Surgical robotic system with robotic telemanipulator and integrated laparoscopic surgery

Abstract

A teleoperated surgical robotic system having a robotic telemanipulator is provided. The surgical robotic system is fully adapted for use by a surgeon, can be seamlessly integrated into an operating room, allows the surgeon to work aseptically between the robot and the patient during surgery, is relatively low cost, and / or allows for integrated laparoscopic surgery. The system preferably includes a master console having a plurality of master links interconnected by a plurality of master joints, and a handle coupled to the master console for operating the telemanipulator. The system further includes a slave console operably coupled to the master console, the slave console having a plurality of slave links interconnected by a plurality of slave joints that move in response to movement at the master console to enable an end effector to perform a surgical procedure.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of priority to U.S. Patent Application No. 16 / 505,585, filed July 8, 2019, which is a continuation of U.S. Patent Application No. 16 / 269,383, filed February 6, 2019, now U.S. Patent No. 10,413,374, which in turn claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 788,781, filed January 5, 2019, and U.S. Provisional Patent Application No. 62 / 627,554, filed February 7, 2018, the entire contents of each of which are incorporated herein by reference. This application also claims the benefit of priority to International Application PCT / IB2019 / 050961, filed February 6, 2019, published as WO 2019 / 155383, which claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 788,781, filed January 5, 2019, and U.S. Provisional Patent Application No. 62 / 627,554, filed February 7, 2018, the entire contents of each of which are incorporated herein by reference.

[0002] (Field of use) This application relates generally to teleoperated surgical robotic systems that include robotic telemanipulators. [Background technology]

[0003] (background) A great many situations and applications require remote actuation by teleoperated surgical devices. These applications include the ability to perform fine manipulations, whether open field or minimally invasive, the ability to operate in confined spaces, hazardous or contaminated environments, clean rooms or sterile environments, and surgical environments. While these applications vary with parameters such as precise tolerances and the skill level of the end user, each application requires many of the same capabilities of the teleoperated system, such as the ability to perform dexterous manipulations with high precision.

[0004] Surgical applications are described in more detail in the following disclosure as exemplary applications for teleoperated device systems for which known devices exist, but for which significant drawbacks are evident in known systems and methods.

[0005] Open surgery remains the preferred method for many surgical procedures. Open surgery has been used in the medical community for decades and typically requires the creation of long incisions in the abdomen or other parts of the body through which conventional surgical instruments are inserted. Due to such incisions, this highly invasive approach results in significant blood loss during surgery and typically results in a long, painful hospital stay.

[0006] Laparoscopic surgery, a minimally invasive technique, was developed to overcome some of the drawbacks of open surgery. Instead of large transmural incisions, several small openings are made in the patient, through which long, slender surgical instruments and an endoscopic camera are inserted. The minimally invasive nature of laparoscopic procedures reduces blood loss and pain and shortens hospital stays. When performed by experienced surgeons, laparoscopic surgical techniques can achieve clinical outcomes similar to those of open surgery. However, despite the above advantages, laparoscopic surgery requires advanced skill to successfully manipulate the long, rigid instruments used in such procedures. Typically, the entrance incision acts as a rotation point, reducing the degrees of freedom for instrument positioning and orientation within the patient. The surgeon's hand movements around this incision point are reversed and magnified at the instrument tip (the "fulcrum effect"), reducing dexterity and sensitivity and increasing the surgeon's hand tremor. In addition, long, straight instruments force the surgeon to work in uncomfortable hand, arm, and body positions, which can lead to significant fatigue during prolonged procedures. Therefore, these drawbacks of laparoscopic instruments have limited minimally invasive techniques to use primarily in simple surgical procedures, with only a small percentage of surgeons being able to use such instruments and methods in complex procedures.

[0007] To overcome the aforementioned limitations of known systems, surgical robotic systems have been developed to provide a user-friendly approach to complex minimally invasive surgical procedures. Through a computerized robotic interface, these systems enable the performance of telelaparoscopic surgery, in which a surgeon sits at a console and operates two master manipulators to perform the procedure through several small incisions. Like laparoscopic surgery, robotic approaches are minimally invasive and offer the aforementioned advantages over open surgery in terms of reduced pain, blood loss, and recovery time. Additionally, robotic approaches offer better ergonomics for the surgeon compared to open and laparoscopic surgical procedures, as well as improved dexterity, precision, and tremor suppression, and elimination of the fulcrum effect. Although technically straightforward, robotic surgery still suffers from several drawbacks. One major drawback of known robotic surgical systems relates to the high level of complexity of such systems, which often include four to five robotic arms that replace both the surgeon's and assistant's hands, an integrated endoscopic imaging system, and the ability to perform telesurgery. These systems require significant capital costs for acquisition and maintenance, making them unaffordable in most surgical departments worldwide. Another drawback of these systems is the bulkiness of known surgical robots, which takes up valuable space within the operating room environment and significantly increases setup time, potentially impeding patient access and raising safety concerns.

[0008] For example, the Da Vinci® Surgical System (available from IntuitiVe Surgical, Inc., SunnyVale, California, USA) is a robotic surgical system that enables surgeons to perform remote laparoscopic surgery. However, the Da Vinci® Surgical System is a highly complex robotic system, with each system costing approximately $2,000,000 per robot, $150,000 per year in maintenance costs, and $2,000 per surgical procedure in surgical instruments. The Da Vinci® Surgical System also requires a lot of space in the operating room, making it difficult to move to a desired location within the operating room and difficult to switch between anterior and posterior surgical workspaces (also known as multi-quadrant surgery).

[0009] Furthermore, the surgeon's operating console is typically located away from the surgical site, so the surgeon and operating console are not in the sterile zone of the operating room. If the surgeon's operating console is not sterilized, the surgeon will not be permitted to treat the patient as needed without undergoing additional sterilization procedures. During certain surgical procedures, the surgeon may need to intervene immediately, but current bulky robotic systems may prevent the surgeon from quickly accessing the patient's surgical site in a timely, life-saving manner.

[0010] WO 97 / 43942 to Madhani, WO 98 / 25666 to Cooper, and U.S. Patent Application Publication No. 2010 / 0011900 to Burbank each disclose robotic teleoperated surgical instruments designed to replicate the movements of a surgeon's hands inside a patient's body. Through a computerized robotic interface, the surgical instruments enable remote laparoscopic surgery, in which a surgeon sits at a console and manipulates two joysticks to operate through a few small incisions. These systems lack the autonomy or artificial intelligence required for sophisticated instruments fully controlled by the surgeon. Control commands are transmitted between the robotic master and robotic slaves by complex computer-controlled mechatronic systems, which are very costly to manufacture and maintain and require significant training of hospital staff.

[0011] International Publication No. 2013 / 014621 to Beira, the entire contents of which are incorporated herein by reference, describes a mechanical teleoperated device for remote manipulation having a master-slave configuration including a slave unit driven by a kinematically equivalent master unit such that each component of the slave unit mimics the movement of a corresponding component of the master unit. A typical master-slave telemanipulator provides seven degrees of freedom of movement. Specifically, these degrees of freedom include three macro-translational movements (e.g., inward / outward, upward / downward, and left / right) and four micro-movements, including one rotational degree of freedom (e.g., pronosupination), two joint degrees of freedom (e.g., yaw and pitch), and one actuation degree of freedom (e.g., open / close). While the mechanical transmission system described in that publication is well-suited to the device, routing a cable from the handle through the entire kinematic chain to the instrument with low friction is expensive, complex, bulky, and requires precise calibration and careful handling and maintenance.

[0012] Additionally, known purely mechanical solutions do not provide wrist alignment, low device complexity, low mass and inertia, high surgical volume, and excellent tactile feedback. For example, in a purely mechanical teleoperated device, to perform a pure pronation / supination / roll movement of an instrument, the surgeon must typically perform a combination of pronation / supination / roll movements of his or her hand / forearm and translational movements in a curved path with his or her wrist. Such movements are complex to perform properly, and if not performed properly, the pitch and yaw of the end effector can cause undesirable parasitic movements.

[0013] Furthermore, the routing of joint and actuation degrees of freedom cables through a mechanical telemanipulator can limit the dexterity of the angular range of the various joints in the telemanipulator's link and joint structure. This limits the available surgical volume of accessible instruments within the patient's body. During rapid movements of the mechanical telemanipulator, the inertia of the telemanipulator can also be a hindrance, resulting in target overshoot and fatigue of the surgeon's hands. Some of this mass can be attributed to the parts and components required to route the actuation and joint degrees of freedom.

[0014] It would therefore be desirable to provide a teleoperated surgical robotic system that has a robotic telemanipulator well adapted for use by a surgeon, that is seamlessly integrated into the operating room, that allows the surgeon to work in a sterile environment between the robot and the patient, that is relatively low cost, and / or that allows for integrated laparoscopic surgery.

[0015] Additionally, it would be desirable to provide a teleoperated surgical robot having mechanical and / or electromechanical telemanipulators. Summary of the Invention [Means for solving the problem]

[0016] (overview) The present invention overcomes the shortcomings of known systems by providing a teleoperated surgical robotic system that preferably has a robotic telemanipulator that is well adapted for use by a surgeon, can be seamlessly integrated into an operating room, allows the surgeon to work sterilely between the robot and the patient throughout the procedure, is relatively low cost, and / or allows for integrated laparoscopic surgery.

[0017] As will be understood by those skilled in the art, the term "master" as used herein refers to a component controlled by a surgeon, sometimes referred to as the "surgeon," and the term "slave" as used herein refers to a component that interacts with a patient undergoing a surgical procedure, sometimes referred to as the "patient." For example, the terms "master console" and "surgeon console" are interchangeable, the terms "slave console" and "patient console" are interchangeable, etc. A teleoperated surgical robotic system includes a master console having a plurality of master links and a handle coupled to the master console such that motion applied at the handle moves at least one of the plurality of master links. The master console can be designed to maintain sterility during a surgical procedure. According to one aspect, the handle can be removably coupled to the master console so that it is sterile during a surgical procedure and can be sterilized while removed for additional procedures. For example, the handle can be removably coupled to the master console via, for example, a clip or screw attachment. The detachable handle can be purely mechanical, without electronics such as circuitry, sensors, or electrically coupled buttons, to facilitate sterilization between surgical procedures while the handle is detached from the master console. In this way, the master console can be sterile during surgery (e.g., covered with sterile drapes except for the handles) while allowing the surgeon to have tactile feedback available from direct contact with the robot's handles.

[0018] The surgical robotic system further includes a slave console having a plurality of slave links. According to one aspect, a distal end of the slave console can be rotatable about an alpha axis of the angled slave links of the plurality of slave links such that the distal end of the slave console is positionable to allow a user to move from the master console and manually perform laparoscopic surgery on a patient undergoing surgery.

[0019] Additionally, the system may include an end effector coupled to the slave console, the end effector moving in response to motions applied at the handle and in response to motions at the slave console to perform a surgical procedure. For example, the slave console may include a plurality of actuators, e.g., motors, operably coupled to the end effector, which, when actuated in response to actuation at the handle, impart macro-translational motions to the plurality of slave links during a macro-synchronized state but not during a macro-asynchronized state, and impart micro-motions to the end effector during a micro-synchronized state but not during a micro-asynchronized state. Further, the surgical robotic system may include an instrument having a proximal end and a distal end, the proximal end having an instrument hub designed to be coupled to the distal end of the slave console, the distal end having the end effector.

[0020] The handle can include a retractable piston that moves in response to actuation thereof. Accordingly, at least one sensor in the master console is designed to detect movement of the retractable piston and cause the multiple actuators to perform corresponding micro-movements at the end effector. According to one aspect of the present invention, the slave console does not respond to movements at the master console unless at least one sensor detects at least a predetermined degree of retractable piston movement. Furthermore, at least one sensor coupled to the handle can be designed to detect a pattern of handle actuation that transitions the robot from a micro-asynchronous state to a micro-synchronized state. For example, in the micro-asynchronous state, movement at the handle detected by the multiple sensors does not trigger a corresponding micro-movement by the end effector until the robot transitions to a micro-synchronized state due to at least one sensor detecting the handle actuation pattern.

[0021] The master console may include a mechanical limiter designed to limit the movement of at least one master link of the plurality of master links and may further include a clutch that, when activated, prevents macro-translational movement of the plurality of master links. The surgical robotic system may further include a display coupled to the master console that allows a user to visualize the end effector during operation of the remote manipulator. Additionally, the system may include a removable dissection pointer that allows alignment of the distal end of the slave console with a trocar placed inside the patient undergoing surgery.

[0022] Furthermore, the base of the slave console can be coupled to a proximal slave link of the plurality of slave links via the proximal slave joint such that the plurality of slave links and joints are movable about the proximal slave joint of the plurality of slave joints while the base of the slave console remains fixed to place the distal end of the slave console in a desired horizontal position before performing a surgical procedure. Additionally, the base of the slave console can include an adjustable vertical post coupled to the proximal slave link of the plurality of slave links. The adjustable vertical post can adjust the height of the plurality of slave links and joints to place the distal end of the slave console in a desired vertical position prior to operation of the remote manipulator.

[0023] According to one aspect of the present application, a slave link and joint of a plurality of slave links and joints distal to a beta joint of a plurality of slave joints are designed to move relative to the beta joint to flip the distal end of the slave console between a forward surgical workspace and an inverted surgical workspace, while a slave link of the plurality of slave links proximal to the beta joint and the base of the slave console remain fixed.

[0024] The surgical robotic system may also include a controller operatively coupled to the plurality of actuators such that the plurality of actuators apply movement to the plurality of slave links of the slave console in response to commands executed by the controller. For example, the controller may execute commands to cause the plurality of actuators to move the plurality of slave links of the slave console to a home configuration in which the plurality of slave links are retracted so that the end effector can be placed within a trocar inserted into a patient undergoing a surgical procedure. In addition, the controller may execute commands to cause the plurality of actuators to move an angled slave link of the plurality of slave links to an angle at which the angled slave link and a slave link of a slave console proximal to the angled slave link remain fixed during manipulation of the remote manipulator. Thus, the angle of the angled slave link enables the distal end of the slave console to perform surgery in a hemispherical surgical workspace tilted at an angle essentially parallel to the angle of the angled slave link.

