in more detail below.

[0057] Scoped Roles FIG. 5 illustrates a ureteroscope 40 disposed within a portion of a patient's urinary system, according to one or more embodiments. As mentioned above, ureteroscopic procedures can be performed to investigate and / or treat abnormalities within a person's ureter. For example, ureteroscopic procedures can be performed to treat and / or remove kidney stones. Such procedures can be performed at least partially manually and / or at least partially using robotic technology. For example, the use of robotic devices and / or systems for certain endoscopic procedures can provide relatively greater precision, control, and / or coordination compared to strictly manual procedures. In some embodiments, the scope 40 includes a working channel 44 for deploying the basket device 30 (e.g., basket component 35) into a working area at the distal end of the scope 40.

[0058] The scope / shaft (e.g., endoscope / ureteroscope) 40 may comprise a tubular and flexible medical shaft / instrument configured to be inserted into a patient's anatomy to capture images of the anatomy and to perform a specific task using its one or more working channels. In some embodiments, the scope 40 may house an optical assembly that may include an imaging device 48, such as an optical camera, and wires and / or fiber optics for transmitting signals to / from the distal end 42 of the scope 40. The scope 40 may further include a light source 49, such as an LED or fiber optic light source / lens.

[0059] The scope shaft 40 may be advanced to the target location through the access sheath 190. The access sheath 190 may be advanced through the ureter 63 to a position near the renal pelvis 71 and / or the ureteropelvic junction 71. The distal end of the access sheath 190 may be left in place at a position within the ureter 63 and / or the renal pelvis 71. The access sheath 190 may be positioned as deep within the renal anatomy as permitted by the urinary tract pathway, which may be somewhat tortuous within certain portions thereof. Generally, the access sheath 190 may not be articulatable to the extent that the scope 40 can be articulated, and therefore, it may not be practical to navigate / drive the access sheath 190 into the kidney.

[0060] The scope 40 may be articulatable, such as relative to at least a distal portion 230 of the scope 40, so that the scope 40 can be maneuvered within the human anatomy. In some embodiments, the scope 40 is configured to be articulated with six degrees of freedom, including, for example, XYZ coordinate translation as well as pitch, yaw, and roll. Certain position sensors (e.g., electromagnetic sensors) of the scope 40, if implemented, may have similar degrees of freedom with respect to the position information they generate / provide.

[0061] In a robotic implementation, a robotic arm of the robotic system may be configured / configurable to manipulate the scope 40. For example, an instrument device manipulator (e.g., a scope handle) may be coupled to the end effector of the robotic arm and may manipulate the scope 40 using an elongated movement member. The elongated movement member may include one or more pull wires (e.g., pull or push wires), cables, fibers, and / or a flexible shaft. For example, the robotic arm may be configured to actuate multiple pull wires (not shown) coupled to the scope 40 to deflect the tip 42 of the scope 40. The pull wires may include any suitable or desirable material, such as metallic and non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, and the like. In some embodiments, the scope 40 is configured to exhibit nonlinear behavior in response to forces applied by the elongated movement member. The nonlinear behavior may be based on the stiffness and compressibility of the scope and the variability in slack or stiffness between different elongated movement members.

[0062] A camera / imaging device 48 can be used to capture images of an internal anatomical space, such as the internal cupule of kidney 70. Scope 40 can be further configured to house an optical fiber for carrying light from a proximally located light source, such as a light emitting diode, to the distal end 42 of the scope. In some embodiments, scope 40 is configured to be controlled by a robotic system similar in one or more respects to robotic systems 100, 101, and 104 shown in FIGS. 1, 2, and 3, respectively.

[0063] In some embodiments, the shaft (e.g., scope) 40 includes a sensor configured to generate and / or transmit sensor position data to another device or to generate a detectable distortion or signature in an electromagnetic field. The sensor position data can indicate the position and / or orientation of the medical instrument 40 (e.g., its distal end 42) and / or can be used to determine / estimate the position / orientation of the medical instrument. For example, the sensor (sometimes referred to as a “position sensor”) can include an electromagnetic (EM) sensor having a coil of conductive material or other form / embodiment of an antenna.

[0064] Embodiments of the present disclosure relate to the implementation of robotically controlled shaft roll and locking of the shaft roll function when an instrument is undocked from a robotic system. Such robotic shaft roll can be restricted to a limited angle of rotation, which can prevent instrument damage. When a medical instrument and / or its handle is unlatched, undocked, or otherwise separated from a robotic end effector and / or its associated adapter (e.g., sterile adapter) component, the medical instrument and / or its handle may be considered "off the robot," while when the medical instrument and / or its handle is latched, docked, or otherwise coupled to a robotic end effector and / or its associated adapter (e.g., sterile adapter) component, the medical instrument and / or its handle may be considered "on the robot."

[0065] The instrument base / handle 31 may be configured to be attached to, mounted to, or otherwise connected or coupled to the robotic end effector 6. For example, the robotic arm may include an instrument drive mechanism / assembly with an end effector and / or a sterile adapter, and the instrument base / handle 31 may be attached to the instrument drive mechanism / assembly. The instrument drive mechanism may include drive outputs configured to engage and actuate corresponding drive inputs on the instrument base / handle 31 to manipulate the medical instrument 19. For example, one or more drive outputs of the robotic end effector 6 may be configured to control shaft roll, as described in detail herein. The drive outputs of the end effector may be coupled to one or more drive couplings of an adapter (e.g., a sterile adapter) configured to transfer drive torque from the drive output of the end effector to the drive output of the adapter. References herein to a robotic end effector and / or drive output or other features may be understood to refer to the adapter (e.g., a sterile adapter) and / or drive output of the adapter coupled to the end effector. For example, references to docking an instrument onto an end effector should be understood to refer to docking the instrument onto the adapter when the adapter is coupled to the end effector.

[0066] In some configurations, the elongated shaft 40 of the medical instrument 19 is arranged to form a service loop 43 between the instrument handle 31 and the instrument feeder 11 and / or the associated robotic arm. The service loop 43 may include the length of the shaft 40 between the instrument base 31 / handle and the feeder device 11. The length of the shaft 40 may be greater than or equal to the distance D between the instrument base / handle 31 and the feeder device 11. a(See FIG. 1 ), the shaft 40 will hang down (and / or to the side) and a service loop 43 may be formed between the instrument base / handle 31 and the feeder device 11. The service loop 43 can provide slack in the shaft 40 that can be used to allow for faster insertion and / or retraction of the shaft 40. For example, during insertion, slack in the service loop 49 can be addressed (shortening or contracting the service loop 49). During retraction, the service loop 49 can be created (increasing or expanding in length).

[0067] The scope 40 is located in the first / primary plane P p The scope 40 may also be deflectable in one or two directions within the primary plane P p A second / secondary plane P that can be perpendicular to s For example, it may be desirable for at least the distal portion 230 of the scope 40 to be deflectable in two or more planes to reach a desired area, such as a particular forward- or rearward-facing cup. p and secondary deflection surface P s is shown in a particular configuration, the illustrated quadratic plane P s is the first order plane P p It should be understood that it may be the case that

[0068] In some embodiments, the scope 40 includes a distal articulation section 230. One or more cables, pull wires, or pull wire segments can run along the exterior surface of the shaft 40. Additionally, one or more cables can run along a central lumen of the shaft 40. Manipulation of the one or more cables results in actuation or deflection of the articulation section 230. Manipulation of the one or more cables can be controlled via one or more instrument drivers positioned within or connected to the instrument base / handle 31.

[0069] The instrument base / handle 31 can generally include a mounting interface having one or more mechanical inputs (e.g., receptacles, pulleys, spools, female inputs, etc.) designed to reciprocate with one or more torque couplers on a mounting surface of the instrument driver. The instrument handle 31 can include multiple drive inputs. Multiple control cables can be coupled to the multiple drive inputs and extend along the flexible shaft 40. The multiple drive inputs can be configured to control or apply tension to multiple pull wires or control cables in response to drive outputs from the medical robotic system.

[0070] To navigate the scope 40 through the anatomy, the articulation 230 of the scope 40 is aligned in a primary plane P p The distal portion of the articulation portion 230 can be deflectable in a secondary plane P s The distal portion of the articulation section 230 may be further deflectable in two directions within the secondary plane P. Thus, the distal portion of the articulation section 230 may be deflectable in two planes and four directions (e.g., left / right and up / down). The bending radius of the scope 40 may be deflectable in the secondary plane P. s (e.g., less than 180° in either direction) than in the primary plane P p (e.g., up to 270° or more in either direction). This therefore maximizes the reach of the articulating portion 230 of the scope 40 within the calyceal network of the kidney 70, by providing a primary plane P p is the kidney plane P k It may be desirable for the handle 31 to be aligned with the end effector 6. The physician may attempt to manually achieve such alignment through manual manipulation of the handle 31 before docking it to the end effector 6. After manual alignment, the physician may dock the handle 31 onto the end effector 6, which may result in, for example, a roll / rotation of the shaft of approximately 90°. Embodiments of the present disclosure allow for compensation for such out-of-alignment rotation / roll through robot roll control, which in some implementations may be performed automatically after docking of the handle 31.

[0071] Robotic roll control according to aspects of the present disclosure can involve rotation of the elongate shaft 40 relative to the instrument handle 31 about the longitudinal axis of the elongate shaft 40, at least at its proximal end. References herein to shaft roll / rotation about its axis should be understood to refer to rotation of the shaft about its axis, at least at the proximal end or portion of the shaft. Rotation of the shaft 40 relative to the handle 31 can be performed relative to the renal plane P, which may be the patient's superior-inferior plane. k The scope 40 may be operable to align the shaft 40 within the kidney 70. For example, the kidney 70 may be variable in shape, size, and configuration, but can be roughly generalized as a generally planar structure having an upper pole, a middle pole, and an lower pole. From each of these poles stems a series of calyces that point anteriorly or posteriorly. The scope 40 may be rotated / rolled to align the articulation 230 with the direction of the target calyx.

[0072] FIG. 6 shows an exploded view of an instrument device manipulator assembly 150 associated with a robotic arm 12, according to one or more embodiments. The instrument device manipulator assembly 150 includes an end effector 6 associated with the distal end of the robotic arm 12. The instrument manipulator assembly 150 further includes a handle 31 for a shaft-type instrument 19. The instrument handle 31 can incorporate mechanical (and / or electrical) means for rolling / rotating a shaft component associated therewith, such as an endoscope or other shaft-type instrument. Descriptions herein of upper- and lower-oriented surfaces, plates, faces, components, and / or other features or structures can be understood with reference to the particular orientation of the instrument device manipulator assembly 150 shown in FIG. 6 when assembled (rather than the tilted, exploded orientation shown). That is, although the end effector 6 may generally be configurable to face and / or be oriented in a range of directions and orientations, for convenience, descriptions of such components herein (and components / devices directly or indirectly attached / latched thereto) may be within the context of the generally vertically facing orientation of the end effector 6 shown in FIG. 6.