[0025] According to another aspect of the invention, the master console includes a master controller and the slave console includes a slave controller, such that the master controller can execute commands based on movements detected at the handle and send signals to the slave controller based on the movements. The slave controller can then receive signals, execute commands, and move at least one of the slave links or the end effector, or both, based on the signals sent from the master controller. For example, the slave console can include a right slave remote manipulator, a right slave controller, a left slave remote manipulator, and a left slave controller, and the master console can include a right master remote manipulator, a left master remote manipulator, and a master controller, such that in a forward surgical workspace configuration, the master controller communicates with the right slave controller to move the right slave remote manipulator in response to movements at the right master remote manipulator, and the master controller communicates with the left slave controller to move the left slave remote manipulator in response to movements at the left master remote manipulator. Additionally, according to some embodiments, in an inverted surgical workspace configuration, the master controller communicates with the left slave controller to move the left slave telemanipulator in response to movements at the right master telemanipulator, and the master controller communicates with the right slave controller to move the right slave telemanipulator in response to movements at the left master telemanipulator.

[0026] Thus, the distal end of the right slave remote manipulator may be rotatable about the alpha axis of the right angled slave link of the plurality of right slave links, and the distal end of the left slave remote manipulator may be rotatable about the alpha axis of the left angled slave link of the plurality of left slave links, such that the distal ends of the right and left slave remote manipulators are positionable to allow a user to move from the master console and manually perform laparoscopic surgery on a patient undergoing surgery. Additionally, the right handle may be removably coupled to the right master remote manipulator, and the left handle may be removably coupled to the left master remote manipulator.

[0027] According to yet another aspect of the present invention, there is provided a system for teleoperation to perform surgical procedures. The system includes a patient console having a plurality of patient links coupled to a base, and a surgical instrument coupled to the patient console. A distal region of the surgical instrument can be inserted into a surgical site on the patient to perform robotic surgery. The system further includes a controller that executes instructions to: in a surgical mode, move at least one of the plurality of patient links in response to movement applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform robotic surgery; and transition the patient console from the surgical mode to a laparoscopic mode in which the plurality of patient links are withdrawn from the patient while the base of the patient console remains stationary, exposing the surgical site and allowing a surgeon to perform non-robotic surgery at the surgical site without interference from the plurality of patient links.

[0028] Additionally, the controller may further execute instructions to determine that a surgical instrument has been removed from the patient's surgical site, such that the controller transitions the patient console from the surgical mode to the laparoscopic mode only if the surgical instrument has been removed. For example, the controller may determine that a surgical instrument has been removed from the patient by determining that the surgical instrument has been removed from the patient console. Further, the controller may transition the patient console from the surgical mode to the laparoscopic mode in response to a user input received at the patient console. Additionally, the handle may be removably coupled to the surgeon's console so that the handle is sterile during the surgical procedure and can be sterilized while removed for additional surgical procedures. The system may further include a display coupled to the surgeon's console to allow the surgeon to visualize the surgical instrument during operation of the system.

[0029] Additionally, the controller can further execute instructions in the surgical mode to move at least one of the plurality of patient links a scaled amount in response to a movement applied at the handle of the surgeon's console. For example, the controller can execute instructions in the surgical mode to cause a scaled micro-movement of a micro degree of freedom at a surgical instrument in response to a corresponding movement applied at the handle of the surgeon's console. The micro-movement applied at the surgical instrument can be independently scalable for each micro degree of freedom such that the scaled micro-movement of a micro degree of freedom is at a different scale than a second scaled micro-movement of a second micro degree of freedom at the surgical instrument. Additionally, the surgeon's console can include a clutch that, when actuated, prevents micro-movement at the surgical instrument in response to a micro-movement applied at the handle of the surgeon's console.

[0030] According to another aspect of the present invention, there is provided a method for remotely performing surgery, the method including the steps of: coupling a surgical instrument to a patient console including a plurality of patient links coupled to a base; inserting a distal region of the surgical instrument into a surgical site on a patient to perform robotic surgery; moving at least one of the plurality of patient links in a surgical mode in response to movement applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform robotic surgery; and transitioning the patient console from the surgical mode to a laparoscopic mode, wherein the plurality of patient links are retracted from the patient while the base of the patient console remains stationary to expose the surgical site and enable a surgeon to perform non-robotic surgery at the surgical site without interference from the plurality of patient links.

[0031] According to yet another aspect of the present invention, another system for teleoperation for performing a surgical procedure is provided. The system may include a patient console having a plurality of patient links coupled to an alignment joint and a base, and a surgical instrument coupled to the patient console. A distal region of the surgical instrument can be inserted into a surgical site on the patient to perform the robotic surgery. The system may further include a controller that executes instructions to: set a virtual center of motion based on alignment between the alignment joint and the surgical site; and move at least one of the plurality of patient links in response to movement applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform the robotic surgery, the movement of the surgical instrument being constrained about the virtual remote center of motion to maintain alignment between the patient joint and the surgical site during the surgical procedure.

[0032] The system may further include a dissection pointer that can be removably coupled to the alignment joint to enable alignment of the alignment joint with the surgical site. For example, the dissection pointer can be removably coupled to the alignment joint via a magnetic attachment. Additionally, the system can include a trocar that is placed within the patient's surgical site such that a virtual center of motion is established based on alignment of the alignment joint with the trocar.

[0033] According to another aspect of the present invention, there is provided another method for remotely performing surgery, which may include the steps of: aligning one patient joint of a plurality of patient joints of a patient console with a trocar insertion site, the plurality of patient joints being interconnected to a plurality of patient links, the patient console being operatively coupled to a surgeon console and configured to move in response to motion applied at a handle of the surgeon console; establishing a virtual remote center of motion based on the alignment of the patient joint with the trocar insertion site; and moving at least one of the plurality of patient links in response to motion applied at the handle to move a surgical instrument coupled to the patient console to perform the surgery, the movement of the surgical instrument being constrained about the virtual remote center of motion to maintain alignment of the patient joint with the trocar insertion site during the procedure.

[0034] According to yet another aspect of the present invention, another system for teleoperation for performing a surgical procedure is provided. The system may include a patient console having a plurality of patient links coupled to a base and a matching joint, and a surgical instrument coupled to the patient console. A distal region of the surgical instrument can be inserted into a surgical site on the patient to perform the robotic surgery. The system may further include a controller that, in a surgical mode, executes instructions to cause scaled micro-movements of micro-degrees of freedom at the surgical instrument in response to corresponding movements applied at the handle of the surgeon's console, the scaled micro-movements of the surgical instrument being greater than the corresponding movements applied at the handle of the surgeon's console. The micro-movements applied at the surgical instrument may be independently scalable for each micro-degree of freedom such that a scaled micro-movement of a first micro-degree of freedom is on a different scale than a second scaled micro-movement of a second micro-degree of freedom at the surgical instrument.

[0035] Additionally, the surgeon's console can include a clutch that, when actuated, prevents micro-motion in the surgical instrument in response to micro-motion applied at the surgeon's console handle. For example, a surgeon can articulate an instrument's end effector via the handle (e.g., using the end effector's roll, pitch, and / or yaw degrees of freedom) to a particular position, then actuate the clutch, return the handle to a more ergonomic position while the instrument's end effector remains stationary, and then release the clutch to continue relative micro-motion from the handle to the instrument's end effector. [Brief explanation of the drawings]

[0036] BRIEF DESCRIPTION OF THE DRAWINGS [Figure 1] FIG. 1 illustrates an exemplary teleoperated surgical robotic system having a robotic telemanipulator constructed in accordance with the principles of the present invention.

[0037] [Figure 2A] FIG. 2A illustrates an exemplary master console constructed in accordance with the principles of the present invention.

[0038] [Figure 2B] FIG. 2B illustrates an exemplary display constructed in accordance with the principles of the present invention.

[0039] [Figure 2C] FIG. 2C illustrates another exemplary master console constructed in accordance with the principles of the present invention.

[0040] [Figure 3] FIG. 3A shows the master console of FIG. 2A in a seated configuration, and FIGS. 3B and 3C show the master console of FIG. 2A in a standing configuration.

[0041] [Figure 4] FIG. 4 illustrates an exemplary master console handle constructed in accordance with the principles of the present invention.

[0042] [Figure 5A] FIG. 5A illustrates an exemplary handle grip constructed in accordance with the principles of the present invention. [Figure 5B-5C] 5B and 5C show the handle grip of FIG. 5A removably coupled to the master console handle of FIG. 4A in accordance with the principles of the present invention.

[0043] [Figure 5D-5F] 5D-5F illustrate an exemplary handle grip removably coupled to a master console handle via a clip attachment in accordance with the principles of the present invention.

[0044] [Figure 5G] FIG. 5G illustrates an exemplary sterile drape cap coupled to a master console handle in accordance with the principles of the present invention.

[0045] [Figure 6] FIG. 6 illustrates an exemplary handle grip removably coupled to a master console handle via a threaded attachment in accordance with the principles of the present invention.

[0046] [Figure 7A-7C] 7A-7C illustrate an actuation sequence for the handle grip of FIG. 5A in accordance with the principles of the present invention.

[0047] [Figure 7D-7E] 7D and 7E are cross-sectional views of the handle grip of FIG. 5A coupled to the master console handle.

[0048] [Figure 8A] FIG. 8A illustrates another exemplary master console handle constructed in accordance with the principles of the present invention.

[0049] [Figure 8B-8C] 8B and 8C illustrate movement of the handle grip of the master console handle of FIG. 8A in accordance with the principles of the present invention.

[0050] [Figure 8D-8E] 8D and 8E are internal views of the master console handle of FIG. 8A.

[0051] [Figure 8F-8G] 8F and 8G illustrate an exemplary sterile drape interface in accordance with the principles of the present invention.

[0052] [Figures 9A-9C] 9A-9C show the handle grip of FIG. 8A removably coupled with the master console handle of FIG. 8A in accordance with the principles of the present invention.

[0053] [Figure 9D-9F] 9D-9F show the handle grip of FIG. 8A uncoupled from the master console handle of FIG. 8A in accordance with the principles of the present invention.

[0054] [Figures 10A-10C] 10A-10C illustrate yet another exemplary master console handle constructed in accordance with the principles of the present invention.

[0055] [Figures 11A-11B] 11A and 11B illustrate an exemplary slave console constructed in accordance with the principles of the present invention.

[0056] [Figure 12] FIG. 12 illustrates a left slave console constructed in accordance with the principles of the present invention.

[0057] [Figure 13A] FIG. 13A illustrates an exemplary controller for a teleoperated surgical robotic system.

[0058] [Figure 13B] FIG. 13B illustrates another exemplary controller for a teleoperated surgical robotic system.

[0059] [Figures 14A-14E] 14A-14E illustrate the movement of Scara in a slave console in accordance with the principles of the present invention.

[0060] [Figures 15A-15C] 15A-15C illustrate vertical adjustment of a slave console in accordance with the principles of the present invention.

[0061] [Figure 16] FIG. 16 illustrates a slave console in a home configuration in accordance with the principles of the present invention.

[0062] [Figures 17A-17D] 17A-17D show the movement of an exemplary translating instrument interface coupled to a slave console in a forward configuration at 0 degrees angulation of the slave console.

[0063] [Figures 18A-18D] 18A-18D illustrate the anterior surgical workspace of FIGS. 17A-17D.

[0064] [Figure 18E] FIG. 18E is a rear view of the front surgical workspace of the slave console of FIGS. 18A-18D.

[0065] [Figures 19A-19C] 19A-19C show the forward surgical workspace of an exemplary instrument coupled to a slave console in a forward configuration at a 20 degree angulation of the slave console.

[0066] [Figures 20A-20C] 20A-20C show the forward surgical workspace of an exemplary instrument coupled to a slave console in a forward configuration at a 40 degree angulation of the slave console.

[0067] [Figures 21A-21J] 21A-21J illustrate the flipping of a slave console between a forward configuration and a reverse configuration in accordance with the principles of the present invention.

[0068] [Figures 21K-21L] 21K and 21L are schematic diagrams of a master console and a slave console in forward and reverse configurations, respectively, in accordance with the principles of the present invention.

[0069] [Figures 22A-22C] 22A-22C show an exemplary translating instrument interface coupled to a slave console in an inverted configuration at 0, 20, and 40 degree angulations of the slave console, respectively.

[0070] [Figures 23A-23C] 23A-23C illustrate an inverted surgical workspace of FIGS. 22A-22C.

[0071] [Figures 24A-24D] 24A-24D illustrate the adjustment of a slave console for integrated laparoscopic surgery in accordance with the principles of the present invention.

[0072] [Figure 25] FIG. 25 is a flow chart illustrating the use of the teleoperated surgical robotic system of FIG. 1 in accordance with the principles of the present invention.

[0073] [Figure 26] FIG. 26 is a flow chart illustrating the process of deploying the surgeon's console of FIG. 25 in accordance with the principles of the present invention.

[0074] [Figure 27] FIG. 27 is a flow chart illustrating the preparation steps of FIG. 25 in accordance with the principles of the present invention.

[0075] [Figure 28] FIG. 28 is a flow chart illustrating the steps for preparing the device of FIG. 25 in accordance with the principles of the present invention.

[0076] [Figure 29] FIG. 29 is a flow chart illustrating steps preparatory to the operation of FIG. 25 in accordance with the principles of the present invention.

[0077] [Figure 30] FIG. 30 is a flow chart illustrating the operational steps of FIG. 25 in accordance with the principles of the present invention.

[0078] [Figure 31A-31B] 31A and 31B illustrate an exemplary tele-actuated surgical robotic system having a hybrid tele-manipulator constructed in accordance with the principles of the present invention.

[0079] [Figure 32A-32B] 32A and 32B show partial exploded perspective views of the surgical robotic system of FIGS. 31A and 31B.

[0080] [Figure 33] FIG. 33 illustrates a partially exploded top view of an exemplary mechanical transmission system constructed in accordance with the principles of the present invention.

[0081] [Figure 34A-34B] 34A and 34B show side perspective views of an exemplary master unit constructed in accordance with the principles of the present invention.

[0082] [Fig. 34C-34D] Figures 34C and 34D show an alternative embodiment of a handle suitable for use with the master unit depicted in Figures 34A and 34B.

[0083] [Figure 35A-35B] 35A and 35B show side perspective views of an exemplary slave unit constructed in accordance with the principles of the present invention.

[0084] [Figure 36A-36B] 36A and 36B show a cross-sectional end view and a side interior perspective view, respectively, of an exemplary slave hub.

[0085] [Figure 36C-36D] 36C and 36D are a perspective side view and a detailed internal view of the end effector, respectively, of a slave instrument constructed in accordance with the principles of the present invention.

[0086] [Figure 36E] FIG. 36E is a detailed view of an alternative embodiment of an exemplary end effector.

[0087] [Figure 37] FIG. 37 shows a flowchart illustrating exemplary method steps for identifying the kinematics of a selected end effector.

[0088] [Figure 38]FIG. 38 illustrates an alternative exemplary embodiment of a teleoperated surgical robotic system of the present invention.

[0089] [Figure 39] FIG. 39 shows an internal side perspective view of the master unit of the tele-actuated surgical robotic system of FIG.

[0090] [Figure 40A-40B] 40A and 40B are front and rear perspective views of a slave unit of the teleoperated surgical robotic system of FIG.

[0091] [Figure 40C-40D] 40C and 40D illustrate another exemplary dissection pointer constructed in accordance with the principles of the present invention.

[0092] [Figure 41A-41B] 41A and 41B are schematic diagrams of alternative control systems suitable for use in the surgical robotic systems of the present invention.

[0093] [Figure 42A-42B] 42A and 42B are side perspective views of an alternative embodiment of a remote manipulator constructed in accordance with the principles of the present invention.

[0094] [Figure 43] FIG. 43 illustrates another exemplary master console constructed in accordance with the principles of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0095] (Detailed explanation) Described herein is a teleoperated surgical robotic system having a robotic telemanipulator and integrated laparoscopic surgery, constructed in accordance with the principles of the present invention, that can be used in minimally invasive surgical procedures or other applications. The surgical robotic system provides the benefits of robotics for time-consuming and difficult surgical tasks, such as suturing and dissection, and allows users, e.g., surgeons, to efficiently switch to integrated laparoscopic surgery for shorter, specialized surgical tasks, such as sealing and stapling vessels. Fully articulating instruments simplify complex surgical tasks, and replicating hand movements improves precision. Users can sit or stand in a relaxed, ergonomic working position to improve the surgeon's focus and performance.

[0096] Referring to FIG. 1, an exemplary teleoperated surgical robotic system 10 having a robotic telemanipulator is shown. The surgical robotic system 10 includes a master console 20 electrically and operably coupled to a slave console 50, e.g., via an electrical cable. As described in further detail below, the surgical robotic system 10 includes a macro-synchronization state in which a plurality of actuators, e.g., preferably motors, coupled to the slave console 50 apply macro-translational motions to an end effector of the slave console 50 in response to motions applied at the master console 20 via a processor-driven control system, and a micro-synchronization state in which a plurality of actuators, e.g., preferably motors, coupled to the slave console 50 apply micro-motions to the end effector of the slave console 50 in response to motions applied at a handle of the master console 20 via a processor-driven control system.

[0097] The control system may include a master controller 2 operably coupled to the right and left master remote manipulators 22 a and 22 b of the master console 20, and slave controllers 4 a and 4 b operably coupled to the right and left slave remote manipulators 51 a and 51 b of the slave console 50, respectively. For example, the master controller 2 may include a non-transitory computer-readable medium, e.g., a memory, having stored thereon instructions that, when executed by its one or more processors, enable operation of the master console 20. Similarly, the slave controllers 4 a, 4 b may each include a non-transitory computer-readable medium, e.g., a memory, having stored thereon instructions that, when executed by their respective one or more processors, enable operation of the slave console 50. The master controller 2 is operably coupled to the slave controllers 4 a and 4 b via a communications link, such as a cable (illustrated), or via wireless communication components.

[0098] The master controller 2 may be operatively coupled to one or more sensors of the master console 20, and the slave controllers 4a, 4b may be operatively coupled to one or more actuators of the slave console 50, such that the master controller 2 receives signals indicative of movements applied at the master console 20 by the one or more sensors of the master console 20, performs the coordinate transformations necessary to execute instructions stored therein to operate one or more actuators of the slave console 50, and transmits processed signals to the respective slave controllers 4a, 4b which execute the instructions stored therein to move the slave console 50 based on the processed signals in a manner corresponding to the movements of the master console 20. For example, the one or more actuators may comprise one or more motors. Alternatively, the master controller 2 may receive signals from one or more sensors in the master console 20, process the signals, and transmit the processed signals to the respective slave controllers 4 a, 4 b, which may execute instructions stored therein to perform coordinate transformations based on the processed signals and then execute the instructions to actuate one or more actuators in the slave console 50 to move the slave console 50 to correspond to movements of the master console 20 based on the transformed processed signals. Preferably, the slave links and slave joints in the slave console 50 move such that the end effector / instrument tip replicates movements applied at the handle of the master console 20 without deviating from the remote center of motion during operation of the surgical robotic system 10, as described in more detail below. Thus, translational degrees of freedom, e.g., left / right, up / down, medial / lateral, joint degrees of freedom, e.g., pitch and yaw, actuation degrees of freedom, e.g., open / close, and rotational degrees of freedom, e.g., pronation / supination, are electromechanically replicated via sensors, actuators, and control systems, as described in more detail below.

[0099] According to one aspect of the present invention, the slave links and joints of the slave console 50 can move in response to movements applied at the handle of the master console 20 such that the surgical instrument replicates, at a scaled scale, the movements applied at the handle of the master console 20. For example, the master controller 2 can receive signals from one or more sensors of the master console 20, process the signals, and send the processed signals to respective slave controllers 4a, 4b, which can execute instructions stored therein to perform coordinate transformations based on the processed signals to generate signals indicative of corresponding scaled movements, and execute the instructions to actuate one or more actuators of the slave console 50 to move the slave console 50 in a scaled manner corresponding to the movements of the master console 20 based on the transformed and scaled processed signals. Thus, the surgeon can apply a micro-roll movement, e.g., 30 degrees, to the handle of the master console 20, which can cause the actuators of the slave console 50 to perform a micro-roll movement of the surgical instrument on the slave console 50 at a scaled degree, e.g., 60 degrees, thereby causing movement by the slave console 50 at a scaled ratio (e.g., 1:2) in response to movement at the master console 20. Preferably, the micro-scaling results in a micro-movement at the end effector that is greater than the micro-movement occurring at the handle. Each macro-degree of freedom, e.g., translation, and each micro-degree of freedom, e.g., articulation, actuation, and rotation, can be independently scaled such that the corresponding movement of the assigned degree of freedom at the slave console 50 is selectively scaled compared to the movement applied at the master console 20 by the surgeon. For example, rotational micro degrees of freedom can be programmed to have corresponding scaled movement between the master and slave on a first scale (1:2), and actuation and / or articulation micro degrees of freedom can be programmed to have corresponding scaled movement between the master and slave on a second scale (2:3) that is different from the first scale.A third scale can be used for the third micro degree of freedom. As will be appreciated by those skilled in the art, the scale ratio can be, for example, 3:1, 2.5:1, 2:1, 1.5:1, 1:1.5, 1:2, 1:2.5, or 1:3, and can vary by degree of freedom. Advantageously, if the micro scaling requires a larger scaled movement at the end effector than at the handle, the surgeon need not apply as much movement to the handle of the master console 20 in order for the surgical instrument on the slave console 50 to achieve the desired large movement. This allows for more efficient aspects of robotic surgery (e.g., suturing) with reduced strain on the surgeon's hand / wrist / arm.

[0100] The master console 20 can be positioned in the operating room, where a user, e.g., a surgeon, may be located, and in close proximity to the slave console 50, where a patient undergoing surgery may be located, e.g., in a sterile zone, so that the user can quickly move between the master console 20 and the slave console 50 during surgery to manually perform laparoscopic surgery, as needed. The slave console 50 is therefore designed to efficiently retract to a configuration that allows the surgeon to access the patient's surgical site, as described in more detail below. The master console 20 can include a removable handle that can be covered with a sterile drape and removed and sterilized between surgeries, so that the handle is sterile during surgery and there is no physical barrier between the handle and the surgeon's hands, thereby enhancing the surgeon's control and performance. The removable handle can be purely mechanical, without electronics such as circuitry, sensors, or electrically coupled buttons, so that the removable handle can be easily sterilized between surgeries. In this way, the master console can be sterile during surgery, but still allow the surgeon to have tactile feedback from direct contact with the robotic handle.

[0101] As illustrated in FIG. 1 , the master console 20 includes a right master remote manipulator 22 a and a left master remote manipulator 22 b. The right master remote manipulator 22 a and the left master remote manipulator 22 b can be arranged on a single master console such that, when a surgeon is present at the master console 20, the right master remote manipulator 22 a can be operated by the surgeon's right hand and the left master remote manipulator 22 b can be operated by the surgeon's left hand. Accordingly, the master console 20 can include wheels for mobility within the operating room and wheel locks that can be activated to lock the remote manipulators in place, e.g., during storage or during use by the surgeon during a surgical procedure. Additionally, the right master remote manipulator 22 a and the left master remote manipulator 22 b can be operated simultaneously and independently of one another, e.g., by the surgeon's right and left hands. Preferably, the surgical robotic system 10 is optimized for use in surgical procedures.

[0102] As further illustrated in FIG. 1 , the slave console 50 includes a right slave telemanipulator 51a operably coupled to the right master telemanipulator 22a and a left slave telemanipulator 51b operably coupled to the left master telemanipulator 22b. The right and left slave telemanipulators 51a and 51b can be located on separate consoles so that the right slave telemanipulator 51a can be positioned to the right of a patient undergoing a surgical procedure and the left slave telemanipulator can be positioned to the left of the patient. Accordingly, the right and left slave telemanipulators 51a and 51b can each be equipped with wheels for movement within the operating room and floor locks that can be activated to lock the telemanipulators in place, for example, during storage or near a patient during surgery. Additionally, the right and left slave telemanipulators 51a and 51b can each be equipped with a pull bar for pushing or pulling the telemanipulators within the operating room.

[0103] Additionally, a camera system may be used with the surgical robotic system 10. For example, a camera, e.g., an endoscope, operated by an assistant located at the slave console 50 may be operated and / or held in place at the slave console 50. Accordingly, the camera system may include a display 21 mounted on the master console 20 in a location that is easily observable by the surgeon during the surgical procedure. The display 21 may display status information regarding the surgical robotic system 10 and / or display the surgical site captured by the endoscopic camera to the surgeon in real time.

[0104] 2A, an exemplary master console 20 is shown. As mentioned above, the master console 20 includes a right master remote manipulator 22a and a left master remote manipulator 22b. The left master remote manipulator 22b may be a structural mirror image of the right master remote manipulator 22a, as illustrated, and therefore the following description of the right master remote manipulator 22a also applies to the left master remote manipulator 22b.

[0105] The master telemanipulator 22a includes a plurality of master links, e.g., a first master link 26, a second master link 28, a third master link 30, and a fourth master link, e.g., an induction master link 32, interconnected by a plurality of master joints, e.g., a first master joint 25, a second master joint 27, a third master joint 29, a fourth master joint 31, and a fifth master joint 34. As shown in FIG. 1 , a handle portion 35 is connected to the master telemanipulator 22a via joint 34 and includes a plurality of handle links interconnected by a plurality of handle joints for operating the master telemanipulator 22a. In addition, the master telemanipulator 22a includes a base portion having telescopic bases 23a and 23b and a base cap 24 fixed on the telescopic bases 23a and 23b. A link 26 is rotatably coupled to the base cap 24 via joint 25. Thus, link 26, and therefore all of the master joints and links distal to link 26, can rotate relative to base cap 24 about axis δ1 at joint 25. As shown in Figure 1, link 28, and therefore all of the master joints and links distal to link 28, can rotate relative to link 26 about axis δ2 at joint 27, link 30, and therefore all of the master joints and links distal to link 30, can rotate relative to link 28 about axis δ3 at joint 29, and guide master link 32, and therefore all of the master joints and links distal to guide master link 32, can rotate relative to link 30 about axis δ4 at joint 31.

[0106] The master console 20 includes a number of sensors located within the master remote manipulator 22a so that any movement applied to any of the master links and joints can be detected and transmitted to a control system which then executes instructions to cause one or more actuators coupled to the slave console 50 to replicate the movement in the corresponding slave links and joints of the slave remote manipulator 51a, as described in more detail below with reference to FIG. 12.

[0107] 2A , the master remote manipulator 22a includes a mechanical limiter 33 that includes an opening in link 26 sized and shaped to allow placement of a guiding master link 32 therethrough, thereby limiting movement of the master remote manipulator 22a about its pivot point. For example, the mechanical limiter 33 ensures that the guiding master link 32 translates along the longitudinal axis δ5 when the master remote manipulator 22a is actuated. In addition, the mechanical limiter 33 allows the guiding master link 32 to rotate about mutually perpendicular axes δ1 and δ6, forming a plane that intersects the longitudinal axis δ5 at a fixed pivot point P, regardless of the orientation of the guiding master link 32. As a result, the slave remote manipulator generates a corresponding movement, thereby effectively maintaining the pivot point of the master remote manipulator at a fixed incision point on the patient, for example, where a trocar enters the patient's abdomen.

[0108] When the surgical robotic system 10 is positioned so that the remote center of motion V is aligned with the patient's incision, translational motion applied to the handle portion 35 is replicated by the end effector located inside the patient. Because the end effector replicates the motion applied to the handle portion 35, this configuration advantageously eliminates the fulcrum effect between the handle and the end effector.

[0109] Additionally, the master console 20 can include an arm support 12, for example, coupled to the base cap 24, sized and shaped to allow a surgeon to rest their arm on the arm support during operation of the master console 20. Thus, the arm support 12 remains stationary during operation of the master telemanipulator 22a. The master console 20 can further include a clutch 11, for example, a foot pedal, that, when activated, prevents macro- and / or micro-synchronization of the surgical robotic system 10, as described in more detail below. Thus, the master console 20 enables macro- and micro-clutching.

[0110] Referring now to FIG. 2B, display 21 is shown. Display 21 can have a simple design without text, utilizing only visible graphic elements and LEDs, such as white, yellow, and red lights. For example, a white light communicates that a component is functioning properly, a yellow light communicates that the surgeon has performed an improper action, and a red light communicates that a component has an error. As shown in FIG. 2B, display 21 graphically displays various components of slave console 50 and their status. Icon 21a corresponds to system activation, icon 21b corresponds to a system warning, icon 21h corresponds to a working limit being reached, and icon 21j corresponds to whether the respective slave telemanipulator of slave console 50 is in the forward surgical workspace or the reverse surgical workspace. All of these icons can be invisible when not illuminated, while all other icons have graphic elements that are visible even when not illuminated. Icon 21c corresponds to the homing, e.g., home configuration, of the slave console 50, icon 21d corresponds to the state of the instrument 82, icon 21e corresponds to the sterile interface of the converter instrument interface 81, icon 21f corresponds to macro synchronization, icon 21g corresponds to micro synchronization, and icon 21i corresponds to whether the wheels of the slave console 50 are locked or unlocked, all of which functions are described in more detail below. As will be appreciated by those skilled in the art, the display 21 can be any display known in the art capable of conveying information to the surgeon.