[0073] In some embodiments, the instrument device manipulator assembly 150 further includes an adapter component 8 mountable to the end effector 6 and configured to provide a driver interface between the end effector 6 and the instrument handle 31. The adapter 8 and / or the instrument handle 31 may be removable or detachable from the robotic arm 12 and, in some embodiments, may lack any electromechanical components, such as motors. This dichotomy may be caused by the need to sterilize medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to the medical instruments' complex mechanical assemblies and sensitive electronics. Therefore, the instrument handle 31 and / or the adapter 8 may be designed to be detached, removed, and replaced from the end effector 6 (and thus the system) for individual sterilization or disposal. In contrast, the end effector 6, in some cases, does not need to be replaced or sterilized and may be covered (e.g., using a drape 301) for protection.

[0074] In some embodiments, the adapter 8 can include connectors for transmitting air pressure, power, electrical signals, and / or optical signals from the robotic arm 12 and / or end effector 6 to the instrument handle 31. The robotic arm 12 can advance / insert or retract the coupled instrument handle 31 into and out of a treatment site. In some embodiments, the instrument handle 31 can be removed and replaced with a different type of instrument. The end effector 6 of the robotic arm 12 can include various components / elements configured to connect to and / or align with components of the adapter 8, the instrument handle, and / or the shaft 40. For example, the end effector 6 may include a drive output 302 (e.g., a drive spline, gear, or rotatable disk with mating features) for controlling / articulating the medical instrument, a reader 304 for reading data from the medical instrument (e.g., a radio-frequency identification (RFID) reader for reading a serial number from the medical instrument), one or more fasteners 306 for attaching the instrument handle 31 and / or the adapter 8 to the end effector 6, and a marker 308 for aligning with an instrument (e.g., an access sheath) manually attached to the patient and / or for defining a front surface of the device manipulator assembly 150. In some embodiments, a portion (e.g., a plate) 315 of the adapter 8 may be configured to rotate / spin independently of one or more other components of the adapter 8 and / or end effector 6 when coupled to the end effector 6. The adapter 8 may include one or more outputs 309 configured to mate / couple with corresponding inputs 602 of the handle 31.

[0075] In some configurations, a sterile drape 301, such as a plastic sheet, may be disposed between the end effector 6 and the adapter 8 to provide a sterile barrier between the robotic arm 12 and the instrument handle 31. For example, the drape 301 may be coupled to the adapter 8 in such a manner to enable transmission of mechanical torque from the end effector 6 to the adapter 8. The adapter 8 may generally be configured to maintain a seal around its working components such that the adapter 8 itself provides a sterile barrier. The use of the drape 301 coupled to the adapter 8 and / or more other components of the device manipulator assembly (i.e., “robotic manipulator” or “robotic manipulator assembly”) 150 may provide a sterile barrier between the robotic arm 12 and a surgical field, thereby enabling use of a robotic cart associated with the arm 12 in a sterile surgical field. The end effector 6 may be configured to be coupled to various types of sterile adapters that may be loaded onto and / or removed from the end effector 6 of the robotic arm 12. With the arm 12 covered in plastic, a physician and / or other technician may interact with the arm 12 and / or other components of the robotic cart (e.g., a screen) during a procedure. The draping may further protect against biohazard contamination of the equipment and / or minimize post-procedure cleanup.

[0076] The instrument handle 31 can include multiple drive inputs 602, 87 on the lower surface 336 of the housing 80 of the instrument handle 31. In the illustrated embodiment, the driver 31 includes three drive inputs 602, 87, although other numbers of drive inputs can be included in other embodiments. The drive inputs can be at fixed, spaced locations along the lower mating surface 336 of the instrument handle 31, facilitating coupling of the drive inputs 602, 87 to corresponding drive outputs 302 of the end effector 6, which can be at fixed, spaced locations along the corresponding mating surface, designed for modular use to attach a variety of other instruments. The handle 31 can include a latch clip 719 or other latching feature / means for physically coupling to corresponding structure on the adapter 8 and / or end effector 6.

[0077] A mechanical assembly within the instrument handle 31 can enable the drive input 602 to be used to drive articulation of the shaft 40, while the drive input 87 can be used to drive roll of the shaft 40. Each of the drive inputs 602, 87 can be configured to engage a corresponding drive output 302 on the end effector 6. For example, each drive input can include a receptacle configured to mate with a drive output configured as a spline. The drive input and drive output can be configured to engage to transfer motion therebetween. Thus, rotation of the drive output can cause a corresponding rotation of the drive input to control various functions of the instrument handle 31.

[0078] References herein to an "instrument device manipulator assembly," "instrument manipulator assembly," "manipulator," "manipulator assembly," and other variations thereof, can refer to any subset of the components of assembly 150 shown in FIG. 6 , including a robotic arm, an end effector of a robotic arm, an adapter configured to couple to a robotic end effector, an instrument base / handle configured to couple to an end effector and / or adapter, and / or other actuator components, means, and / or mechanisms associated with the instrument base / handle. Furthermore, it should be understood that references herein to an "actuator" can refer to any component of assembly 150 shown in FIG. 6 that directly or indirectly affects or causes movement of an instrument / component engaged with, coupled to, or otherwise actuable by a component of assembly 150. For example, according to embodiments disclosed herein, an "actuator" may comprise any set or subset of the following devices or components: feed rollers, shaft actuation wheels / rollers, feed roller channels, instrument feeder drive inputs, adapter drive outputs, adapter drive inputs, pulleys, belts, gears, pegs, pins, end effector drive outputs, and / or structures and / or control circuits configured to cause their actuation. For example, an actuator may be any component, device, or structure configured to cause a corresponding movement in another component, device, or structure, whether that movement is integrated with or separate from the actuator.

[0079] 7A and 7B show cross-sectional perspective views of an instrument handle configured to implement robotic shaft roll, according to one or more embodiments of the present disclosure. Unlike certain solutions in which shaft roll is limited to manual rolling of the shaft and / or handle, some embodiments of the present disclosure advantageously allow for robotic shaft roll control that may be implemented using one or more mechanical gears and / or other rotational-translational means / mechanisms.

[0080] The handle 31 is associated with one or more mechanisms that enable the instrument shaft 40 to be robotically rolled / rotated. For example, such mechanisms may be configured to transmit rotation of the robot end effector output drive to the handle / base 31 and further to the base (e.g., proximal end) 45 of the shaft 40 via a belt 83 or other rotation transmission component. In some embodiments, a bevel gear or other angle-changing gear / component 89 may be attached to the belt 83 and thereby to at least one of the roll axle / gear 85 and / or shaft gear 45. The bevel gear 89 may translate the rotation of the axle / belt gear 85 by 90° or other angle, allowing for meshing engagement with the shaft gear 45, causing the shaft gear 45 to rotate and thereby roll the shaft 40.

[0081] The proximal end of the elongate shaft 40 extends from the instrument handle / base 31. In some embodiments, the elongate shaft 40 comprises a flexible shaft and / or an articulating shaft. As described above, pull wires (not shown) can be included in or on the handle 31 and the elongate shaft 40 to control articulation of the elongate shaft 40. The handle 31 is configured to allow both manual and robotic control of the shaft 40. For example, the instrument handle 31 can be configured to be physically held and manually manipulated to provide manual control, and to be coupled to an instrument drive mechanism to provide robotic control. In some embodiments, a sterile adapter can be positioned between the instrument handle 31 and the instrument drive mechanism (e.g., a robotic end effector or other robotic manipulator) to maintain a sterile field during a medical procedure.

[0082] As shown, the instrument handle 31 includes a housing 80 that may house one or more of the roll control components / mechanisms described herein. The housing 80 of the instrument handle 31 may be shaped to provide an ergonomic fit for the instrument handle in the user's / practitioner's hand and / or to allow for coupling of another instrument to it. For example, the shape of the housing 80 may allow the instrument handle 31 to be more easily or comfortably held during manual control, such as for manually rolling the shaft 40 according to embodiments of the present disclosure. Additionally, the shape of the housing 80 may provide access to (e.g., not block) one or more robotic drive outputs associated with an adapter and / or end effector to which the handle 31 physically couples / latches for use with another instrument / device (e.g., a basket or laser processing cartridge). The instrument handle 31 may include a power access port 714 for connection to a power unit to power one or more instruments (e.g., internal control circuits) of the medical instrument system. The power access port 714 may be configured to provide an electrical and / or visual connection to the shaft 40.

[0083] In some embodiments, the instrument handle 31 includes a manual roll input controllable by a shaft strain relief feature 43. In some embodiments, the elongate shaft 40 extends through the shaft exit strain relief feature 43 and into the housing 80 of the handle 31. The shaft exit strain relief feature 43 may be configured to allow the elongate shaft to rotate relative to the instrument handle 31. As shown, the shaft exit strain relief feature 43 may be a twistable or rotatable handle or grip that can rotate relative to the housing 80. For example, the shaft strain relief feature 43 may rotate in a clockwise and / or counterclockwise motion. The shaft 40 may be rotationally fixed relative to the shaft exit strain relief feature 43 such that rotation of the shaft strain relief feature 43 causes rotation of the shaft 40. The rotation of the shaft 40 may be in the same direction and equal / coincident with the corresponding movement of the strain relief feature 43, although this need not be the case in all embodiments. The shaft 40 may be allowed to rotate (e.g., roll) by at least 90, at least 100, at least 110, at least 120, at least 130, at least 140, at least 150, at least 160, at least 170, at least 180, at least 190, at least 200, at least 210, at least 220, at least 230, at least 240, at least 250, at least 260, at least 270, at least 280, at least 290, at least 300, at least 310, at least 320, at least 330, at least 340, at least 350, or at least 360 degrees in both rotational directions. Such roll may be limited by roll axis rotation limiting features / mechanisms described in detail below with respect to Figures 10-1, 10-2, 10-3, and 10-4.