[0111] FIG. 2C illustrates another exemplary master console similar to that shown in FIG. 2A, except that the master console 20 of FIG. 2C further includes an additional clutch 11′, e.g., an additional foot pedal. In this manner, as described in further detail below, actuation of clutch 11 allows the master / slave to transition between one type of synchronization / desynchronization (e.g., for macro-movements), and actuation of clutch 11′ allows the master / slave to transition between another type of synchronization / desynchronization (e.g., for micro-movements, or for both micro- and macro-movements). This allows for independently actuable macro- and micro-clutching. Alternatively, or in addition, different predetermined actuation patterns of clutch 11 and / or clutch 11′ (e.g., multiple pedal presses within a predetermined time period vs. a single pedal press within a predetermined time period) can be used for the independently actuable macro- and micro-clutching.

[0112] 3A-3C, the master console 20 can be adjusted between a seated configuration and a standing configuration via the telescoping bases 23a and 23b. For example, as illustrated in FIG. 3A, the master console 20 can be adjusted to a seated configuration such that the telescoping bases 23a and 23b have a vertical height D1. In this seated configuration, a surgeon can be seated while operating the master console 20. As illustrated in FIGS. 3B and 3C, the master console 20 can be adjusted to a standing configuration such that the telescoping bases 23a and 23b have a vertical height D2. In this configuration, a surgeon can be standing while operating the master console 20. Additionally, the vertical height of the telescoping bases 23a and 23b can be adjusted via an actuator located on the master console 20, such as the master link 26. For example, the actuator can include an up button that increases or a down button that decreases the vertical height of the telescoping bases 23a and 23b when activated. As will be appreciated by those skilled in the art, the vertical height of telescoping bases 23a and 23b can be adjusted to any vertical height between D1 and D2 as desired by the surgeon.

[0113] Referring now to FIG. 4, a master console handle portion 35 is shown. The master console handle portion 35 includes a plurality of handle links, e.g., handle link 36 and handle link 38, interconnected by a plurality of handle joints, e.g., handle joint 37 and handle joint 39. As illustrated in FIG. 4, handle link 36 is rotatably coupled to guide master link 32 via joint 34 and, therefore, can rotate relative to guide master link 32 about axis δ7. Additionally, handle link 38 is rotatably coupled to handle link 36 via handle joint 37 and, therefore, can rotate relative to handle link 36 about axis δ8. Furthermore, a handle grip 40 can be removably coupled to the master console handle portion 35 at joint 39, such that the handle grip 40 can rotate relative to handle link 37 about axis δ9. As shown in FIG. 4, the handle grip 40 can include a finger strap 41 for engaging a surgeon's fingers, e.g., the thumb and index finger.

[0114] Inward / outward movement of the handle portion 35 causes the guiding master link 32 to move inward / outward along the longitudinal axis δ, which is detected by one or more sensors coupled to the master telemanipulator 22a and transmitted to the control system, which then executes commands to cause the corresponding slave link to replicate the inward / outward movement along the virtual longitudinal axis ω by one or more actuators coupled to the slave telemanipulator 51a. Similarly, upward / downward movement of the handle portion 35 causes the guiding master link to move up / down along the longitudinal axis δ, which is detected by one or more sensors coupled to the master telemanipulator 22a and transmitted to the control system, which then executes commands to cause the corresponding slave link to replicate the inward / outward movement along the virtual longitudinal axis ω by one or more actuators coupled to the slave telemanipulator 51a. 10Finally, left / right movement of the handle portion 35 causes the guiding master link to move left / right along the longitudinal axis δ1, which is detected by one or more sensors coupled to the master telemanipulator 22a and transmitted to the control system, which then executes commands to cause one or more actuators coupled to the slave telemanipulator 51a to cause the corresponding slave link to replicate left / right movement about the virtual longitudinal axis ω5.

[0115] Continuing with reference to FIG. 4 , motions applied at the handle portion 35 of the master telemanipulator 22a electromechanically achieve joint degrees of freedom, such as pitch and yaw, actuation degrees of freedom, such as open / close, and rotational degrees of freedom, such as pronation and supination, via sensors, actuators, and a control system. The master telemanipulator 22a preferably includes one or more sensors coupled to the handle portion 35 for detecting motion of the handle portion 35. As will be appreciated, the sensors can be any sensor designed to detect rotational motion, such as a magnetic-based rotation sensor with a magnet on one side and a sensor on the other side to measure rotation by measuring angle and position. The sensors are coupled to a control system for generating signals indicative of the rotation measured by the sensors and transmitting the signals to one or more actuators coupled to the slave console 50, which can replicate the motions applied to the handle portion 35 at the end effector. For example, an electrical cable may extend from the handle portion 35 to a control system, e.g., a unit containing control electronics, and an additional electrical cable may extend from the control system to one or more actuators coupled to the slave console 50.

[0116] 5A, the handle grip 40 includes triggers 41 a, 41 b biased toward an open configuration, such that the triggers 41 a, 41 b can be actuated to generate signals that are transmitted through a control system that executes commands to cause actuators coupled to the slave console 50 to open / close the end effectors.

[0117] Referring back to FIG. 4, the handle grip 40 may be rotatable about a handle axis δ9 such that rotation of the handle grip 40 is detected by a sensor that generates and sends a signal through a control system that executes a command to an actuator coupled to the slave console 50 to rotate the end effector in the pronation-supination degree of freedom.

[0118] The handle portion 35 may also be rotatable about a handle axis δ such that rotation about the handle axis δ is detected by a sensor that generates and sends a signal through a control system that executes a command to an actuator coupled to the slave console 50 to rotate the end effector in the yaw degree of freedom. Additionally, the handle portion 35 may be rotatable about a handle axis δ such that rotation of the handle portion 35 about the handle axis δ is detected by a sensor that generates and sends a signal through a control system that executes a command to an actuator coupled to the slave console 50 to rotate the end effector in the pitch degree of freedom.

[0119] 5B and 5C, the handle grip 40 can be removably coupled to the handle portion 35 of the master telemanipulator 22a via joint 39. Thus, the handle grip 40 can be removed between procedures for sterilization and reconnected to the master telemanipulator 22a immediately prior to surgery. Thus, during operation of the surgical robotic system 10, the entire master console 20 can be covered with a sterile drape, so that the handle grip 40 is sterile and can be connected to the master console 20 outside of the sterile drape. This allows the surgeon to directly interact with the handle grip 40 without a physical barrier between them, thereby improving tactile feedback and overall performance.

[0120] 5D-5F, the handle grip 40 can be removably coupled to the handle portion 35 of the master console 20 via a clip attachment. As shown in FIGS. 5D-5F, a spring 43 can be coupled to the joint 39 of the handle portion 35 and the clip portion 42 of the handle grip 40 to preload the attachment and eliminate locking backlash.

[0121] As shown in FIG. 5G, a sterile drape cap 13 can be removably coupled to the master console handle portion 35 in accordance with the principles of the present invention. As described above, the master console 20 can be covered with a sterile drape 14 during a surgical procedure, yet still allow the surgeon to have tactile feedback available through direct contact with the robotic handle. The sterile drape interface 14 includes a sterile drape ring 14a defining an opening 14b in the sterile drape interface 14, and a sterile drape 14c coupled to the sterile drape ring 14a. While the handle grips are not attached to the master console 20, e.g., during sterilization and / or cleaning, the sterile drape cap 13 can be temporarily coupled to the sterile drape ring 14a and the master console handle portion 35 to prevent accidental contact by the clinician with the interior of the master console handle interface. For example, the sterile drape cap 13 can be attached to the master console handle portion 35 and held in place by methods known in the art, including, but not limited to, a magnetic system, friction, a Velcro surface, a matching shape, a hook, or the like. When the handle grip is ready to be coupled to the master console handle portion 35, the sterile drape cap 13 may be removed and discarded. The sterile drape ring 14a is preferably formed from a rigid material, such as metal, and is designed to be sandwiched between the master console (e.g., at the master console handle portion 35) and the handle grip when the handle grip is coupled to the master console 20. This ensures that the sterile drape 14c with the removable handle is securely coupled to the master console. Additionally, the sterile drape interface 14 can be easily removed from the master console once the handle grip is removed for sterilization for further surgery. Opening 14b in sterile drape interface 14 allows components of the handle to move through opening 14b in sterile drape interface 14 and into the master console in response to actuation by the surgeon without being obstructed by sterile drape 14c.This allows interaction between the detachable handle and the master console while ensuring sterile surgery.

[0122] According to another aspect of the present invention, as shown in Figure 6, a handle grip 40' can be removably coupled to a handle portion 35' of the master console 20 via a threaded attachment. As shown in Figure 6, a threaded portion 42' of the handle grip 40', having an internally threaded portion 44a, can be threaded into an externally threaded portion 44b of a joint 39' of the handle portion 35', thereby threading the handle grip 40' onto the handle portion 35'.

[0123] 7A-7C, an actuation process of the handle grip 40 is shown. As illustrated in FIGS. 7B and 7C, the handle grip 40 includes a retractable piston 45 disposed within its central lumen. The retractable piston 45 is mechanically coupled to the handle grip's 40 trigger 41a via connector 46a and to the handle grip's 40 trigger 41b via connector 46b. As shown in FIG. 7A, when the triggers 41a and 41b are in a relaxed state, e.g., biased to an open configuration, the retractable piston 45 resides entirely within the central lumen of the handle grip 40. As shown in FIGS. 7B and 7C, when the handle grip 40 is actuated, e.g., when the triggers 41a and 41b are pressed toward each other, the connectors 46a and 46b cause the retractable piston 45 to protrude from the central lumen of the handle grip 40. Movement of the retractable piston 45 beyond the central lumen of the handle grip 40 can be detected by a sensor within the handle portion 35.

[0124] For example, as shown in FIGS. 7D and 7E , a portion of the master console adjacent to where the handle grip 40 is removably coupled to the handle portion 35 can include one or more sensors 47 for detecting movement in the handle portion 35. The one or more sensors 47 can then send a signal indicative of movement of the retractable piston 45 to a control system, which can then execute commands to move the end effector via one or more actuators. This can function as a fail-safe because if the sensor 47 does not detect movement of the retractable piston 45, the control system will not command the actuators to move the end effector. For example, when the triggers 41 a, 41 b of the hand grip 40 are in a relaxed state, no movement is detected until the triggers 41 a, 41 b are intentionally actuated by the surgeon, allowing for small accidental movements of the triggers 41 a, 41 b. Therefore, for the retractable piston 45 to protrude beyond the central lumen of the handle grip 40, the triggers 41 a, 41 b would have to be actuated at least to a pre-specified extent. Additionally, as illustrated in Figures 7D and 7E, the handle portion 35 can include a spring 48 for pushing the retractable piston 45 to bias the triggers 41a, 41b to the open configuration via the connectors 46a, 46b.

[0125] 8A-8G, another exemplary handle grip is shown. Handle grip 71 is configured to be coupled to master console handle portion 35 at sterile drape interface 14 (e.g., by sandwiching sterile drape ring 14a between master console handle portion 35 and a movable outer flange to clip the components together). Handle grip 71 includes triggers 72a and 72b that are biased to an open configuration. For example, as shown in FIG. 8B, when a clinician is not applying force to triggers 72a, 72b, triggers 72a, 72b can be biased, for example, 150-160 degrees, or preferably 155 degrees, apart. Whenever a clinician releases triggers 72a, 72b, triggers 72a, 72b return to a predetermined open configuration. Triggers 72a, 72b can be biased to the open configuration via springs, as described above with reference to triggers 41a, 41b. Similar to the handle grip 40, the triggers 72a, 72b of the handle grip 71 may need to be pressed to a first predetermined angle relative to one another before the control system executes commands to move the surgical instrument via one or more actuators. For example, as shown in FIG. 8C , the actuators do not cause movement by the slave links and slave joints or end effector until the triggers 72a, 72b are pressed to within a first predetermined angle, e.g., 90 degrees or less apart. This may function as a fail-safe, preventing small accidental movements of the triggers 72a, 72b from being reproduced by the end effector until the triggers 72a, 72b are intentionally actuated by the surgeon. For example, the triggers 72a, 72b must be pressed to within 90 degrees (or another set angle) apart before the slave links and slave joints will move in response to movement of at least one of the master links and master joints. When the triggers 72a, 72b are released by the surgeon, the slave console stops moving in response to the movement on the master console.In this manner, the surgeon can realign the multiple master links and master joints to different desired configurations without causing corresponding movement in any of the slave links or joints. This allows the surgeon to realign the master console to a more comfortable position without moving the slave console. When the triggers 72a, 72b are realigned below a first predetermined angle, the controller responds to movement at the handle by causing a corresponding movement at the slave console. The handle grip 71 further includes a palm extension 72c extending from the trigger toward the surgeon's palm so that the surgeon's palm can contact the palm extension 72c during surgery for ergonomic purposes.

[0126] Additionally, the controller will not cause movement at the slave console unless the surgeon grasps the handle in a predetermined manner (e.g., triggers 72a, 72b moving toward each other less than a first predetermined angle), and the controller will not cause micro-movement at the end effector unless the surgeon grasps the handle in a second predetermined manner. For example, the second predetermined manner may be moving triggers 72a, 72b toward each other less than a second predetermined angle (e.g., 30 degrees apart), which is less than the first predetermined angle. In this manner, the slave console will not move in response to movement at the handle / master console unless a first actuation pattern (e.g., triggers 72a, 72b moved toward each other less than the first predetermined angle) is detected at the handle by the controller, and the end effector will not open or close unless a second actuation pattern (e.g., triggers 72a, 72b moved toward each other less than the second predetermined angle) is detected at the handle by the controller.

[0127] 8D and 8E, the internal components of the handle grip 71 are shown. As shown in FIGS. 8D and 8E, the handle grip 71 has a release grip 76 coupled to a coaxial retraction tube 74, such that retraction of the release grip 76 retracts the retraction tube 74. The retraction tube 74 has several openings 75 corresponding to several hooks 73, such that when the release grip 76 and the retraction tube 74 are in a relaxed state, each of the hooks 73 protrudes from a respective opening 75. For example, the handle grip 71 may have one, two, three, or four hooks. The hooks 73 have, for example, surfaces angled away from the direction in which the handle grip 71 is coupled to the master console, such that when the retraction tube 74 is retracted through the release grip 76, the edges of the openings 75 move over the angled surfaces of the hooks 73, causing the hooks 73 to bend radially inward toward the central axis of the retraction tube 74. When the release grip 76 is released, both the release grip 76 and the retraction tube 74 return to their relaxed state, causing the opening 75 to realign with the hook 73 so that the hook 73 protrudes through the opening 75 .

[0128] The master console handle portion 35 includes an angular limiter 80b shaped to correspond to the angular limiter 80a of the handle grip 71 so that the retraction tube 74 can be inserted into the lumen of the angular limiter 80b in a specific rotational orientation. As shown in FIG. 8E , the angular limiter 80b includes one or more grooves 77 on its inner surface shaped to correspond to the hooks 73 so that the hooks 73 engage with the grooves 77 when the retraction tube is inserted into the lumen of the angular limiter 80b and protrude through the opening 75. The number of grooves may correspond to the number of hooks 73, or the grooves 77 may extend completely circumferentially along the inner surface of the angular limiter 80b. Additionally, the handle grip 71 may include an actuation rod 78 sized to fit within the lumen of the preload spacer 86 and to interact with an actuation rod 79 of the master console. For example, the actuation rod 79 can extend a predetermined distance within the preload spacer 86 to press against the actuation lobe 78 of the handle grip 71 to bias the triggers 72a, 72b to the open configuration as described above.

[0129] The preload spacer 86 can be coupled to the preload spring 85 such that the preload spacer presses against the handle grip 71 when the handle grip 71 engages the master console handle portion 35. Thus, when the hook 73 engages the groove 77, the preload spacer 86 presses against the handle grip 71 to maintain the hook 73 within the groove 77 and eliminate backlash. Specifically, when the handle grip 71 is engaged, the rear edge of the hook 73 presses against the rear edge of the groove 77, preventing lateral movement of the handle grip 71 relative to the master console handle portion 35.

[0130] As shown in Figure 8F, the release grip 76 may have a textured surface to facilitate the clinician's retraction of the release grip 76 when coupling and detaching the handle grip 71 from the master console handle portion 35. As shown in Figures 8F and 8G, the release grip 76 engages the sterile drape interface 14 such that the handle grip 71 can still rotate freely when engaged with the master console handle portion 35. As shown in Figure 8F, the sterile drape ring 14a of the sterile drape interface 14, with the sterile drape 14c coupled thereto, snaps onto the master console handle portion 35 so that the sterile drape 14c maintains the sterility of the master console during operation.

[0131] 9A-9C, a process for coupling the handle grip 71 to the master console is shown. FIG. 9A shows the release grip 76 of the handle grip 71 in a relaxed state, with the hook 73 protruding from the opening 75 of the retraction tube 74. FIG. 9B illustrates the retraction of the release grip 76 as the edge of the opening 75 moves the hook 73 radially inward to allow the retraction tube 74 to be inserted into the lumen of the angular limiter 80b. Once the retraction tube 74 is fully inserted into the lumen of the angular limiter 80b, the release grip 76 is released as shown in FIG. 9C, allowing the hook 73 to protrude from the opening 75 of the retraction tube 74 and engage with the groove 77 in a relaxed state. FIG. 9C shows the handle grip 71 coupled to the master console handle portion 35.

[0132] 9D-9F, a process for removing the handle grip 71 from the master console is shown. FIG. 9D shows the release grip 76 being pulled back so that the edges of the opening 75 move the hooks 73 radially inward and out of the grooves 77. Once disengaged, the handle grip 71 can be removed from the master console, as shown in FIG. 9E. Once the handle grip 71 is removed from the master console, the release grip 71 is released and allowed to return to its relaxed state, with the hooks 73 protruding from the openings 75 in the pullback tubes 74.

[0133] According to another aspect of the present invention, as illustrated in FIGS. 10A-10C , a handle grip 40″ can be removably coupled to the handle portion 35 of the master telemanipulator 22a. For example, the handle grip 40″ can have a pistol shape including a handle and a trigger 49 to perform a desired surgical task. As will be appreciated by those skilled in the art, handle grips of various shapes can be removably coupled to the master telemanipulator to effect desired movements of the end effectors of the slave telemanipulators. Accordingly, the handle grip can have an integrated identifier element, such as an RFID tag, such that a control system can detect the identifier element and determine whether the handle grip is authorized for use with the surgical robotic system 10.

[0134] 11A and 11B, there is shown a slave console 50. As shown in FIG. 11A, the slave console 50 includes a right slave remote manipulator 51 a and a left slave remote manipulator 51 b. The left slave remote manipulator 51 b may be a structural mirror image of the right slave remote manipulator 51 a, as illustrated, so that the following description of the right slave remote manipulator 51 a also applies to the left slave remote manipulator 51 b.

[0135] 12, the slave telemanipulator 51a comprises a plurality of slave links, e.g., a first slave link 55, a second slave link 57, a third slave link 59, a fourth slave link, e.g., an angulating link 61, a fifth slave link 63, a sixth slave link 65, a seventh slave link 67, and an eighth slave link, e.g., a slave hub 69, interconnected by a plurality of slave joints, e.g., a first slave joint, e.g., a proximal Scara joint 54, a second slave joint, e.g., a central Scara joint 56, a third slave joint, e.g., a distal Scara joint 58, a fourth slave joint, e.g., an angulating joint 60, a fifth slave joint, e.g., an alpha joint 62, a sixth slave joint, e.g., a beta joint 64, a seventh slave joint, e.g., a gamma joint 66, and an eighth slave joint, e.g., a theta joint 68. As shown in FIG. 12, a translational instrument interface 81 is coupled to the slave telemanipulator 51a via the theta joint 68.

[0136] The translational instrument interface 81 can be configured as described in commonly assigned U.S. Patent Application Publication No. 2018 / 0353252 to Chassot, the entire contents of which are incorporated herein by reference. For example, the translational instrument interface 81 includes a slave hub 69 and a surgical instrument. As shown in FIG. 11B , the slave hub 69 can be attached to a link 67 of the slave remote manipulator 51 a. The surgical instrument can include an end effector disposed at the distal end of its shaft and can be coupled to the slave hub 69. For example, the end effector can be removably coupled to the slave hub 69. A sterile interface can be disposed between the slave hub 69 and the surgical instrument. Additionally, the translational instrument interface 81 includes a translational transmission system extending from one or more actuators disposed within the slave hub 69 to components of the end effector. For example, the end effector may include multiple end effector links interconnected by multiple end effector joints coupled to a translational transmission system of the translational instrument interface 81 such that actuation of the translational transmission system by one or more actuators moves the end effector via the multiple end effector links and joints.

[0137] Additionally, the slave telemanipulator 51a comprises a base portion 52 with an adjustable strut, and a slave support 53 fixed on the adjustable strut. A link 55 is rotatably coupled to the slave support 53 via a proximal Scara joint 54. Thus, the link 55, and therefore all slave joints and links distal to the link 55, can rotate relative to the slave support 53 about the axis ω1 of the proximal Scara joint 54. As shown in FIG. 12, link 57, and therefore all of the slave joints and links distal to link 57, can rotate relative to link 55 about axis ω of central Scara joint 56; link 59, and therefore all of the slave joints and links distal to link 59, can rotate relative to link 57 about axis ω of distal Scara joint 58; angled link 61, and therefore all of the slave joints and links distal to angled link 61, can rotate relative to link 59 about axis ω of angled joint 60; and link 63, and therefore all of the slave joints and links distal to link 63, can rotate relative to link 59 about axis ω of angulating joint 60. Angular link 61 can rotate about the alpha axis ω of beta joint 62, link 65, and therefore all slave joints and links distal to link 65, can rotate about the beta axis ω of beta joint 64, link 67, and therefore all slave joints and links distal to link 67, can rotate about the gamma axis ω of gamma joint 66, and slave hub 69, and therefore translation instrument interface 81 when coupled to slave hub 69, can rotate about the theta axis ω of theta joint 68, relative to link 67.

[0138] A strut integral with the slave support 53 includes an actuator, e.g., an electric motor, that allows the strut to extend and retract, thereby adjusting the height of all links distal to the slave support 53 relative to the ground. Alternatively, instead of a strut integral with the slave support 53, the slave support 53 can include a mechanical linear guidance system with a counterweight-based counterbalance system and an electric brake to prevent vertical movement. Thus, when the electric brake is released, the vertical height of all links distal to the slave support 53 can be adjusted relative to the ground. The proximal Scara joint 54, the central Scara joint 56, and the distal Scara joint 58 each include an electric brake that prevents movement of the corresponding joint when the respective brake is engaged and allows manual movement of the respective joint when the respective brake is released. The angulating joint 60 includes an actuator, e.g., an electromagnetic motor, that allows adjustment of the angular position of link 61 about link 59. The alpha joint 62, beta joint 64, gamma joint 66, and theta joint 68 are each coupled to a dedicated electromagnetic motor and brake pair, allowing the control system to adjust the angular position of each joint by issuing position commands to its respective motor, and to stop all motion of the joint by actuating its respective brake.

[0139] As will be appreciated by those skilled in the art, the slave console 50 may include multiple sensors and the master console 20 may include multiple actuators so that a movement applied at the slave console 50 can cause a movement to be applied at the master console 20, thereby providing haptic feedback.

[0140] Referring now to FIG. 13A, a controller 70 is shown. The controller 70 may be a remote controller, a graphical user interface operably coupled to the control system of the surgical robotic system 10, or a series of actuators integrated into the left and right remote manipulators 51a and 51b, respectively. Thus, the controller 70 may include multiple actuators, e.g., buttons, or a touchscreen interface, allowing a user to select multiple options by touch. For example, the controller 70 may provide the user with options for selecting at least one of the following commands: engage and release the Scara brake 70a, stop position configuration 70b, reverse forward gear to reverse gear or reverse gear to forward gear 70c, vertical adjustment of the slave console 70d, release the vertical column brake 70e, laparoscopic configuration 70f, home configuration 70g, and increase or decrease forward angulation 70h. The controller 70 is operably coupled to one or both of the slave controllers and / or the master controller. As shown in FIG. 13A, the controller 70 may be integrated into the link of the slave console itself. For example, a controller 70 may be integrated into the third slave link 59' of the left slave telemanipulator 51b to control a specific function of that slave telemanipulator in response to user input, and a second controller having the same function may be integrated into a slave link (e.g., the third slave link) to control a specific function of that slave telemanipulator, e.g., the right slave telemanipulator 51a, in response to user input.

[0141] For example, when a user activates the Scara brake engage / disengage 70a interface, the controller changes the Scara brake from engaged to disengaged, or vice versa. When a user activates the stop position configuration 70b interface, the controller moves the slave telemanipulator to a position suitable for transport and storage. When a user reverses gear from forward to reverse, or from reverse to forward gear 70c, the controller moves the slave telemanipulator between a forward surgical workspace and a reversed surgical workspace. When a user activates the slave console vertical adjustment 70d, the controller causes vertical adjustment of the slave telemanipulator. When a user activates the vertical column brake release 70e, the controller changes the vertical column brake from engaged to disengaged, preventing vertical adjustment of the slave telemanipulator, or vice versa, allowing vertical adjustment of the slave telemanipulator. When the user activates the laparoscopic configuration 70f, the home configuration 70g, the controller moves the slave hub away from the patient undergoing surgery, thereby enabling the surgeon to quickly and safely travel from the master console to the patient's surgical site to manually perform laparoscopic surgery on the patient. When the user activates the increase / decrease forward angulation 70h, the controller adjusts the forward angle of the slave remote manipulator. In response to user inputs on the controller 70, each slave controller executes instructions stored therein to carry out the command(s) entered by the user, as described below. Each slave console may have its own dedicated controller 70, or a shared controller 70 for both slave consoles may be used.

[0142] 13B, there is shown a controller 70'. The controller 70' is configured similarly to the controller 70, except that the controller 70' is a remote controller separate from the slave console and is powered by a wired or wireless connection. Thus, the controller 70' can be removed and operated at a distance from the slave console for the convenience of the clinician and / or operator.

[0143] 14A-14E, the controller 70 can allow the user to release the brakes on the proximal Scara Joint 54, the middle Scara Joint 56, and the distal Scara Joint 56, allowing the surgeon to manually horizontally reposition the slave arm by grasping and holding the slave arm link distal to the proximal Scara Joint 54 and pushing / pulling, while the slave support 53 of the slave telemanipulator remains fixed. Specifically, as the Scara moves, the slave links 55, 57, 59 can move about the axes ω1, ω2, ω3 of the joints 54, 56, 58, while the slave support 53 of the slave telemanipulator remains fixed and the slave joint and link distal to the slave link 59 remain fixed relative to the slave link 59. Thus, the user can adjust the distal end of the slave telemanipulator, e.g., the slave hub 69, to a desired position relative to the patient undergoing surgery.

[0144] 15A-15C, the control device 70 can allow a user to select a vertical adjustment command for the slave console, whereby the control system executes a command to extend or retract an actuator, e.g., a motor, coupled to the column of the slave support 53. Specifically, during vertical adjustment of the slave telemanipulator, the relative distance between the slave link 55 of the slave telemanipulator and the upper surface of the base portion 52 can be adjusted. For example, as illustrated in FIG. 15A, the vertical distance between the slave link 55 of the slave telemanipulator and the upper surface of the base portion 52 is H1; as shown in FIG. 15B, the vertical distance between the slave link 55 of the slave telemanipulator and the upper surface of the slave base portion 52 is H2; and as shown in FIG. 15C, the vertical distance between the slave link 55 of the slave telemanipulator and the upper surface of the base portion 52 is H3. Thus, a user can adjust the relative distance between the slave link 55 of the slave telemanipulator and the upper surface of the base portion 52 to a desired height relative to a patient undergoing a surgical procedure. In embodiments where the slave console includes a mechanical linear guidance system with a counterweight-based counterbalance system, the controller 70 can allow the user to select a vertical adjustment command for the slave console, which causes the control system to execute a command to release the electric brake on the support column so that the mechanical counterbalance linear guidance system can be moved up or down, thereby adjusting the relative distance between the slave link 55 of the slave telemanipulator and the top surface of the base portion 52 to a desired height relative to the patient undergoing surgery.

[0145] 16, the controller 70 can allow a user to select a home configuration command, which causes the control system to execute instructions to the actuators coupled to the beta joint 64, the gamma joint 66, and theta joint 68 to move the slave links and joints to a retracted position so that the slave hub 69 of the slave telemanipulator is in a desired position for positioning the shaft of the translating instrument interface 81 within a trocar within the body of a patient undergoing surgery. In the home position, the slave hub 69 is positioned relative to a trocar within the patient's body such that an instrument 82 is inserted into and coupled to the slave hub 69, such that the instrument tip 84 slides within, but does not pass through, the trocar, allowing the surgeon to safely insert the instrument without the need to monitor the distal end of the trocar using an endoscope.