[0084] The strain relief feature 43 may comprise rubber or other at least partially elastic / flexible material in the shape of a tapered cone, as shown. Such a cone may have a circumferential apex 47 that may provide a visual indication and / or manual / tactile engagement feature indicative of the roll position of the shaft 40. For example, the apex 47 may rotate about the axis of the shaft as the shaft rotates. The cone's configuration, as may be provided at least in part by the apex feature, may provide a manipulation surface for manual manipulation by a user to manually rotate the shaft 40. Generally, alignment of the apex 47 of the cone 43 with, for example, the side portion 747 or other portion of the handle 31 may be associated with rotational alignment of the shaft 40 to a home (e.g., zero / lock) position. In some embodiments, the apex 47 may be aligned with a camera and / or the working channel of the shaft 40. In some embodiments, the visual indication of the roll position of the shaft 40 may be indicated by one or more other visual markers in addition to and / or as an alternative to the apex. For example, bands, notches, or other visual markings, strain relief features on the shaft 40 and / or the side 747 or other portion of the handle 31 may indicate the roll orientation of the shaft 40 .

[0085] With reference to FIGS. 6, 7A, and 7B, the handle 31 can include multiple robot drive inputs 87, 602 (not shown in FIGS. 7A and 7B, see FIG. 6), which can be accessible via one or more input ports 762. A robot drive output of an end effector and / or adapter (see FIG. 6) can engage and transmit torque (e.g., rotate) to the robotic endoscope drive inputs 87, 602. For example, the drive input 87 can be associated with the roll axis 85. Any of the drive inputs can be rotatable in both clockwise and counterclockwise directions. The drive inputs 87, 602 can be configured as grooved or keyed recesses and can be configured to engage with the robot drive output 302 (see FIG. 6), which is configured as a protruding / protruding spline. The robot drive output 302 is driven by a motor and can rotate in both clockwise and counterclockwise directions. When the robotic drive output is engaged with a respective robotic endoscope drive input, the robotic drive output can generally transmit rotational motion to the robotic endoscope drive input. Each of the drive inputs 602 and input ports 762 can be associated with one or more pulleys, gears, and / or other mechanisms configured to cause articulation of the shaft 40.

[0086] The orientation of the shaft 40 may be rotated approximately 90° in the process of manually docking the handle 31 onto the end effector 6 and / or adapter 8. When manually rolling the shaft 40, the physician holds the handle 31 and rotates the entire handle to cause the desired rotation / roll of the shaft 40, thereby aligning the plane of articulation P of the shaft 40. p The renal plane P k When the instrument handle 31 is docked to the robot end effector 6, the plane of articulation of the shaft 40, P p The renal plane P k and such alignment may be at least partially compensated for and / or required by rotation of the handle 31 for purposes of docking to the end effector 6.

[0087] Robot shaft roll can be achieved by a first bevel gear 89 and a second bevel gear 45. That is, in some embodiments, the shaft gear 45 can be a bevel gear. The first bevel gear 89 can be coupled to the robot drive input 87 and / or the roll axis 85 such that rotation of the drive input 87 and / or the roll axis 85 causes rotation of the first bevel gear 89. The first bevel gear can act as an angle conversion gear to convert the torque / rotation axis of the gear 89, the roll axis 85, and / or the roll drive input 87 to an axis that is parallel and / or coaxial with the base of the shaft 40 and / or the shaft gear 45. The shaft gear 45 (e.g., a bevel gear) can be attached to the proximal end of the shaft 40 such that rotation of the shaft gear 45 can cause rotation of the elongated shaft 40 relative to the instrument handle 31.

[0088] The first and second bevel gears 89, 45 may be engaged / meshed to transmit the rotational motion of the roll axis 85 to the shaft 40. For example, as shown, a drive belt 83 or other rotational transmission means / mechanism may be used to operably couple the first bevel gear 89 to the roll axis 85 from a distance. The roll axis 85 and its drive input feature 87, or its associated roll axis 85 and drive input feature 87, may be proximal to the angle-changing bevel gear 89 and, in some embodiments, disposed between the shaft articulation inputs 602 / 762. Other methods and mechanisms for transmitting the rotational motion of the roll axis 85 to the shaft 40 are also possible. In some embodiments, as the shaft 40 rolls, internal components (e.g., one or more coil pipes, pull wires, electrical wires, and / or optical fibers) may tilt to twist due to fixation to both the proximal and distal ends of the shaft 40. The twisting of the internal components can occur throughout the length of the elongate shaft 40, minimizing the resulting force / torque applied to its proximal and distal ends.

[0089] 7A and 7B, and further referring to FIG. 5, implementation of shaft roll according to embodiments of the present disclosure may involve aligning the deflection plane of the shaft 40 with the plane P of the kidney 70. k For example, it may be desirable to have a means or mechanism for aligning the primary deflection plane P associated with the shaft 40. p is the plane P of the renal calyx of kidney 70 k It may be desirable for the working channel 44 of the shaft 40 to be aligned with the kidney 70. Additionally, a shaft roll may be implemented to align the working channel 44 of the shaft 40 in a position that facilitates utilization of a working instrument disposed within the working channel 44. That is, as shown in the detailed image of FIG. 5, the working channel 44 may not generally be axially centered on the shaft 40, but rather may be radially offset, at least in part, to one side. Thus, if the working channel 44 is misaligned, the ability to utilize an instrument disposed therein for its intended purpose may be limited. Generally, the working channel 44 of the kidney 70 may be aligned with the kidney 70 in a position that facilitates utilization of a working instrument disposed therein. k may correspond to the bisecting plane of the kidney, as shown in Figure 5. However, it should be understood that, based on the anatomy of a particular patient, one or more calyces may be slightly out-of-plane. However, such calyces may not be aligned with the primary plane P of the kidney. k The primary deflection plane P of the shaft 40 may be accessible from a position p and renal plane P k Alignment with the can advantageously provide maximum / highest reach of the shaft 40 within the kidney.

[0090] As mentioned above, in some embodiments, the shaft 40 may be configured such that its articulation in one or more planes may be implemented. For example, in some embodiments, the shaft 40 may be configured such that its articulation in one or more planes may be implemented. p , while the scope may be configured to articulate an amount greater than 180°, such as about 270° or more, in the secondary deflection plane P s In this case, the shaft 40 is in the primary articulation plane P pFor example, shaft 40 may be configured in some embodiments to articulate up to 90° or less in one or more planes. Shaft roll control according to aspects of the present disclosure advantageously provides control over the primary articulation plane P of shaft 40. p This allows for robotic registration of the area of the calyx within the calyceal network to allow targeted navigation of the kidney stone or other specimen to be extracted. p and the quadratic plane P s Articulation as described above may advantageously be in both / two directions within a given plane of articulation. Generally, the degree of deflection / articulation in a given plane of deflection of the shaft 40 may be limited based on the amount of degrees of freedom provided by the individual structural links of the articulation portion 230 of the shaft 40. In some embodiments, the proximal portion of the shaft 40 at, within, and / or near the handle 31 may be configured to bend in only two directions, while the distal portion of the shaft 40 may be configured to bend in four directions, or vice versa.

[0091] In some implementations, after a certain amount of manual rotation / manipulation, the handle 31 can be placed on the robotic manipulator 6 (see FIG. 6 ). In such a transition between a manually held position on the end robotic manipulator (e.g., effector 6 and / or adapter 8) and a docked position, the orientation of the instrument handle 31 and / or shaft 40 can be rotated approximately 90° so that the shaft 40 rolls an amount commensurate with the rotation of the handle 31. Thus, in some cases, a robot roll adjustment can be desirable after docking the handle 31. For example, the system control circuitry can be configured to drive the associated actuator / maneuver of the handle 31 to roll the shaft 40 to compensate for the 90° (or other) change in shaft roll resulting from docking the handle 31. Such automatic roll correction can be based at least in part on the patient's position. While automatic shaft roll correction is described, it should be understood that such shaft roll correction can be implemented by the operator using certain user input controls (e.g., control device 55 of FIG. 1 ), as described herein.

[0092] Figure 8 shows a cross-sectional view of an instrument handle 831 in accordance with one or more embodiments of the present disclosure. The embodiment of Figure 8 provides an alternative rotational transmission mechanism compared to the embodiments of Figures 7A and 7B for transmitting rotation of a roll axis 885 of a handle 831 with a shaft base / gear 845 to rotation of a shaft roll axis. For example, the embodiment of Figure 8 shows a shaft-based transmission of rotational force from roll axis 885, where handle 831 is coupled to shaft gear 845, and the associated output drive of a robot end effector / adapter, with rotation of shaft 885 transmitting rotation to a transverse axis rod 883 via a bevel gear 881 or other angle conversion gear.

[0093] 8 includes a direct drive rod 883 that may be mechanically coupled to a roll shaft 885 via meshing engagement between the roll shaft 885 and a bevel gear 881 coupled to the rod 883. The rod 883 may be coupled to a distal shaft actuation gear 889. Generally, compared to belt or other solutions, the use of a rod to drive the shaft roll can advantageously provide relatively fewer losses. That is, a higher percentage of the rotation of the drive gears 885, 881 can generally be transmitted to the working gear 845 than with certain other solutions, such as certain belt-type solutions.

[0094] The distal drive gear 889 and the shaft gear 845 can be spur gears in some embodiments. In some embodiments, the proximal drive gear 881 is a bevel gear configured to allow meshing of the proximal drive gear 881 with a bevel-shaped roll axis 885, the roll axis 885 being orthogonal / transverse to the proximal drive gear 881. Implementing spur gears for one or more of the roll axis 885, the proximal drive gear 881, the distal drive gear 889, and / or the shaft gear 845 may be desirable in some cases due to the relatively secure meshing of the spur gear teeth with the bevel gear. That is, the positioning and engagement of bevel gears may require relatively greater precision compared to spur gears due to their tendency to bind and / or split. Thus, the use of spur gears for one or more of the gears of the device can provide greater flexibility regarding the position and / or angle of the gears compared to bevel gears and / or other solutions.

[0095] Distal drive gear 889 may be advantageously positioned in a location that allows a distal cable (e.g., a power cable / wire) to pass through port 814. Compared to belt-type roll control systems such as those shown in Figures 7A and 7B, cable or rod-based mechanisms may have less play / flex, but may be relatively more difficult to install and / or assemble. Furthermore, with respect to belt-based systems, such systems may be prone to losing tension to a greater or lesser extent over time.

[0096] Figure 9 shows a cross-sectional view of an instrument handle 931 having a rod-based rotational transmission mechanism, which may be similar in some respects to the embodiment shown in Figure 8, in accordance with one or more embodiments of the present disclosure. In the embodiment of Figure 9, a distal drive gear 989 is configured to transmit rotation of a rod 983 to a shaft gear 945 via a belt 901 or other rotational transmission engaged to both gears 989, 945.