[0146] Additionally, the controller 70 can allow a user to select an angulation command, which causes the control system to execute a command to cause an actuator coupled to the angulation joint 60 to adjust the angulation of the angulation link 61 about the axis ω4 of the angulation joint 60 to a desired angulation angle, e.g., between 0 and 45 degrees, relative to the base 52 of the slave telemanipulator 51a. Specifically, when the angulation command is executed, the slave link 59 and all slave links and joints proximal to it and the base portion 52 of the slave telemanipulator remain fixed, while the angulation link 61, and therefore all slave links and joints distal to it, rotate about the axis ω4 of the angulation joint 60. Adjusting the angulation angle of the slave telemanipulator adjusts the angle of the surgical workspace of the slave telemanipulator, thereby facilitating the surgeon's access to the patient via the translation instrument interface 81.

[0147] For example, FIGS. 17A-17D illustrate the movement of the translation instrument interface 81 coupled to the slave telemanipulator 51a when the slave console is angulated at 0 degrees. As shown in FIGS. 17A-17D, the angulation link 61, and therefore the angulation axis ω5, is parallel to the longitudinal axis of the base 52 of the slave telemanipulator 51a and perpendicular to the ground. During operation of the slave telemanipulator 51a, the control system executes commands to the actuators coupled to the slave console 20 to move only the slave links and joints distal to the angulation link 61. Thus, as shown in FIGS. 18A-18D, the translation instrument interface 81 of the slave telemanipulator 51a has a forward surgical workspace FSW, e.g., a range that the translation instrument interface 81 can reach in a forward configuration when the slave console is angulated at 0 degrees. FIG. 18E is a rear view of the forward surgical workspace FSW of the slave console of FIGS. 18A-18D.

[0148] 19A-19C illustrate the movement of the translation instrument interface 81 coupled to the slave telemanipulator 51a during a 20-degree angulation of the slave console. As shown in FIG. 19A, the angulation link 61, and therefore the angulation axis ω5, is adjusted to a 20-degree angle relative to the longitudinal axis of the base 52 of the slave telemanipulator 51a. During operation of the slave telemanipulator 51a, the control system executes commands to the actuators coupled to the slave console 20 to move only the slave links and joints distal to the angulation link 61. Thus, as shown in FIG. 19B, the translation instrument interface 81 of the slave telemanipulator 51a has a forward surgical workspace FSW, e.g., a range that the translation instrument interface 81 can reach in a forward configuration during a 20-degree angulation of the slave console. FIG. 19C is a rear view of the forward surgical workspace FSW of the slave console of FIG. 19B during a 20-degree angulation of the slave console.

[0149] 20A-20C illustrate the movement of the translation instrument interface 81 coupled to the slave telemanipulator 51a during a 40-degree angulation of the slave console. As shown in FIG. 20A, the angulation link 61, and therefore the angulation axis ω5, is adjusted to a 40-degree angle relative to the longitudinal axis of the base 52 of the slave telemanipulator 51a. During operation of the slave telemanipulator 51a, the control system executes commands to the actuators coupled to the slave console 20 to move only the slave links and joints distal to the angulation link 61. Thus, as shown in FIG. 20B, the translation instrument interface 81 of the slave telemanipulator 51a has a forward surgical workspace FSW, e.g., a range that the translation instrument interface 81 can reach in a forward configuration during a 40-degree angulation of the slave console. FIG. 20C is a rear view of the forward surgical workspace FSW of the slave console of FIG. 19B during a 40-degree angulation of the slave console.

[0150] As illustrated in FIGS. 21A-21J, the controller 70 can allow a user to select a flip command, whereby the control system executes a command to cause multiple actuators coupled to the slave console to move the slave telemanipulator 51a between a forward surgical workspace and an inverted surgical workspace. For example, the control system can cause multiple actuators coupled to the slave console to flip the slave telemanipulator 51a from the forward surgical workspace to the inverted surgical workspace and vice versa. Specifically, during execution of the flip command, link 65, and therefore all slave links and joints distal to link 65, rotate about the beta joint 64 of the slave telemanipulator 51a. Additionally, as link 65 rotates about the beta joint 64, link 67 rotates relative to link 65 at the gamma joint 66, and slave hub 69 rotates relative to link 67 about the theta joint 68, until the slave telemanipulator 51a is in the inverted surgical workspace configuration. 22B-22H, to prevent the translation instrument interface 81 from injuring the patient, the translation instrument interface 81 is detached from the slave hub 69 before executing the reverse command. The slave telemanipulator 51a can be flipped between the forward surgical workspace and the reverse surgical workspace simply by detaching the translation instrument interface 81 and executing the reverse command, without the need to unlock the slave telemanipulator 51a and move it around the operating room, or to execute the Scara brake release command and the vertical adjustment slave console command, thereby saving the user a lot of time and allowing them to quickly continue the patient surgery in the other surgical workspace.

[0151] 21K and 21L, there are shown schematic diagrams of a master console and a slave console having a forward surgical workspace and an inverted surgical workspace, respectively. When the remote manipulators of the slave console 50 have a forward surgical workspace, as shown in FIG. 21K, the master controller 2 of the master console 20 is programmed so that the right master remote manipulator 22a communicates with the right slave remote manipulator 51a and the left master remote manipulator 22b communicates with the left slave remote manipulator 51b. Thus, the master controller 2 can receive signals indicative of movements applied by the right master remote manipulator 22a via one or more sensors in the master console 20, execute instructions stored therein to perform the coordinate transformations necessary to operate one or more actuators in the slave console 50, and transmit processed signals to the respective slave controllers 4a, which execute the instructions stored therein to move the right slave remote manipulator 51a in a manner corresponding to the movements of the right master remote manipulator 22a. Similarly, the master controller 2 can receive signals indicative of movements applied by the left master remote manipulator 22b by one or more sensors in the master console 20, execute instructions stored therein to perform the coordinate transformations necessary to operate one or more actuators in the slave console 50, and send processed signals to respective slave controllers 4b which execute instructions stored therein to move the left slave remote manipulator 51b in a manner corresponding to the movements of the left master remote manipulator 22b based on the processed signals.

[0152] 21L, when the remote manipulators of the slave console 50 have an inverted surgical workspace, the master control unit 2 of the master console 20 functions as a switchboard and is programmed so that the right master telemanipulator 22a communicates with the left slave telemanipulator 51b, and the left master telemanipulator 22b communicates with the right slave telemanipulator 51a. This is necessary so that a surgeon located at the master console 20 and viewing the surgical site via the display 21 can use the right master telemanipulator 22a to manipulate what he sees as the "right" slave telemanipulator (left slave telemanipulator 51b in the inverted surgical workspace), and the left master telemanipulator 22a to manipulate what he sees as the "left" slave telemanipulator (right slave telemanipulator 51a in the inverted surgical workspace). Thus, the master controller 2 can receive signals indicative of movements applied at the right master remote manipulator 22a by one or more sensors in the master console 20, execute instructions stored therein to perform the coordinate transformations necessary to actuate one or more actuators in the slave console 50, and transmit processed signals to respective slave controllers 4b executing the instructions stored therein to move the left slave remote manipulator 51b to correspond to the movements of the right master remote manipulator 22a based on the processed signals. Similarly, the master controller 2 can receive signals indicative of movements applied at the left master remote manipulator 22b by one or more sensors in the master console 20, execute instructions stored therein to perform the coordinate transformations necessary to actuate one or more actuators in the slave console 50, and transmit processed signals to respective slave controllers 4a executing the instructions stored therein to move the right slave remote manipulator 51a to correspond to the movements of the left master remote manipulator 22b based on the processed signals.

[0153] Thus, in the forward surgical workspace configuration, the master controller 2 communicates with the right slave controller 4a to move the right slave telemanipulator 51a in response to movements at the right master telemanipulator 22a, and the master controller 2 communicates with the left slave controller 4b to move the left slave telemanipulator 51b in response to movements at the left master telemanipulator 22b. Further, in the inverted surgical workspace configuration, the master controller 2 communicates with the left slave controller 4b to move the left slave telemanipulator 51b in response to movements at the right master telemanipulator 22a, and the master controller 2 communicates with the right slave controller 4a to move the right slave telemanipulator 51a in response to movements at the left master telemanipulator 22b.

[0154] Figure 22A illustrates the slave telemanipulator 51a in an inverted configuration when the slave console is angulated at 0 degrees, Figure 22B illustrates the slave telemanipulator 51a in an inverted configuration when the slave console is angulated at 20 degrees, and Figure 22C illustrates the slave telemanipulator 51a in an inverted configuration when the slave console is angulated at 40 degrees. Additionally, as shown in Figures 23A-23C, the translation instrument interface 81 of the slave telemanipulator 51a has an inverted surgical workspace RSW, e.g., the range that the translation instrument interface 81 can reach in the inverted configuration when the slave console is angulated at 0 degrees, 20 degrees, and 40 degrees, respectively.

[0155] 24A-24D , the controller 70 can enable a user to select a laparoscopic surgery configuration command, whereby the control system executes instructions to cause a plurality of actuators coupled to the slave console to transition from a surgical mode in which a plurality of slave links move the slave hub 69 in response to movements applied at the master console handle, thereby moving surgical instruments to perform robotic surgery, to a laparoscopic mode in which the slave hub 69 is positioned away from the patient undergoing surgery, thereby enabling a surgeon to quickly and safely travel from the master console 20 to the patient's surgical site to manually perform laparoscopic surgical procedures on the patient. Thus, in the laparoscopic mode, the plurality of slave links proximal to the slave hub 69 are retracted away from the patient, exposing the surgical site while the base 52 of the slave console 50 remains stationary, allowing the surgeon to perform non-robotic surgery at the surgical site without being obstructed by the plurality of slave links and slave hub 69. Specifically, execution of the laparoscopic configuration command causes angulation link 61, and therefore all slave links and joints proximal to angulation link 61, including base 52 of slave telemanipulator 51a, to remain fixed, while link 63, and therefore all slave links and joints distal to link 63, rotates about the alpha axis ω5 of joint 62 until slave hub 69 is turned away from the patient, as shown in FIG. 24D.

[0156] Thus, in a preferred embodiment, the longitudinal axis of at least one link of the slave console (e.g., angulation link 61 and / or link 63) remains aligned with the remote center of motion in both the surgical and laparoscopic modes, allowing for seamless transitions between modes. For example, the alpha axis ω5 may remain aligned with the remote center of motion of the slave console 50 during the transition from surgical to laparoscopic mode. Advantageously, this allows the surgeon to move the slave console 50 between surgical and laparoscopic modes without having to realign the angulation link 61 and alpha axis ω5 with the remote center of motion of the slave console 50, and thus the incision point on the patient's body, when returning to surgical mode. In accordance with another aspect of the present invention, upon actuation of a laparoscopic configuration command, the distal slave link of the slave console 50 can be rotated away from the patient about an axis other than the alpha axis ω while the base 52 of the slave console 50 remains stationary to expose the surgical site, such that the alpha axis ω remains misaligned with the remote center of motion of the slave console 50 during the transition from surgical mode to laparoscopic mode. For example, the distal slave link of the slave console 50 can be rotated about, for example, axis ω, axis ω, axis ω, or axis ω while the base 52 of the slave console 50 remains stationary to expose the surgical site.

[0157] Additionally, the control system executes instructions to determine whether the translator interface 81 is removed from the slave hub 69 of the slave console 50, and thus from the patient's surgical site, such that a laparoscopic configuration command cannot be executed unless the control system determines that the translator interface 81 is not coupled to the slave hub 69. Thus, to transition the slave console from surgical mode to laparoscopic mode, the user must remove the translator interface 81 from the slave hub 69 before executing a laparoscopic configuration command.

[0158] 25-30, an exemplary method 90 for using the surgical robotic system 10 via a control system is shown. As will be appreciated by those skilled in the art, the method steps described herein may be performed by one or more processors of the control system (e.g., in the master controller, first slave controller, and / or second slave controller) executing instructions stored in one or more memory components in response to user input. As shown in FIG. 25, at step 91, the system 10 is powered on. At step 92, as further illustrated in FIG. 27, the slave console 50 is prepared for surgery on a patient undergoing a surgical procedure, and at step 93, as further illustrated in FIG. 26, the master console 20 is positioned in the surgeon's desired configuration during surgery.

[0159] For example, FIG. 26 illustrates step 93 of placing the master console 20 in a surgeon's desired configuration. The master console 20 can be moved around the operating room by wheels on its base when the wheels are unlocked. Once the desired location in the operating room is reached, the wheel locks are activated to keep the master console 20 in place. As shown in FIG. 26, at step 93A, the master remote manipulator is locked and the telescoping bases 23a, 23b have an initial height. A controller, e.g., a button, operably coupled to the master console 20 can then be activated to adjust the height of the telescoping bases 23a, 23b, e.g., increase or decrease the height of the telescoping bases 23a, 23b, until the master console 20 is at the surgeon's desired height at step 93B. For example, the master console 20 can be adjusted to a seated configuration in which the surgeon can sit while operating the master console 20, or to a standing configuration in which the surgeon can stand while operating the master console 20. Thus, for storage purposes, for example, the controller can be activated to return the master console 20 to its initial height.

[0160] Referring now to FIG. 27 , step 92 of preparing the slave console 50 is shown. As shown in FIG. 27 , in step 92A, the wheel locks of the slave telemanipulator are released so that the slave console 50 can be moved around the operating room to a desired position relative to the patient. The wheel locks can be released only when no instruments 82 are inserted into the slave hub 69 to prevent injury to the patient. Because multiple slave telemanipulators can be used, each slave telemanipulator is positioned during step 92A. When the slave console 50 is in the desired position in the operating room adjacent to the patient undergoing surgery, the wheels of the slave console 50 are locked in step 92B to prevent further movement of the slave console 50 around the operating room on the wheels. Thus, if the slave console 50 needs to be moved to a different desired position, the wheel locks can be released again in step 92A.

[0161] At step 92C, the Scara brake release command has not been executed, and the Scara brake of the slave console 50 has not been released. At step 92D, the Scara brake release command can be executed by the user to position the distal end of the slave telemanipulator, e.g., the distal slave link of link 59, at a desired position relative to the patient undergoing surgery. Specifically, when the Scara brake release command is executed, slave links 55, 57, 59 are allowed to rotate about axes ω1, ω2, ω3 of joints 54, 56, 58, while slave support 53 of the slave telemanipulator remains fixed and the slave joint and link distal to slave link 59 remain fixed relative to slave link 59. Once the distal end of the slave telemanipulator is in the desired position relative to the patient, execution of the Scara brake release command is completed at step 92C. 15A-15C, the vertical height of the slave telemanipulator can be adjusted so that the distal end of the slave telemanipulator is at a desired height relative to the trocar inside the patient. The Scara brake release command can be enabled only when no instrument 82 is present at the slave hub 69 to prevent injury to the patient.