[0097] 10-1, 10-2, and 10-3 show perspective views of a roll axis assembly 105 according to one or more embodiments of the present disclosure. FIG. 10-4 shows an exploded view of the roll axis assembly 105 shown in FIGS. 10-1, 10-2, and 10-3. The roll axis assembly 105 includes a roll axis 85, which may represent an embodiment of any of the roll axes disclosed herein. The roll axis assembly 105 includes the roll axis 85, as well as a rotation-limited slider component / portion 26 and an axis-retaining structure 84 having specific rotation-limited features according to aspects of the present disclosure.

[0098] Generally, rotation of the medical instrument shaft a full 360° or more in either / both directions (i.e., clockwise and counterclockwise) may be desirable. However, with respect to robotically controlled shaft rolls, it may not be desirable to allow infinite rolls because rolls greater than 360° can cause damage to wires and other components associated with the shaft from twisting due to over-rolling. Therefore, it may be desirable to limit the rotation of shaft 85 to avoid twisting and / or damage to certain pull wires, camera wires, and / or other wires, cables, or other components that may emanate from the proximal end of the shaft and / or shaft gear. That is, it may be desirable to limit the rotation of shaft 85 to prevent shaft 85 and / or shaft gear 45 from rotating more than about 360° in either direction (e.g., less than 720° of full rotation).

[0099] Limiting rotation of the shaft 85 may be achieved using an open annular channel 118 in the shaft 85 and / or an open annular channel 111 in the shaft-retaining structure 84, and such channels may, in some embodiments, open toward one another. While annular channels are shown associated with both the shaft 85 and the retaining structure 84, it should be understood that shaft rotation limitation may be implemented using annular channels in either the shaft 85 or the retaining structure 84, but not both. For example, the shaft 85 may be a generally rotating component, while the shaft-retaining structure 84 may be a generally static / stationary component, and rotation of the shaft 85 in one or both directions may be stopped by direct or indirect contact between stop contact surfaces / faces 116, 117 of the shaft 85 exposed in the channel 118 and stop contact surfaces / faces 114, 115 of the shaft-retaining structure 84 exposed in the annular channel 111 of the retaining structure 84. Such contact between the shaft 85 and the shaft-retaining structure 84 may occur indirectly via a slider structure / component 26, which may transmit contact within the annular channel 118 of the shaft 85 to the contact surfaces 114, 115 of the annular channel 111 of the sensor-retaining structure 84. For example, the slider 26 may include a lower engagement feature 125 configured to at least partially fit within the annular channel 118 of the shaft 85 and slidably move therein. The slider 26 may further include an upper engagement feature 127 configured to at least partially fit within the annular channel 111 of the shaft-retaining structure 84 and slidably move therein.

[0100] Rotation of the shaft 85 may be limited by contact of either annular end of the slider 26 with stop surfaces on the shaft and the shaft-retaining structure, respectively. For example, such stop surfaces may be exposed within the open annular channels 111, 118 of the shaft 85 and the shaft-retaining structure 84, respectively. That is, as the shaft 85 rotates in a given direction, the lower portion 125 of the slider 26 may be configured to fit within the open annular channel 118 of the shaft 85 and may slide within the channel until it contacts and becomes exposed within the channel 118. With the slider in contact with the stop surfaces within the open annular channel 118 of the shaft 85, the shaft may be allowed to continue rotating until the upper portion 127 of the slider 26 reaches a hard stop against and becomes exposed within the stop surfaces of the channel 111 of the shaft-retaining structure 84.

[0101] The slider 26 can advantageously extend the rotational range of the shaft 85 through sliding motion within the annular channel 111 of the sensor-retaining structure 84. For example, when rotating the shaft 85 in a given direction, such rotation can be stopped by a hard stop caused by the contact surfaces of the slider 26 and the shaft channel 118 contacting each other; after contacting the stop surface of the shaft channel 118, and after the shaft rotates further in the same direction, the contact surface on the opposite end of the slider can also contact the hard stop surface of the open channel 111 of the shaft-retaining structure 84. As an exemplary use case, FIG. 10-1 shows the roll shaft 85 at its farthest allowed clockwise rotation. FIG. 10-2 shows the roll shaft 85 rotated counterclockwise (compared to the configuration of FIG. 10-1) to a contact position with the opposite end of the slider 26, with the side surface 112 and / or inner side 129 of the slider 26 in the area associated with the lower portion 125 of the slider 26 contacting the stop surface 117 in the channel 118 of the shaft 85. In FIG. 10-2, the shaft 85 can continue to rotate counterclockwise until the side surface 113 of the upper portion 127 of the slider 26 is stopped by the inner stop contact surface 115 of the annular channel 111 of the retaining structure 84, a configuration shown in FIG. 10-3.

[0102] The slider 26 advantageously extends effective contact of the shaft 85 into the annular channel 118 of the shaft-retaining structure 84, and the arc length L of the channel 111 c1 to the arc length L of the slider 26 s The allowable rotation of the shaft can be extended beyond the limitations of the shaft channel 111 by allowing the shaft 85 to rotate an additional amount equal to the arc length L of the shaft channel 118 minus c1 and the arc length L of the retaining structure channel 111 c2 From the sum of the degrees of the slider, the arc length L s The arc length of the slider, L, can be approximately equal to (or proportional to) the arc length of the slider minus two times the s may need to be considered in terms of the space occupied in both the shaft channel 118 and the retaining structure channel 111. In some embodiments, the shaft channel 118 may allow for an amount of rotation less than 360°, but additional engagement of the slider 26 with the shaft channel 111 of the retaining structure 84 can extend the range of rotation of the shaft even beyond 360°.

[0103] Circular / arc length L of slider channel 118 of axis 85 c1 may be limited, at least in part, by the presence of mating features / channels 88, which may provide keyways / locking flanks / areas for shaft 85, as described in detail below. That is, in some embodiments, the size of mating features / channels 88 occupies space away from the usable annular length of channel 118 of shaft 85.

[0104] The rotation range of the roll shaft 85 is the arc length L of the slider 26. s That is, the arc length L of the slider 26 s However, the longer the amount of annular length within channel 118 of shaft 85 and channel 111 of retaining structure 84 that is occupied by the respective portions of the slider, the smaller the range of rotation that is permitted.

[0105] Generally, the radial thickness T of the slider 26 s and arc length L smay be determined to provide the slider 26 with the desired structural stability with respect to the tendency of the slider 26 to bind within one or more channels and / or withstand hard stop forces relative to the respective stop surfaces. For example, if the slider 26 has an annular length L s and / or the radial thickness T s , fracture and / or shearing can occur from hard stop forces thereon. However, such dimensions may limit rotation of the shaft 85 and / or require a larger size / space. Therefore, the design of the slider involves a trade-off between structural stability and size. For example, it may be desirable to design the slider 26 to be relatively sturdy to facilitate sliding within and provide a convenient fit within the annular channel 118 of the shaft 85 and the annular channel 111 of the retaining structure 84. Furthermore, a relatively long annular length L of the slider 26 may be desirable. s may facilitate sliding within their respective channels and reduce the risk of the slider 26 tipping over, binding within the channel, or otherwise becoming askew within the channel.

[0106] The shaft 85, slider 26, and retaining structure 84 assembly 105 shown in FIGS. 10-1 through 10-4 provide a solution for increasing the rotation range of a rotation-limited shaft that may be suitable for certain applications. In connection with embodiments of the present disclosure, additional solutions for increasing the roll axis rotation range may be implemented, such as by varying the gear diameter associated with one or more of the roll control gears associated with the associated handle / instrument. For example, decreasing the gear diameter of the shaft gear associated with the proximal end of the instrument shaft can increase the allowable shaft rotation. Additionally, increasing the diameter of the distal drive gear can increase the shaft rotation relative to the roll axis rotation, thereby increasing the roll range of motion. The particular assembly shown in FIGS. 10-1 through 10-4 may be suitable for providing a desired shaft roll range in environments limited by space constraints, such as within a handle, as shown in various figures of the present disclosure.

[0107] In some implementations, embodiments of the present disclosure enable shaft-type instruments to be used both manually and robotically. As may be desirable in such implementations, certain embodiments of the present disclosure relate to instrument handles configured to automatically lock or secure shaft rotation in place when the handle is manually manipulated. For example, such instrument handles may be configured so that when the handle is docked to a robotic end effector, shaft rotation / roll is automatically unlocked, allowing it to be controlled robotically via the end effector (and / or an attached adapter) and one or more components associated with the instrument handle. It should be understood that any reference herein to an end effector and / or its components or features may refer to similar components or features associated with an adapter coupled to the end effector, rather than the end effector itself.

[0108] 11A, 11B, and 11C show perspective views of certain instrument handle components including axle catch 90 in a locked position, in which rotation of roll shaft 85 is limited / restricted by axle catch 90, in accordance with one or more embodiments of the present disclosure. 12A, 12B, and 12C show perspective views of the instrument handle components shown in FIGS. 11A-11C, with the axle catch in an unlocked position, in which an actuator engagement boss 9 of an adapter or end effector device engages catch 90 and causes vertical translation of catch 90, thereby lifting / moving key feature 95 of catch 90 from mating feature 88 of roll shaft 85, thereby allowing roll shaft 85 to freely rotate in response to a drive input. Any of the following descriptions may be understood with reference to FIGS. 11A-11C and / or 12A-12C.

[0109] As mentioned above, in some cases, a physician or other operator / technician may perform an instrument shaft roll by holding the handle of the instrument in their hand and rotating their arm and / or hand to rotate the handle and its coupled shaft together as a unit. That is, with respect to any of the figures / embodiments of the present disclosure, when manually rolling the shaft 40 of the instrument 19, it may be necessary or desirable to limit / lock the roll of the shaft 40 relative to the handle 31 to allow the rotation of the handle 31 to be transmitted to the shaft 40. Generally, handheld manual roll / rotation implementations may allow for rotation of approximately 180°, with such rotation being limited by the physical constraints of the arm and / or hand / wrist, which may vary to some extent across users.

[0110] The instrument handle 31 of Figures 11A-11C and 12A-12C includes a roll axis locking structure / catch 90 that may be configured to translate and key with the roll axis 85. The term "catch" is used herein according to its broad and ordinary meaning and may refer to any type of lock, stop, blocking, impeding, or interference structure that may be understood with respect to a rotation axis component, feature, or device. When the instrument is used manually, such as when the handle 31 is manually held / operated by a user, a spring or other biasing feature 93 may bias the catch structure 90 toward the roll axis 85 in such a way that a key component 95 of the catch 90 engages a mating feature 88 (e.g., a keyway) of the roll axis 85. For example, when a user manually rotates shaft 40 (not shown in FIGS. 11A-11C ) to align the mating feature of roll axis 85 with key feature 95 of axis catch 90, biasing catch 90 toward the plane of roll axis 85 can cause key feature 95 to engage keyway mating feature 88, thereby locking in place the rotation of roll axis 85. In such a locked state, shaft 40 may not be allowed to rotate freely and / or be actuated through a robotic drive.

[0111] 11A and 11B and 12A and 12B, the roll axis 85 is rotated to a home / zero position where the mating feature 88 is rotationally aligned with the key feature 95 so that the key feature 95 can move in and out of the mating feature 88. If the roll axis 85 is not in a home rotation position, which may be associated with a predefined angular position with respect to the shaft 40 about its roll axis and / or the roll axis 85 about its rotation axis, it may not be possible to implement a shaft roll lock as described herein. Therefore, it may be necessary or desirable to rotate the shaft 40 and / or the axis 85 to the home position to enable the shaft roll lock before latching or unlatching the handle 31 from the robotic system. For example, if the shaft 40 and / or the axis 85 are rotated to the home position before unlatching / undocking the handle 31, such unlatching / undocking may cause the catch 90 to automatically lock the axis 85. In some implementations, the system control circuitry is configured to automatically roll the shaft 40 and / or axis 85 to the home position before undocking the handle 31. In some implementations, unlatching / undocking may be limited / locked unless and until the shaft 40 and / or axis 85 are in the home position. Whether the shaft roll is in the home position may be determined electronically and / or mechanically.

[0112] 6 , the robot end effector 6 and / or its associated adapter component 8 may include a catch actuation boss 9 or other feature configured to depress an actuator feature 91 of the catch 90 when the handle 31 is docked to the end effector / adapter 8; such actuator engagement may serve to disengage a lockout mechanism of the catch 90 by translating a key feature 95 of the catch 90 from a mating feature (e.g., keyway) 88 of the shaft 85. That is, by depressing the handle 31 onto the adapter 8 to latch the handle 31 to the adapter 8, the catch actuation boss / boss 9 may automatically depress an actuator contact surface 98, moving / translating the shaft catch 90 vertically (with respect to the orientation shown) from its locked position and removing the key 95 from the mating feature 88 of the shaft 85. Thus, embodiments of the present disclosure provide a solution that allows a user to unlock a shaft roll control mechanism associated with an instrument handle by docking the handle onto the end effector and / or adapter 8 (or other type of robotic manipulator). In such an unlocked state, the handle is free to operate to roll the instrument shaft in response to particular control signals and / or drive inputs.

[0113] The key feature 95 provides a locking feature for the shaft 85. In some embodiments, the key feature 95 keys into the mating feature 88 of the shaft 85 in a locked position, where rotation of the shaft 85 is limited. The fit of the key 95 in the mating feature 88 may advantageously be tight enough to prevent backlash / ejection of the key feature 95 when restricting roll / rotation of the shaft, but not too tight so as to cause binding friction when actuating the catch into and / or out of mating engagement with the mating feature 88. For example, the catch actuator component 91 may be positioned at a separate end 501 of the catch 90 relative to the key feature 95 such that actuation of the catch actuator 91 (e.g., its vertical translation) may result in the catch 90 tending to bind due to applying uneven force to the catch 90. Therefore, some clearance around the key feature 95 may be desirable. However, any amount of clearance between the key features 95 within the mating feature 88 may impart allowable rotation of the shaft 85 when the key 95 is in the locked position. Thus, the key 95 may fit relatively snugly within the mating feature 88 in some embodiments.

[0114] In some embodiments, the axis A of the shaft 85 a With respect to the axis catch 90, the key 95 is raised from the mating feature 88 so that the axis catch 90 is aligned with the axis A. a 11A-11C and 12A-12B ). The shaft retaining structure 84 (not shown in FIGS. 11A-11C and 12A-12B for clarity) can present a limit to the distance the catch 90 can translate vertically. Referring also to FIGS. 10-1-10-4 , the shaft cover / retaining feature 84 can serve to align the roll shaft 85 with its associated drive input. In some embodiments, a pin 181 is disposed within the axial cup 119 of the shaft 85 and within a corresponding opposing cup 120 of the shaft retaining structure 84. Alternatively, the alignment pin 181 can be an integral feature of the cover 94. The pin 181 can advantageously be adapted for rotation thereabout by the shaft 85.

[0115] The axle 85 may be biased in the locked position shown in FIGS. 11A-11C , with the axle catch 90 positioned so that the key 95 engages the mating feature 88 of the axle 85. In some embodiments, such biasing may be implemented using one or more springs 122 or other biasing features. For example, the spring 122 may press downward on the axle catch 90 (relative to the orientation shown), biasing the key feature 95 downward into the mating feature / channel 88. In some embodiments, the spring 122 presses against the underside / surface of one or more components of the handle housing, such as the underside of the axle retaining structure 84 or other structure. In some embodiments, the axle catch 90 includes a spring retaining feature 93, such as a cup or recessed feature, as shown in FIGS. 11A and 11B . For example, the spring retaining feature 93 may have an open cylindrical shape with a seat 94 against which the spring 122 can apply a biasing force. Although a cup-shaped spring retention feature is shown, it should be understood that any type of spring retention configuration or structure may be implemented, such as an attachment means or mechanism (e.g., one or more hooks, clips, adhesive, etc.) for securing the spring 122 to the catch 90.

[0116] One or more alignment pins 121 are utilized to align the axis A of the shaft 50. aThat is, pin 121 can be configured to control / guide the direction and / or orientation of movement of catch 90, thereby keeping catch 90 in-plane (e.g., with respect to the flat top surface of catch 90) as it translates. For example, in embodiments in which biasing component (e.g., spring) 122 is disposed relatively close to one end 501 of catch 90, the biasing force provided thereby can be angled to cause catch 90 to tilt and / or bind as it translates. Pin 121 can prevent / reduce such tilting / binding. In some embodiments, catch 90 includes one or more openings or other features 92 configured for pin 121 to be disposed within to provide a track / guide for catch 90 relative to pin 121. Pin 121 may be secured to housing 80 in some manner, may be integrated with other structure of the handle, or may be a separate component that is secured in place by nesting with one or more retention features of the housing and / or shaft retaining structure 84.

[0117] Referring back to FIG. 6 , the adapter component 8 includes a catch actuator engagement feature / boss 9 configured to engage the actuator 91 when the handle 31 is latched to the adapter 8 and / or end effector 6. For example, when the handle 31 is latched / docked to the adapter 8 and / or end effector 6, the boss 9 can be configured to press against the engagement surface 98 of the actuator 91, thereby translating the catch actuator 91 and associated / integrated catch 90 in a direction that is generally parallel to the axis of the boss 9, the actuator 91, and / or the catch actuator access channel 176. By such means, the boss 9 can be configured to unlock the shaft 85 by translating the catch 90 such that the key 95 exits the mating feature 88 of the shaft 85. Such unlocking can be performed from outside the housing 30 of the handle 31. In some embodiments, the shaft actuator 91 is axially aligned with the spring retaining cup 93, as shown in FIG. 11C .

[0118] In some embodiments, the catch actuator 91 (e.g., a plug, pin, button, peg, plunger, or other actuator means or feature) protrudes into and / or through the actuator access channel 176 of the handle housing 80. In some embodiments, the actuator 91 includes an annular gap or space 96 that may house an O-ring or other type of sealing component configured to prevent fluid ingress into the handle housing 80 through the actuator channel 176. In some embodiments, the annular gap / channel 96 does not have a sealing feature disposed therein, but rather provides a void in which any fluid passing around the periphery of the actuator may generally collect within the gap space 96.

[0119] The catch 90 may have a height dimension H1 corresponding to the height of the area of the catch including the alignment pin channel 92, which provides a surface area around the alignment pin 121 to facilitate its alignment and keep the alignment channel 92 substantially parallel to the alignment pin. For example, it may be advantageous to allow the catch 90 to rock / tilt when translated, and such tilt to rock / tilt may depend at least in part on the height dimension H1 and / or the clearance around the pin within the alignment channel 92. Thus, to reduce rocking / tilting, the alignment channel 92 may advantageously fit relatively closely around the alignment pin 121 with little clearance, while allowing some clearance to avoid frictional binding of the catch 90 around the pin when axially translated. Furthermore, the height H1 of the catch in the area of the alignment channel 92 may be as large as possible given relevant space constraints within the housing 80. For example, pulleys, wires, and / or other components of handle 31 may be at least partially disposed above catch 90 within housing 80, with catch 90 not occupying such space during the unlocked or locked configurations. The underside topology of catch 90 may advantageously fill available space within housing 80 and provide one or more bearing surfaces that allow catch 90 to contact a structural component at the base of housing 80 with its underside when catch 90 is in the locked position, allowing catch 90 to rest in the locked position. Catch 90 may have an overall height H2, including actuator 91, that is greater than the height H1 of the body of catch 90.

[0120] The actuator engagement boss 9 of the adapter 8 (and / or end effector 6) may be limited in height to avoid contact with instrument components when an instrument other than the handle 31 is touched thereto. For example, the adapter 8 may be configured to accommodate various types of instruments, including catheter-type instruments, etc. In some embodiments, the pin has a height of about 2.2 mm or less. In some embodiments, the pin is greater than 2.2 mm in height.

[0121] Catch 90 may have a length dimension L and a width dimension W, as shown, with length dimension L being greater than width dimension W. For example, width dimension W may be generally parallel to the projection dimension of key 95, while length dimension L may be transverse / orthogonal to width dimension W. Ends 501, 502 of catch 90 may be considered to be longitudinal halves or one-thirds of catch 90, and in some embodiments, key 95 may be part of or otherwise associated with the longitudinal side / end 502 of catch 90 opposite actuator 91 and / or spring 122 and spring retaining cup 93. At least one alignment pin 121 and / or associated alignment pin channel 92 may be associated with a longitudinal intermediate portion of catch 90 between opposing ends 501, 502.