[0162] Referring again to FIG. 27 , at step 92E, the angulating link 61 of the slave telemanipulator is fixed relative to the slave link 59. For example, the slave telemanipulator may initially have an angulating angle of 0 degrees. At step 92F, an angulating command can be executed to adjust the angulating link 61 about axis ω4 of the angulating joint 60 to a desired angulating angle, for example, between 0 and 45 degrees relative to the base 52 of the slave telemanipulator 51a. Specifically, upon execution of the angulating command, the slave link 59 and all slave links and joints proximal to the slave link 59, as well as the base portion 52 of the slave telemanipulator, remain fixed, while the angulating link 61, and therefore all slave links and joints distal to the angulating link 61, rotate about axis ω4 of the angulating joint 60. Once the desired angulation of the slave telemanipulator is achieved, execution of the angulating command is terminated at step 92E such that the angulating link 61 of the slave telemanipulator is fixed relative to the slave link 59. The angulation command may have two buttons, one to increase the angulation and one to decrease the angulation.

[0163] At step 92G, the slave telemanipulator has a forward surgical workspace, or at step 92H, the slave telemanipulator has an inverted surgical workspace. During both steps 92G and 92H, the instrument 82 must not be within the slave hub 69. If at step 92G the slave telemanipulator has a forward surgical workspace and the user desires an inverted surgical workspace, a flip command can be executed to flip the slave telemanipulator 51a from the forward surgical workspace to the inverted surgical workspace. Specifically, upon execution of the flip command, link 65, and therefore all slave links and joints distal to link 65, rotate about the beta joint 64 of the slave telemanipulator 51a. Additionally, as link 65 rotates about the beta joint 64, link 67 rotates relative to link 65 at the gamma joint 66, and the slave hub 69 rotates relative to link 67 at the theta joint 68, until the slave telemanipulator 51a is in the inverted surgical workspace configuration. Similarly, in step 92H, if the slave telemanipulator has an inverted surgical workspace and the user desires a forward surgical workspace, a flip command can be executed to flip the slave telemanipulator 51a from the forward surgical workspace to the inverted surgical workspace.

[0164] In step 92I, the translation instrument interface 81 is not coupled to the slave hub 69 of the slave telemanipulator. In step 92J, a temporary incision pointer can be removably coupled to the slave telemanipulator. For example, the temporary incision pointer can be removably coupled to the slave telemanipulator to point to a virtual telecenter of motion V located at a predetermined point on axis ω5, thereby causing the virtual telecenter of motion V to coincide with the surgical incision point, reducing patient trauma and improving the cosmetic outcome of the surgery. The temporary incision pointer can be detached, if desired, before attachment of the translation instrument interface 81. During preparation step 92, the instrument 82 should not be coupled to the slave hub 69 of the slave telemanipulator. Thus, if the instrument 82 is coupled to the slave hub 69 of the slave telemanipulator, in step 92K, the control system prevents further operation until the translation instrument interface 81 is detached.

[0165] At step 92L, the slave link and joint distal to link 61 of the slave telemanipulator can be in any position. Accordingly, at step 92M, a home configuration command can be executed to move the slave link and joint to a retracted position so that the slave hub 69 of the slave telemanipulator is in a desired position for positioning instrument tip 84 within a trocar within the body of a patient undergoing surgery. At step 92N, the slave telemanipulator is in the home position, with the slave hub 69 positioned relative to a trocar within the patient's body so that an instrument 82 can be inserted and coupled through the slave hub 69, with instrument tip 84 sliding within, but not passing through, the trocar.

[0166] At step 92O, a laparoscopic configuration command can be executed to move the slave hub 69 away from the patient undergoing surgery, thereby enabling a surgeon to quickly and safely travel from the master console 20 to the patient's surgical site to manually perform laparoscopic procedures on the patient. Specifically, upon execution of the laparoscopic configuration command, angulation link 61, and thus all slave links and joints proximal to angulation link 61, including base 52 of slave telemanipulator 51a, remain fixed, while link 63, and thus all slave links and joints distal to link 63, rotate about the alpha axis ω5 of joint 62 until the slave hub 69 is turned away from the patient. At step 92P, the slave hub 69 is in a retracted position.

[0167] At step 92Q, the sterile interface of the translating instrument interface 81 is not coupled to the slave hub 69 of the slave remote manipulator. At step 92R, the sterile interface is coupled to the slave hub and the control system determines whether the sterile interface has been identified, for example, by reading an RFID tag embedded in the sterile interface. If the sterile interface has not been identified, at step 92S, the control system waits for removal of the sterile interface until it is removed from the slave hub 69 at step 92Q. If the sterile interface has been identified, at step 92T, the sterile interface is successfully attached.

[0168] In step 92U, a stop position command can be executed to move the slave telemanipulator 51b to a position suitable for transport and storage. Specifically, upon execution of the stop position command, the vertical strut of the slave support 53 retracts to its minimum height, the Scara brake is released to collapse the Scara arm to its folded position, the angulation returns to 0 degrees, and the distal joint of joint 62 moves to collapse the slave arm to its compact position. After step 92, the surgical robotic system 10 can be powered off, if desired.

[0169] If the surgical robotic system 10 is not powered down after step 92, the control system determines whether the sterile interface is properly installed and whether the floor lock is activated at step 94. If it is determined that the sterile interface is not properly installed or the floor lock is unlocked, the surgical robotic system 10 must return to preparation step 92 to correct the above. If it is determined in step 94 that the sterile interface is properly installed and the floor lock is activated, the surgical robotic system 10 can proceed to step 95.

[0170] In step 95, as shown in FIG. 28, the surgical robotic system is ready for the instrument 82. For example, in step 95A, the control system of the slave console 50 waits for the instrument 82 until it is coupled to the slave hub 69 of the slave telemanipulator. Thus, the instrument 82 is selected and inserted into the slave hub 69. To ensure that the instrument does not fall out of the slave hub, the user can mechanically lock the instrument to the slave hub 69 by rotating the proximal end of the instrument. The slave hub 69 has an integrated sensor that detects whether the instrument is locked. In step 95B, a sensor located in the slave hub 69 reads the selected instrument, e.g., an identifier element embedded in an RFID tag that contains the identity of the selected instrument. In step 95C, the control system determines whether the selected instrument is authorized based on the detection of the RFID tag. If the selected instrument is unauthorized, in step 95D, the control system waits until the selected instrument is removed. Once the unauthorized instrument is removed, step 95D returns to step 95A. At step 95E, if the selected instrument is authorized and locked into the slave hub 69 of the slave telemanipulator, method 90 may proceed to step 96. At any point in step 95, if the sterile interface is removed, the floor lock is released, a reverse command is executed, a Scara brake release command is executed, a home configuration command is executed, or a dissection pointer is inserted, method 90 may return to preparation step 92.

[0171] At step 96, the surgical robotic system 10 is ready for operation. As shown in FIG. 29, at step 96A, the control system verifies that the instrument 82 is coupled to the slave hub 69 of the slave telemanipulator. At step 96B, the control system detects when the surgeon grasps the handle grip 40 of the handle portion 35. As shown in FIGS. 9A and 9B, a sensor in the handle can detect when the surgeon has grasped the handle. At step 96C, the clutch 11 is actuated to prepare the control system for macro synchronization, as shown in step 97A.

[0172] As shown in FIG. 30 , the surgical robotic system 10 is immediately operational. For example, at step 97A, the surgical robotic system 10 is in a macro-synchronization state but not a micro-synchronization state. In the macro-synchronization state, macro-translational movements applied at the master console 20 are sensed and transmitted to the control system, which commands actuators coupled to the slave console 50 to move corresponding slave links and joints such that macro-movements of the instrument tip 84 (i.e., up / down, left / right, inward / outward) correspond to macro-movements of the handle at the master console 20. However, in the macro-asynchronization state, the control system does not cause macro-movements applied at the master console 20 to correspondingly affect the slave console 50. For example, in the macro-asynchronization state, a macro-movement at the master console 20, whether intentional or unintentional, causes the master link at the master console 20 to move, but does not result in any corresponding movement at the slave console 50.

[0173] In the micro-synchronized state, micro-motions applied at the handle portion 35 of the master console 20 are detected and transmitted to the control system, which commands an actuator coupled to the slave console 50 to move the instrument tip 84 in a manner corresponding to the micro-motions applied at the handle portion 35 of the master console 20. However, in the micro-asynchronized state, the control system does not cause the micro-motions applied at the master console 20 / handle portion 35 to be correspondingly caused at the slave console 50 / end effector. Thus, at step 97A, macro-translational movements are reproduced, but the micro-movements are not synchronized. At step 97B, the clutch 11 can be activated to transition the surgical robotic system 10 to a macro-asynchronized state, where macro-translational movements are prevented by the master console 20 and, therefore, are not reproduced by the slave console 50. For example, the clutch 11 can be a foot pedal that, when depressed, maintains the surgical robotic system 10 in a macro-asynchronized state. When the clutch 11 is released, the surgical robotic system 10 returns to the macro-synchronized state at step 97A. Thus, for example, a surgeon can apply a macro-motion to the handle portion 35 in a macro-synchronized state, e.g., move the handle portion 35 inward / outward, thereby causing an inward / outward movement of the surgical instrument, then actuate the clutch 11 to transition the surgical system from a macro-synchronized state to a macro-asynchronized state, move the handle portion 35 back to its original position or to another more comfortable position, thereby causing no macro-motion of the surgical instrument, release the clutch 11 to transition the surgical system from a macro-asynchronized state to a macro-synchronized state, and then apply an additional macro-motion to the handle portion 35, thereby causing a corresponding macro-motion of the surgical instrument. Advantageously, this allows the surgeon to readjust the master console 20 for comfort while maintaining the slave console 50 in a desired position. In a further example, actuation of the clutch 11 transitions the surgical system between a synchronized and an asynchronized state for both macro-motions and micro-motions.

[0174] Additionally, the control system can be programmed to detect actuation patterns by the handle portion 35 such that micro-movements at the handle portion 35 are not replicated by the end effector unless the control system detects the actuation pattern. For example, the actuation pattern may include a rapid double actuation of the handle grip 40. Thus, if the user repeatedly presses the handle grip 40 twice at step 97C, the control system will detect the actuation pattern, causing the surgical robotic system 10 to enter a micro-synchronized state, and the micro-movements at the handle portion 35 will be replicated by the end effector. Upon transitioning from the micro-asynchronized state to the micro-synchronized state, the control system executes instructions to cause the micro-position of the instrument tip 84 relative to the instrument shaft 82 to have the same spatial orientation as the handle portion 35 relative to the corresponding link 32 of the master telemanipulator 22a. At step 97D, for example, when the end effector is at the target surgical position and the surgeon is able to use the surgical robotic system 10 to perform a surgical task, the surgical robotic system 10 is fully in both the macro-synchronized state and the micro-synchronized state. When clutch 11 is activated, surgical robotic system 10 is in a micro-synchronization state but not in a macro-synchronization state at step 97E.

[0175] 2C, according to another aspect of the present invention, master console 20 may have a second clutch 11' for use in conjunction with clutch 11 to place surgical robotic system 10 in a macro-synchronized state and / or a micro-synchronized state. For example, actuation of clutch 11 may transition surgical robotic system 10 between a macro-synchronized state and a macro-asynchronous state, and actuation of clutch 11' may transition surgical robotic system 10 between a micro-synchronized state and a micro-asynchronous state. Thus, for example, a surgeon can apply a micro-movement to the handle portion 35 while in the macro-synchronized state, e.g., rotate the handle portion 35, thereby causing a roll motion in the surgical instrument, then actuate the clutch 11′ to transition the surgical system from the micro-synchronized state to the micro-asynchronized state, move the handle portion back to its original position or to another more comfortable position, thereby causing a macro-movement of the surgical instrument, while no micro-movement of the surgical instrument occurs when the surgical system is in the macro-synchronized state, release the clutch 11′ to transition the surgical system from the micro-asynchronized state to the micro-synchronized state, and subsequently apply an additional micro-movement to the handle portion 35, thereby causing a corresponding micro-movement of the surgical instrument. Advantageously, this allows the surgeon to readjust the master console 20 for comfort while maintaining the slave console 50 in a desired position.

[0176] A surgeon can selectively select any combination of macro-synchronous, macro-asynchronous, micro-synchronous, and micro-asynchronous states of surgical robotic system 10. According to yet another aspect of the present invention, actuation of clutch 11 causes surgical robotic system 10 to transition between both macro-synchronous and asynchronous states and between micro-synchronous and asynchronous states; whereas actuation of clutch 11' only causes surgical robotic system 10 to transition between micro-synchronous and micro-asynchronous states. Alternatively, actuation of clutch 11 causes surgical robotic system 10 to transition between both macro-synchronous and asynchronous states and between micro-synchronous and asynchronous states, whereas actuation of clutch 11' only causes surgical robotic system 10 to transition between macro-asynchronous and macro-synchronous states.

[0177] In accordance with another aspect of the present invention, described herein is a tele-actuated surgical robotic system having a hybrid tele-manipulator constructed in accordance with the principles of the present invention, which can be used in minimally invasive surgical procedures or other applications.

[0178] Referring to FIGS. 31A and 31B, an exemplary teleoperated surgical robotic system 100 with a hybrid telemanipulator is shown. The surgical robotic system 100 is illustratively mounted atop a mobile cart 101, to which the hybrid telemanipulator can also be attached for easy movement and transport within the operating room. The surgical robotic system 100 includes a master area 400, where a surgeon can be located to operate the system 100, and a remote slave area 500 adjacent to a sterile zone where a patient undergoing surgery can be positioned. As shown in FIG. 31B, the surgeon performing the surgery preferably sits with ready access to the master area 400, while another surgeon or assistant can be positioned near the slave area 500 over the patient. In the embodiment of FIGS. 31A and 31B, the master area 400 is positioned laterally adjacent to the slave area 500. Additionally, camera system 102 can be used with surgical robotic system 100, for example, to operate and / or hold an endoscope operated by an assistant located in slave region 500 in the position shown in FIG. 31B. Camera system 102 can also include a display 103 for displaying to the surgeon in real time the surgical site captured by camera 102. Display 103 can be mounted on master region 400 or anywhere in proximity to master region 400 that is easily observable by the surgeon during the surgical procedure.