[0122] While a single actuator peg / feature 91, channel 176, and actuator boss 9 are shown and described above, it should be understood that the catch 90, housing 80, and / or adapter 8 may be implemented with any number of actuators, actuator access channels, and / or actuator pin components. For example, by including two catch actuators, stability of the catch 90 during translation may be improved. For example, such multiple actuators and associated components / features may be associated with and / or between separate sides / ends 501, 502 of the catch 90. Generally, the location of the actuator 91 in the end region 501 may not be ideal from a translational alignment perspective. However, due to certain physical / positional constraints associated with the handle housing 80, the configurations shown in Figures 11A-11C and 12A-12C may be necessary or desirable, and any alignment imperfections presented by the position / location of the actuator 91 may be compensated for using one or more of the alignment pin channel 92, the spring retaining cup 93, the height / thickness dimensions H1, H2, and the key shaft engagement features.

[0123] FIGS. 13-1 and 13-2 show perspective views of certain instrument handle components including an axial catch 146 according to one or more embodiments. Compared to the embodiments shown in FIGS. 11A-11C and 12A-12C, the use of a rotational catch rather than a vertical translational catch can provide certain advantages. For example, with vertically translating catch structures, certain contaminants may become trapped within the associated actuator channel, which may be relatively difficult to disinfect / clean. For example, with the plug-type actuator embodiments of FIGS. 11A-11C and 12A-12C, the area between the actuator contact surface 98 and the base of the actuator plug 91 may be difficult to clean and / or access. With the rotational actuator of FIGS. 13A-13C, contaminants may not be prone to passing around the actuator 140 due to the actuator simply rotating into place, as opposed to physically translating along an axis and / or within the handle housing.

[0124] In some embodiments, the actuator 140 of the catch 146 is a cam actuator. In such a system, the adapter to which the handle 131 is attached and / or the end effector 147 can include an actuator engagement protrusion / boss 143, which can have any suitable or desirable shape or be configured to actuate the cam socket 141 of the actuator 140. For example, the actuator engagement protrusion / boss 143 can have a rectangular / oval cross-sectional shape, as shown. By forcing the actuator engagement protrusion / boss 143 into the cam socket 141, the angled / curved cam surface / groove 142 of the cam socket 141 aligns the axis catch 146 with the axis A of the actuator 140. c , thereby rotating a flexed projection 149 of the catch 146 out of a mating feature 148 of the shaft 145. The catch 146 may be biased in a locked position in which the end 144 of the flexed projection 149 protrudes into a mating feature 148 associated with the side of the shaft 145, thereby locking the shaft against rotation.

[0125] The catch 146 may be biased toward the roll axis 145 via a torsion spring or some other biasing device / mechanism, and the catch 146 is configured to automatically rotate away from the roll axis 145 when docked with the end effector and / or its associated adapter.

[0126] With respect to the cam actuator 140, the more aggressive the angle of the angled / curved cam surface / groove 142, the more rotations are imparted to the catch 146 per unit of distance projected into the cam socket 141 of the actuator 140 by the actuator engagement boss 143, which may increase the probability that a successful unlatching / unlocking can be achieved when the handle 131 is docked onto the adapter / end effector 147. Generally, the actuator engagement boss 143 may need to overcome a biasing force (e.g., a spring force) to effect rotation of the cam catch 146.

[0127] The rotating shaft catch 146 is configured to rotate into engagement with the keying feature 148 of the shaft 145 rather than translate vertically to engage and disengage from the mating feature on the shaft. Rotation may be achieved using cam features formed on and / or associated in some manner with the catch 146. The rotating catch embodiment of FIGS. 13-1 and 13-2 may be suitable for preventing fluid ingress.

[0128] 14-1 and 14-2 illustrate a roll lock feature 163 for an instrument having an instrument handle 175 and shaft 40 component, according to one or more embodiments. The roll lock feature 163 can comprise a forked shaft rotation stop, which in some embodiments can be disposed generally radially outward of an adapter and / or end effector component to which the instrument handle 175 is attached. The stop 163 can be configured to lock the shaft 440 by directly contacting the shaft 440 and / or base 151 or its associated strain relief feature 153. The shaft roll stop 163 can extend distally from a distal portion of the instrument handle 175.

[0129] The stopper 163 may include a strip 166 or area having a high coefficient of friction material configured to increase roll resistance when the strip 166 and a component / portion of the shaft 440 are in contact. References herein to the shaft 440 may refer to the elongated tubular shaft portion 440 itself and / or either or both of the shaft base 151 and the strain relief feature 153. In some embodiments, the stopper feature 163 includes a key feature (not shown) configured to key to a corresponding engagement feature associated with the shaft 440, the strain relief feature 153, and / or its base 151.

[0130] The base 151 of the shaft 440 may be coupled to and / or integral with the shaft 440 in such a manner that the shaft 440 and the base rotate together. In some embodiments, the base 151 comprises a rigid cylindrical base structure 151 of the shaft 440, which in some embodiments may be proximal to the strain relief feature 153 (if present) and may provide an engagement surface for the stop feature 163. For example, the forked portion 162 of the stop 163 may be configured to engage / contact an outer surface of the base portion 151 to provide roll stop resistance / traction for the shaft 440.

[0131] The stopper 163 may include a generally straight and / or elongated base portion 160, as shown in FIGS. 14-1 and 14-2 , or may have any other suitable or desirable shape configured to allow vertical sliding or other movement (e.g., rotation) of the stopper 163 to bring its contact surface 166 into contact with a portion of the shaft 440 (e.g., the shaft base 151). In some embodiments, the base portion 160 includes a slot 161 or other feature configured to facilitate translation / sliding of the stopper 163. For example, a pin 152 or other feature / component may be at least partially inserted / disposed within the slot 161 to retain the stopper 163 while allowing translation of the stopper 163 corresponding to movement of the stopper such that the pin 152 slides within the slot 161 between a locked position and an unlocked position. For example, in the unlocked position (FIG. 14-1), the pin 152 may be at or near the top of the slot 161, while in the locked position (FIG. 14-2), the pin 152 may be at or near the bottom of the slot 161. FIG. 14-1 shows the stopper 163 in the unlocked position, where the stopper fits within the housing 170 such that the contact area / strip 166 does not contact the shaft 440 or any component associated therewith (e.g., the shaft base 151).

[0132] FIG. 14-2 shows stopper 163 in a locked position, in which stopper 163 has been vertically translated / actuated to exert a force at contact area 166 against a component of shaft 440, such as shaft base 151, strain relief component 153, and / or shaft body 440. Actuation of stopper 163 between the locked and unlocked positions can be achieved using any suitable or desired actuator means or mechanism. In some embodiments, stopper 163 is biased in either the locked or unlocked position, such as through the use of one or more springs or other biasing devices. In some embodiments, stopper 163 is configured to be robotically actuated in some manner. While fork portion 162 of stopper 163 is illustrated as having a semicircular shape / configuration, it should be understood that such component / portion can have any suitable or desired shape and / or contact surface / area.

[0133] Shaft Roll Process 15-1, 15-2, and 15-3 provide a flow diagram for a process 1500 for rolling an instrument shaft 154, according to one or more embodiments. 16-1, 16-2, and 16-3 illustrate certain images corresponding to various blocks, states, and / or operations associated with the process 1500 of FIGS. 15-1, 15-2, and 15-3, respectively, according to one or more embodiments. The process 1500 may be performed, at least in part, by certain robotic system control circuitry, as described herein.

[0134] Process 1500 may be performed in connection with a medical procedure, such as a kidney stone removal procedure, or other procedure that may be performed using a shaft-type medical instrument 159, such as an endoscope, ureteroscope, etc. That is, process 1500 may be performed, at least in part, following placement of the distal end of the shaft 154 of the shaft-type medical instrument 159 (e.g., an endoscope) within a particular target anatomical structure of a patient, such as the calyceal rete of the patient's kidney. One or more operations of process 1500 may be performed prior to accessing the target anatomical structure by the distal end of the medical instrument shaft.

[0135] At block 1502, process 1500 involves manually rotating the shaft 154 of a medical instrument 159 relative to its handle 151 to bring the shaft 154 to a home position, where a shaft roll lock mechanism on the handle 151 may be configured to engage / lock when the shaft is manually rotated to the home position, as shown in image 1602. For example, the handle 151 may be associated with one or more markings or features that indicate the alignment of the shaft 154 relative to the handle 151. For example, a strain relief feature 153, such as a conical feature as described in detail herein, may have one or more features, such as a circumferential apex or other feature, that indicate the orientation of the shaft 154. For example, the marker / indicator may be aligned with a working channel or other feature of the shaft 154. In some implementations, the action associated with block 1502 of process 1500 involves manually holding or grasping a strain relief feature 153 associated with the proximal end portion of the shaft 154 and rotating such feature / feature 153 to the home position shown, which can cause a roll lock catch or other feature to engage with the roll axis of the handle 151, thereby locking the relative roll between the shaft 154 and the handle 151 of the medical instrument 159.

[0136] At block 1504, the process 1500 involves manually rolling / rotating the shaft 154 of the medical instrument 159 by manually rotating the handle 151 with the shaft 154 in a relative locked-roll configuration implemented by a shaft roll lock bias (e.g., a spring load on the shaft lock / catch biasing the shaft lock / catch in a locked configuration), as described herein. For example, the shaft 154 may be associated with the handle 151, which may be coupled to a proximal portion of the shaft 154. Due to an automatic roll lock, the medical instrument 159 may be configured such that rotation of the handle 151 is transferred to rotation of the shaft 154. That is, the shaft 154 may not freely rotate relative to the handle 151, but rather may have a locked rotation relative to the handle 151. For example, the handle 151 may have a roll locking catch feature associated therewith, as described in detail herein, which may be biased in a locked position to prevent relative rotation between the shaft 154 and the handle 151 when the instrument 159 is manually manipulated / actuated. Manually rolling the handle 151 of the medical instrument 159 relative to the block 1504 can be performed to align the plane of deflection of the shaft 154 and / or its distal end portion with the plane of the particular anatomy in which the shaft is disposed. For example, manual manipulation and rotation of the handle 159 of the medical instrument can be performed to align the shaft 154 with a patient's kidney for kidney surgery.

[0137] In block 1506, the process 1500 involves docking the handle 151 of the medical instrument 159 onto a robotic end effector / system 158. For example, the handle 151 may be docked onto an adapter, such as a sterile adapter as described in detail herein, and then physically coupled to an end effector of a robotic arm of a robotic system (e.g., a cart system). Docking the handle 151 may involve rotating the handle longitudinally approximately 90° to align the handle 151 with an engagement surface of the robotic instrument manipulator assembly 158 (e.g., the adapter and / or the end effector).

[0138] At block 1508, the process 1500 involves unlocking a roll axis of (e.g., within) the handle 151 of the medical instrument 159. For example, such unlocking may occur substantially automatically when the handle 151 is latched onto the end effector / adapter 158. For example, one or more features of the end effector / adapter 158 may be configured to activate an axis catch component of the handle 151 when the handle 151 is placed and / or pressed onto the end effector / adapter 158.

[0139] At block 1510, the process 1500 involves robotically rolling the shaft 154 relative to the handle 151 of the medical instrument 159. For example, one or more drive outputs of the robotic system 158 may be implemented to cause shaft roll through engagement with a drive input of the instrument handle 151. At block 1512, the process 1500 may involve returning the shaft 154 to a home position with respect to its roll orientation relative to the handle. Such an operation may be performed robotically or manually and may occur before or after undock of the handle / instrument 151 from the robotic system 158.

[0140] At block 1514, the process 1500 entails unlatching / undocking the handle 151 from the end effector / adapter 158, thereby locking the rotation of the shaft 154 relative to the handle 151. If the shaft 154 has not already been moved to the home position, it may be necessary to manually rotate the shaft 154 relative to the handle 151 to move the shaft 154 to the home roll position, thereby enabling the shaft 154 roll lock through the bias of the handle 151 axis catch.

[0141] Described herein are systems, devices, and methods that facilitate robotic roll of a medical instrument shaft, as well as limiting and / or restricting such roll, in connection with particular medical procedures. In particular, systems, devices, and methods according to one or more aspects of the present disclosure can facilitate locking of robotic shaft roll, which may be performed automatically in connection with undocking of the instrument from a robotic end effector or other system component. Robotic shaft roll, shaft roll locking, and shaft roll limiting / restriction according to various embodiments disclosed herein can advantageously reduce certain risks and / or inefficiencies associated with instrument roll.

[0142] In some implementations, the present disclosure relates to a medical instrument comprising an elongate shaft defining a roll axis and a handle coupled to the elongate shaft, the handle comprising a robotic drive input operable to rotate the elongate shaft relative to the handle about the roll axis, and a lockout mechanism movable between an engaged position, in which the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, in which the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis.

[0143] The lockout mechanism can be configured to move to the engaged position in a configuration where the handle is remote from the robot, hi some embodiments, the lockout mechanism is configured to move to the engaged position in a configuration where the handle is remote from the robot and the elongate shaft is at a predefined angular position about the roll axis.

[0144] The medical instrument can further include a shaft having a first axis, a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis, and a bevel gear having a third axis parallel to the first axis, the bevel gear in meshing arrangement with the shaft gear. The bevel gear can be coupled to the shaft by a belt configured to transfer rotational motion of the shaft to the bevel gear.

[0145] The medical instrument can further include a shaft having a first axis, a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis, a bevel gear disposed within the handle in meshing arrangement with the shaft, the bevel gear configured to rotate about a third axis parallel to the second axis, and a rod coupled to and coaxial with the bevel gear. The rod can be configured to rotate the shaft gear.

[0146] The medical instrument can further include a shaft actuable by a robotic drive input and a shaft-retaining structure at least partially disposed on the shaft, the shaft-retaining structure configured to limit rotation of the shaft. In some embodiments, the shaft-retaining structure includes a first open annular channel and one or more first stop surfaces exposed in the first open annular channel and configured to limit rotation of the shaft. For example, the shaft can include a second open annular channel at least partially open to the first open annular channel and one or more second stop surfaces exposed in the second open annular channel and configured to limit rotation of the shaft. The medical instrument can further include a slider configuration including a first portion at least partially disposed in the first open annular channel and configured to contact the one or more first stop surfaces, and a second portion at least partially disposed in the second open annular channel and configured to contact the one or more second stop surfaces.

[0147] In some implementations, the present disclosure relates to a robotic medical system including a robotic manipulator including multiple drive outputs and a boss. The robotic medical system further includes a medical instrument including a handle mountable to an adapter and an elongated shaft insertable into a patient, the handle including multiple drive inputs and a lockout mechanism configured to selectively allow or prevent rotation of the elongated shaft relative to the handle. The boss is configured to disengage the lockout mechanism when the handle is mounted to the adapter.

[0148] In some embodiments, a robotic manipulator assembly includes a robotic end effector including a plurality of drive outputs; and an adapter mountable to the robotic end effector and including a plurality of drive couplers and a boss. The boss can be configured to vertically translate at least a portion of the lockout mechanism. In some embodiments, the boss is configured to rotate at least a portion of the lockout mechanism.

[0149] In some implementations, the present disclosure relates to a medical instrument comprising: an elongate shaft; a handle coupled to a proximal portion of the elongate shaft; a shaft associated with the handle, wherein rotation of the shaft is configured to rotate the elongate shaft about an axis of the elongate shaft; and a shaft catch at least partially disposed within the handle and configured to operate to prevent rotation of the shaft.

[0150] In some embodiments, the shaft catch includes a key configured to engage a mating feature of the shaft. For example, when the key is at least partially disposed within the mating feature of the shaft, rotation of the shaft can be limited. The key of the shaft catch can be configured to enter the mating feature of the shaft axially with respect to the axis of the shaft. In some embodiments, the shaft catch is configured to be actuated in a direction parallel to the axis of the shaft. For example, the shaft catch can include one or more alignment pin channels, each having an axis parallel to the axis of the shaft and having a respective alignment pin at least partially disposed therein, each alignment pin guiding actuation of the shaft catch in a direction parallel to the axis of the shaft. The key of the shaft catch can be configured to enter the mating feature of the shaft through a side portion of the shaft. For example, the shaft catch can be configured to rotate about an axis parallel to the axis of the shaft. In some embodiments, the key includes a flexure protrusion.

[0151] The axle catch can include a catch actuator. For example, the catch actuator can be integral with the axle catch. In some embodiments, the catch actuator is associated with a first longitudinal end of the axle catch and a catch actuator is associated with a second longitudinal end of the axle catch. In some embodiments, the catch actuator is accessible from outside the handle. For example, the catch actuator can include a plug configured to be at least partially disposed within an open feature of the handle. Alternatively, the catch actuator can include a cam structure configured to rotate about an axis of the cam structure.

[0152] In some implementations, the present disclosure relates to a shaft catch that is biased into a locked configuration in which rotation of the shaft is prevented. The medical instrument can further include a spring at least partially disposed within the cup-shaped body of the shaft catch and configured to exert a force on the shaft catch that biases the shaft catch into the locked configuration. In some embodiments, the medical instrument further includes a shaft retainer structure disposed within the handle, the shaft retainer structure axially securing the shaft in place, and the spring configured to press against an underside of the shaft retainer structure when at least partially disposed within the cup-shaped body.

[0153] For purposes of summarizing the present disclosure, certain aspects, advantages, and novel features have been described. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, the disclosed embodiments may be performed in a manner that achieves or optimizes one advantage or group of advantages taught herein without necessarily achieving other advantages that may be taught or suggested herein.

[0154] Further embodiments Depending on the embodiment, certain acts, events, or functions of any of the algorithms or processes described herein may be performed in a different order, added, merged, or omitted entirely. Thus, in a particular embodiment, not all of the described acts or events are necessary for the execution of a process.

[0155] In particular, conditional language used herein, such as "can," "could," "might," "may," "eg," and the like, unless specifically stated otherwise or understood otherwise within the context in which it is used, is intended to have its ordinary meaning and is generally intended to convey that certain embodiments include certain features, elements, and / or steps, while other embodiments do not. Thus, such conditional language is not generally intended to imply that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining whether those features, elements, and / or steps are included in or performed in any particular embodiment, with or without author input or prompting. Terms such as "comprising," "including," "having," and the like are synonymous and used in their ordinary sense, inclusively in a non-limiting manner, and do not exclude additional elements, features, acts, operations, etc. Also, when the term "or" is used, for example, to connect a list of elements, the term "or" is used in its inclusive sense (and not its exclusive sense) to mean one, some, or all of the listed elements. Unless specifically stated otherwise, conjunctive language such as the phrase "at least one of X, Y, and Z" is understood in the context as it is commonly used to convey that an item, term, element, etc. can be either X, Y, or Z. Thus, such conjunctive language is generally not intended to imply that a particular embodiment requires that at least one of X, at least one of Y, and at least one of Z, each be present.

[0156] In the foregoing description of the embodiments, it should be understood that various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure and aiding in understanding one or more of the various inventive aspects. However, this method of disclosure should not be interpreted as reflecting an intention that any claim requires more features than are expressly recited in that claim. Moreover, any component, feature, or step illustrated and / or described in a particular embodiment herein may be applied to or used in conjunction with any other embodiment. Moreover, no component, feature, step, or group of components, features, or steps is necessary or essential for each embodiment. Accordingly, it is intended that the scope of the invention(s) disclosed herein and claimed below should not be limited by the specific embodiments described above, but should be determined solely by a fair reading of the following claims.

[0157] It should be understood that certain ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply any physical characteristics or ordering. Thus, as used herein, ordinal terms (e.g., "first," "second," "third," etc.) used to modify elements such as structures, components, operations, etc., do not necessarily indicate a priority or order of the element with respect to any other elements, but rather may generally distinguish the element from other elements having a similar or identical name (apart from the use of the ordinal terminology). Additionally, as used herein, the indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Furthermore, an action performed "based on" a condition or event may also be performed based on one or more other conditions or events not expressly recited.

[0158] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the example embodiments belong. It is further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning consistent with their meaning in the context of the relevant art, and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

[0159] Spatially relative terms such as "outside," "inside," "upper," "lower," "below," "upper," "vertical," "horizontal," and similar terms may be used herein for ease of description to describe the relationship between one element or component and another element or component as illustrated in the figures. It should be understood that spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device shown in the figures were inverted, a device positioned "below" or "under" another device would be disposed "above" the other device. Thus, the illustrative term "lower" can include both lower and upper positions. Devices may also be oriented in other directions, and thus spatially relative terms may be interpreted differently depending on the orientation.

[0160] Unless otherwise specified, comparative and / or quantitative terms such as "less," "more," "greater than," etc. are intended to encompass the concept of equality. For example, "less" can mean "less than" in the strict mathematical sense as well as "less than or equal to."

[0161] [Embodiment] (1) A medical device, an elongated shaft defining a roll axis; a handle coupled to the elongate shaft, the handle comprising: a robot drive input operable to rotate the elongate shaft relative to the handle about the roll axis; 1. A medical instrument comprising: a lockout mechanism movable between an engaged position, in which the lockout mechanism prevents rotation of the elongate shaft relative to the handle about the roll axis, and a disengaged position, in which the lockout mechanism allows rotation of the elongate shaft relative to the handle about the roll axis. (2) A medical instrument as described in embodiment 1, wherein the lockout mechanism is configured to move to the engaged position in a configuration in which the handle is away from the robot. (3) A medical instrument as described in embodiment 1 or 2, wherein the lockout mechanism is configured to move to the engaged position in a configuration in which the handle is away from the robot and the elongated shaft is at a predefined angular position about the roll axis. (4) a shaft having a first axis; a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis; a bevel gear having a third axis parallel to the first axis, the bevel gear being in meshing arrangement with the shaft gear; 4. The medical instrument of any one of claims 1 to 3, wherein the bevel gear is coupled to the shaft by a belt configured to transmit rotational motion of the shaft to the bevel gear. (5) a shaft having a first axis; a shaft gear associated with a proximal end of the elongate shaft, the shaft gear having a second axis transverse to the first axis; a bevel gear disposed within the handle in meshing engagement with the shaft, the bevel gear configured to rotate about a third axis parallel to the second axis; a rod coupled to the bevel gear and coaxial with the bevel gear; 5. The medical instrument according to any one of embodiments 1 to 4, wherein the rod is configured to rotate the shaft gear.

[0162] (6) a shaft actuable by the robot drive input; 6. The medical instrument of any one of claims 1 to 5, further comprising a shaft retention structure disposed at least partially on the shaft, the shaft retention structure configured to limit rotation of the shaft. (7) The shaft holding structure is a first open annular channel; 7. The medical device of embodiment 6, comprising one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft. (8) The shaft is a second open annular channel at least partially open to the first open annular channel; 8. The medical device of embodiment 7, comprising one or more second stop surfaces exposed within the second open annular channel and configured to limit rotation of the shaft. (9) A slider configuration is further provided, wherein the slider configuration is: a first portion at least partially disposed within the first open annular channel and configured to contact the one or more first stopper surfaces; A medical device as described in embodiment 8, comprising a second portion at least partially disposed within the second open annular channel and configured to contact the one or more second stopper surfaces. (10) A robotic medical system, a robot manipulator having a plurality of drive outputs and a boss; a medical instrument comprising a handle mountable to the robotic manipulator and an elongate shaft insertable into a patient, the handle comprising a plurality of drive inputs and a lockout mechanism configured to selectively allow or prevent rotation of the elongate shaft relative to the handle; The robotic medical system, wherein the boss is configured to disengage the lockout mechanism when the handle is mounted to an adapter.

[0163] (11) A robotic manipulator assembly comprising: a robot end effector including a plurality of drive outputs; A robotic medical system as described in embodiment 10, comprising an adapter that can be mounted to the robot end effector and that comprises a plurality of drive couplers and the boss. (12) The robot system of claim 10 or 11, wherein the boss is configured to vertically translate at least a portion of the lockout mechanism. (13) A robot system according to any one of embodiments 10 to 12, wherein the boss is configured to rotate at least a portion of the lockout mechanism. (14) A medical device, A long, slender shaft and a handle coupled to a proximal portion of the elongate shaft; a shaft associated with the handle, wherein rotation of the shaft is configured to rotate the elongate shaft about an axis of the elongate shaft; a shaft catch at least partially disposed within the handle and configured to operate to prevent rotation of the shaft. (15) The shaft catch includes a key configured to engage a mating feature on the shaft; 15. The medical instrument of claim 14, wherein rotation of the shaft is restricted when the key is at least partially disposed within the mating feature of the shaft.

[0164] (16) The medical device according to claim 15, wherein the key of the shaft catch is configured to enter the mating feature of the shaft axially relative to an axis of the shaft. (17) The medical device according to embodiment 15, wherein the shaft catch is configured to actuate in a direction parallel to the axis of the shaft. (18) The medical device of embodiment 17, wherein the axial catch includes one or more alignment pin channels, the one or more alignment pin channels having axes parallel to the axis of the shaft and configured to have respective alignment pins at least partially disposed therein, the respective alignment pins directing actuation of the axial catch in the direction parallel to the axis of the shaft. (19) The medical device according to embodiment 17, wherein the key of the shaft catch is configured to enter the mating feature of the shaft through a side portion of the shaft. (20) The medical device according to embodiment 19, wherein the shaft catch is configured to rotate about an axis that is parallel to the axis of the shaft.

[0165] (21) The medical device of claim 20, wherein the key comprises a bending protrusion. (22) The medical device according to any one of embodiments 14 to 21, wherein the shaft catch comprises a catch actuator. (23) The medical device according to claim 22, wherein the catch actuator is integral with the shaft catch. (24) The catch actuator is associated with a first longitudinal end of the shaft catch; 23. The medical device of claim 22, wherein the catch actuator is associated with a second longitudinal end of the axial catch. (25) The medical instrument of embodiment 22, wherein the catch actuator is accessible from outside the handle.

[0166] (26) The medical instrument of claim 25, wherein the catch actuator comprises a plug configured to be at least partially disposed within the open feature of the handle. (27) The medical instrument according to embodiment 25, wherein the catch actuator comprises a cam structure, the cam structure configured to rotate about an axis of the cam structure. (28) The medical device according to any one of embodiments 14 to 27, wherein the shaft catch is biased into a locking configuration in which rotation of the shaft is prevented. (29) The medical device of embodiment 28, further comprising a spring disposed at least partially within the cup-shaped body of the axle catch and configured to exert a force on the axle catch biasing the axle catch into the locking configuration. (30) Further comprising a shaft retainer structure disposed within the handle; the shaft retainer structure axially secures the shaft in place; 30. The medical device of claim 29, wherein the spring is configured to press against an underside of the axial retainer structure when at least partially disposed within the cup-shaped body.

Claims

1. A medical device, an elongated shaft defining a roll axis; a handle coupled to the elongate shaft, the handle comprising: a robot drive input operable to rotate the elongate shaft relative to the handle about the roll axis; a shaft actuatable by the robot drive input; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft; The axis is a second open annular channel at least partially open to the first open annular channel; one or more second stop surfaces exposed within the second open annular channel and configured to limit rotation of the shaft; The medical device further comprises a slider feature, the slider feature comprising: a first portion slidingly disposed at least partially within the first open annular channel and configured to contact the one or more first stop surfaces; a second portion slidingly disposed at least partially within the second open annular channel and configured to contact the one or more second stop surfaces.

2. the second open annular channel faces the first open annular channel of the shaft-retaining structure, and the second open annular channel includes two of the second stop surfaces; the shaft includes a radial locking engagement channel disposed between two of the second stop surfaces; The medical instrument of claim 1 , wherein the medical instrument further comprises a locking mechanism configured to mate with the radial locking mating channel of the shaft.

3. 3. The medical instrument of claim 2, wherein the locking mechanism is configured to automatically move from a disengaged position to an engaged position with the radial locking mating channel when the elongate shaft is manually rotated to a predefined angular position about the roll axis.

4. a shaft gear coupled to a proximal end of the elongate shaft, the shaft gear having a first axis transverse to a second axis of the shaft; a bevel gear having a third axis parallel to the second axis, the bevel gear being in meshing arrangement with the shaft gear; The medical instrument of claim 1 , wherein the bevel gear is coupled to the shaft by a belt configured to transfer rotational motion of the shaft to the bevel gear.

5. a shaft gear coupled to a proximal end of the elongate shaft, the shaft gear having a first axis transverse to a second axis of the shaft; a bevel gear disposed within the handle in meshing engagement with the shaft, the bevel gear configured to rotate about a third axis parallel to the first axis; a rod coupled to the bevel gear and coaxial with the bevel gear; The medical instrument of claim 1 , wherein the rod is configured to rotate the shaft gear.

6. The medical instrument of claim 1 , wherein the shaft retaining structure is fixed to the handle, while the shaft is rotatable relative to the handle.

7. 1. A robotic system comprising: a robotic manipulator assembly comprising one or more drive outputs and a boss; an instrument comprising a handle mountable to the robotic manipulator assembly and an elongated shaft insertable into a patient, the handle comprising: a plurality of drive inputs; a shaft actuatable by one of the plurality of drive inputs; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; a shaft retaining structure comprising one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft; the instrument further comprises an arcuate slider including a first portion configured to slide within the first open annular channel; The boss is configured to actuate a lock configured to engage the shaft and limit rotation of the shaft.

8. the robotic manipulator assembly a robot end effector including a plurality of drive outputs; The robot system of claim 7 , further comprising: an adapter mountable to the robot end effector, the adapter comprising a plurality of drive couplers and the boss.

9. The shaft includes a second open annular channel that opens toward the first open annular channel of the shaft-retaining structure; The robotic system of claim 7 , wherein the arcuate slider further includes a second portion configured to slide within the second open annular channel.

10. A medical device, A long, slender shaft and a handle coupled to a proximal portion of the elongate shaft; a shaft coupled to the handle, wherein rotation of the shaft is configured to rotate the elongate shaft about an axis of the elongate shaft; a shaft support structure disposed at least partially on the shaft and configured to limit rotation of the shaft, the shaft support structure comprising: a first open annular channel; one or more first stop surfaces exposed within the first open annular channel and configured to limit rotation of the shaft; the shaft includes a second open annular channel that opens toward the first open annular channel of the shaft-retaining structure; The medical instrument includes an arcuate slider including a first portion configured to slide within the first open annular channel and a second portion configured to slide within the second open annular channel.

11. a shaft catch disposed at least partially within the handle, the shaft catch configured to move between an unlocked position in which the shaft catch allows rotation of the shaft and a locked position in which the shaft catch restricts rotation of the shaft; the shaft catch comprising a key configured to engage a mating feature on the shaft; The medical instrument of claim 10 , wherein rotation of the shaft is restricted when the key is at least partially disposed within the mating feature of the shaft.

12. The medical instrument of claim 11 , wherein the key of the shaft catch is configured to enter the mating feature of the shaft axially relative to an axis of the shaft.

13. The medical instrument of claim 11 , wherein the shaft catch is configured to actuate in a direction that is parallel to the axis of the shaft.

14. 14. The medical instrument of claim 13, wherein the axial catch includes one or more alignment pin channels configured to have an axis that is parallel to the axis of the shaft and to have a respective alignment pin at least partially disposed therein, the respective alignment pin directing linear translation of the axial catch in the direction that is parallel to the axis of the shaft.

15. The medical instrument of claim 11 , wherein the key of the shaft catch is configured to pass through a side portion of the shaft and into the mating feature of the shaft.

16. The medical instrument of claim 15, wherein the shaft catch is configured to rotate about an axis that is parallel to an axis of the shaft.

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