[0179] 31A, the system 100 includes two hybrid telemanipulators 104 and 105, including a left hybrid telemanipulator 104 operated by the surgeon's left hand and a right hybrid telemanipulator 105 operated by the surgeon's right hand. The hybrid telemanipulators 104 and 105 can be operated, for example, by the surgeon's left and right hands simultaneously and independently of each other. Preferably, the teleoperated, teleactuated surgical robotic system 100 is optimized for use in surgical procedures.

[0180] Each hybrid telemanipulator provides input to a master-slave configuration, with slave units, consisting of multiple rigid slave links and slave joints, kinematically driven by a master unit, consisting of multiple rigid master links and master joints. For example, the left hybrid telemanipulator 104 includes a master unit 401 and a corresponding slave unit 501, and the right hybrid telemanipulator 105 includes a master unit 402 and a corresponding slave unit 502. The master units 401 and 402 are disposed within the master domain 400 of the system 100, while the slave units 501 and 502 are within the slave domain 500 of the system 100. Preferably, the slave units 501 and 502 each mimic the movement of the corresponding portion of the master units 401 and 402 without deviating from the remote center of motion during operation of the device, as described in more detail below.

[0181] 31A , a teleoperated surgical instrument 106 having an end effector 107, e.g., a translating instrument interface, is coupled to the distal end of the slave unit 501, and a handle is coupled to the distal end of the master unit 401 such that movements applied to the handle induce corresponding micro-movements of the end effector 107 via a processor-driven control system. For example, the control system can receive signals indicative of movements applied at the handle by one or more sensors coupled to the handle and perform the coordinate transformations necessary to actuate one or more actuators operably coupled to the end effector 107 to reproduce the corresponding movements of the end effector. The slave instruments 106 of the translational instrument interface are removably attached to and can be manipulated by the slave unit 501, such that translational degrees of freedom, e.g., left / right, up / down, medial / lateral, are obtained by direct mechanical coupling, while joint degrees of freedom, e.g., pitch and yaw, actuation degrees of freedom, e.g., open / close, and rotational degrees of freedom, e.g., pronation / supination, are reproduced electromechanically via sensors, actuators, and control systems, as described in more detail below.

[0182] 32A and 32B, the mechanics of an exemplary tele-actuated surgical robotic system 100 with a hybrid tele-manipulator are shown, with the external cover shown in FIG. 31 omitted for clarity. In FIGS. 32A and 32B, the mechanical transmission 300 is positioned to directly couple the slave unit 501 to the master unit 401, such that macro-translational motions applied to the master joints of the master unit 401 are replicated by corresponding respective ones of the slave joints of the slave unit 501. Similarly, the mechanical transmission 300 also directly couples the slave unit 502 to the master unit 402, such that macro-translational motions applied to the master joints of the master unit 402 are replicated by corresponding respective ones of the slave joints of the slave unit 502. Transmission 300 illustratively comprises one or more cables 301 routed by one or more pulleys from master unit 401 to slave unit 501, and one or more cables 303 routed by one or more pulleys from master unit 402 to slave unit 502, to control one of the four degrees of freedom of slave units 501 and 502. Mechanical limiter 200 of master unit 401 limits the movement of master unit 401 by eliminating a degree of freedom of movement, thereby limiting three translational degrees of freedom, e.g., left / right, up / down, and in / out movement.

[0183] For example, one or more cables 301 may form one or more closed loops beginning at pulley P1 coupled to master unit 401, passing through pulleys P2, P3, P4, P5, P6, tensioning system 302, pulley P7, around pulley P8 coupled to slave unit 501, returning via pulley P7, tensioning system 302, pulleys P6, P5, P4, P3, P2, and terminating at pulley P1. Thus, clockwise or counterclockwise rotation of pulley P1 causes one of the one or more cables 301 to rotate pulley P8, which in turn actuates slave unit 501 in one of its four degrees of freedom. However, the mechanical limiter 200 of the master unit 401 limits the movement of the master unit 401 by eliminating one degree of freedom of movement, thereby limiting the movement of the slave unit 501 to three translational degrees of freedom, e.g., left / right, up / down, and inward / outward. Each of the pulleys P1, P2, P3, P4, P5, P6, P7, and P8 may include a number of individual pulleys corresponding to the number of degrees of freedom of actuatable movement of the slave unit 501 by the master unit 401. Similarly, the cable(s) 301 may include a number of closed cable loops corresponding to the number of degrees of freedom of actuatable movement of the slave unit 501 by the master unit 401.

[0184] Similarly, one or more cables 303 may form one or more corresponding closed loops beginning at pulley P9 coupled to master unit 402, passing through tensioning system 304, pulleys P10, P11, P12, P13, P14, around pulley P15 coupled to slave unit 502, and returning through pulleys P14, P13, P12, P11, P10, tensioning system 304, and terminating at pulley P9. In this manner, clockwise or counterclockwise rotation of pulley P9 may cause one of the one or more cables 303 to rotate pulley P15, thereby actuating slave unit 502 in one of its four degrees of freedom. The mechanical limiter 201 (see FIG. 32A ) of the master unit 402 similarly limits the movement of the master unit 402 by eliminating degrees of freedom of movement, thereby limiting the movement of the slave unit 502 to three translational degrees of freedom, e.g., left / right, up / down, and inward / outward. Each of the pulleys P9, P10, P11, P12, P13, P14, and P15 may include a number of individual pulleys corresponding to the number of degrees of freedom of actuatable movement of the slave unit 502 by the master unit 402. Similarly, the cable(s) 303 may include a number of closed cable loops corresponding to the number of degrees of freedom of actuatable movement of the slave unit 502 by the master unit 402.

[0185] As will be appreciated by those skilled in the art, the number of pulleys P2-P7 utilized to route cable 301 between pulleys P1 and P8, and the number of pulleys P10-P14 utilized to route cable 303 between pulleys P9 and P15, respectively, will depend on the configuration of the right and left hybrid remote manipulators.

[0186] 33, one or more cables 301 of mechanical transmission 300 pass through tensioning system 302, and one or more cables 303 pass through tensioning system 304. Tensioning system 302 is designed to apply a predetermined tension to cable 301, and tensioning system 304 is designed to apply a predetermined tension to cable 303. For example, tensioning system 302 may include pulley P16 coupled to pulley P17 via tensioning link 305, and pulley P18 coupled to pulley P19 via tensioning link 306. Tensioning link 305 is adjustably and rotatably coupled to tensioning link 306 about a vertical axis through axis 307, such that a predetermined tension is applied to cable 301 by pulleys P16, P17, P18, and P19. Additionally, tensioning system 302 can be used to calibrate mechanical transmission 300, ensuring that the angles of corresponding master and slave joints are identical. Tensioning system 304 may be identical in structure to tensioning system 302.

[0187] Also in Figure 33, pulleys P11, P12, and P13 of the right hybrid telemanipulator mechanical transmission are coupled to slave link 308, which is rotatably coupled via slave link 309 to positioning system 310. Positioning system 310 can be, for example, a hydraulic device that restricts the movement of slave unit 502 relative to slave unit 501 along a single plane. For example, the position of pulley P8 can be fixed, such that the position of P15 is movable relative to P8 along the horizontal plane (x and y directions).

[0188] 34A and 34B, there are shown components of an exemplary master unit of system 100. Each of master units 401 is identical in structure to master unit 402, and therefore the following description of master unit 401 also applies to master unit 402.

[0189] The master unit 401 includes a plurality of master links, e.g., a first master link 405a, a second master link 405b, a third master link 405c, and a fourth master link, e.g., a guide master link 404, interconnected by a plurality of master joints. The handle 403 is connected to the distal end of the master unit 401 via the guide master link 404, e.g., a master rod, and includes a plurality of handle links interconnected by a plurality of handle joints for operating the hybrid telemanipulator. For example, a macro translational motion applied to the handle 403 causes corresponding motion of the plurality of master joints via the plurality of master links, which is transmitted to corresponding slave joints of the slave unit 501 via the mechanical transmission 300, thereby replicating the macro translational motion in the slave unit 501. Translational movement of the handle 403 causes the guiding master link 404 to transmit this movement to pulley P1 via the first master link 405a, the second master link 405b, and the third master link 405c, causing the slave unit 501 to mimic the translational movement via the mechanical transmission 300. The first master link 405a, the second master link 405b, the third master link 405c, and the guiding master link 404 are coupled to pulley P1 via a transmission system including, for example, one or more toothed belts 406 routed by one or more pulleys 407. Alternatively, the transmission system coupling pulley P1 to the multiple master links and joints of the master unit 501 may include a cable and pulley system and / or rigid transmission links.

[0190] 34A and 34B, the mechanical limiter 408 of the master unit 401 comprises a yoke pivotally coupled to a sleeve that slides on the guiding master link 404, limiting the movement of the distal end of the slave unit 501 to a center of motion that coincides with the patient's incision point, e.g., the point where a trocar passes through the patient's abdomen. For example, the mechanical limiter 408 ensures that when the hybrid telemanipulator is actuated, the guiding master link 404 of the master unit 401 translates along the longitudinal axis θ1; therefore, as shown in FIGS. 35A and 35B, the corresponding slave link of the slave unit 501, e.g., a translation instrument interface coupled to the distal end of the slave unit 501, also translates along an imaginary axis θ4 that is parallel to the longitudinal axis θ1 of the guiding master link 404 proximal to the telemanipulation, as shown in FIGS. 35A and 35B. In addition, the mechanical limiter 408 allows the guiding master link 404 to rotate about a second axis θ2 and a third axis θ3 that are perpendicular to each other. 34A and 34B, axis θ3 is coaxial with the axis of pulley P1. The plane defined by the longitudinal axis θ1 and second axis θ2 of guiding master link 404 intersects third axis θ3 at a single stationary point 409 regardless of the orientation of master link 404. This configuration allows the corresponding slave link of slave unit 501 to rotate about fifth and sixth imaginary axes θ5 and θ6 that are perpendicular to each other. The longitudinal axis θ4 and the fifth and sixth imaginary axes θ5 and θ6 of the corresponding slave link always intersect each other at a single imaginary stationary point 509 near the patient's incision, e.g., a remote center of motion.

[0191] When the surgical robot system 100 is positioned so that the remote center of motion 509 is aligned with the patient's incision, translational motion applied to the handle 403 is replicated by the end effector located inside the patient. Because the end effector perfectly replicates motion applied to the handle 403, this arrangement advantageously eliminates the fulcrum effect between the handle and end effector, ensuring that the instrument always passes through the remote center of motion. While previously known surgical robots require complex control electronics to maintain a fixed point of motion for the surgical instrument as it passes through the patient's incision, in the present system, mechanical constraints 408 provide a replication of translational motion between the master unit 401 and slave unit 501 that ensures that the instrument always passes through the remote center of motion 509.

[0192] 34A and 34B, inward / outward movement of the handle 403 causes the first master link 405a, the second master link 405b, the third master link 405c, and the guide master link 404 to move inward / outward along the longitudinal axis θ1 of the guide master link 404. This movement is transmitted through the multiple master links to the pulley P1, which causes the slave unit 501 to replicate the inward / outward movement along the longitudinal axis θ4 via the mechanical transmission 300 and the multiple slave links, joints, and timing belt. Similarly, upward / downward movement of the handle 403 causes the first master link 405a, the second master link 405b, the third master link 405c, and the guide master link 404 to rotate upward / downward about the second axis θ2. This motion is transmitted to pulley P1 via multiple master links, causing slave unit 501 to replicate upward / downward motion about fifth axis θ5 via mechanical transmission 300 and multiple slave links, joints, and timing belts. Finally, left / right motion of handle 403 causes first master link 405a, second master link 405b, third master link 405c, and induction master link 404 to rotate left / right about third axis θ3. This motion is transmitted to pulley P1 via multiple master links, causing slave unit 501 to replicate left / right motion about sixth axis θ6 via mechanical transmission 300 and multiple slave links, joints, and timing belts.

[0193] 34A and 34B , motion applied by the handle 403 of the master unit 401 electromechanically induces joint degrees of freedom, such as pitch and yaw, actuation degrees of freedom, such as open / close, and rotational degrees of freedom, such as pronation and supination, via sensors, motors, and a control system. The master unit 401 preferably includes one or more sensors 410 coupled to the handle 403 via a circuit board 411 for detecting motion of the handle 403. As will be appreciated, the sensor 410 can be any sensor designed to detect rotational motion, such as a magnetic rotation sensor including a magnet on one side and a sensor on the other side to measure rotation by measuring angle and position. The circuit board 411 is coupled to a control system for generating signals indicative of the rotation measured by the sensor 410 and transmitting the signals to one or more motors coupled to the slave unit 501, which can replicate the motion applied to the handle 403 at the end effector. For example, an electrical cable may run from the handle 403 to a control system, e.g., a unit containing control electronics, and additional electrical cables may run from the control system to one or more motors coupled to the slave unit 501.

[0194] Actuation of the trigger 412 on the handle 403 generates a signal that is sent via the control system to a motor coupled to the slave unit 501, which actuates a translational transmission system of a translational instrument interface coupled to the slave unit 501, which in turn actuates an end effector of the translational instrument interface to open / close.

[0195] The handle 403 may also include a ball 413 designed for easy grip by the surgeon to align the surgeon's wrist with the master unit 401. The ball 413 may be rotatable about the handle axis θ7 such that rotation of the ball 413 is detected by a sensor that generates a signal and transmits the signal via a control system to a motor coupled to the slave unit 501. The signal received from the control system at the slave unit causes the translation instrument interface coupled to the slave unit 501 to rotate, thus rotating the end effector of the translation instrument interface in the pronation and supination degrees of freedom.

[0196] The handle 403 may also be rotatable about a handle axis θ8, such that rotation about the handle axis θ8 is detected by a sensor that generates a signal and sends the signal to the motor of the slave unit 501 via the control system. This signal actuates a translational transmission system of a translational instrument interface coupled to the slave unit 501, thereby moving the end effector of the translational instrument interface with a yaw degree of freedom. In addition, the handle 403 may be rotatable about a handle axis θ9, such that rotation of the handle 403 about the handle axis θ9 is detected by a sensor that generates a signal and sends the signal to the motor of the slave unit 501 via the control system. This signal actuates a translational transmission system of a translational instrument interface coupled to the slave unit 501, thereby moving the end effector of the translational instrument interface with a pitch degree of freedom.

[0197] 34C and 34D, there is shown an alternative embodiment of the handle of the master unit 401. In FIG. 34C, the handle 403′ is rotatable about handle axis θ7, handle axis θ8, and handle axis θ9, and thus rotation of the handle 403′ about the handle axes is detected by one or more sensors 410, which generate signals and send them to the motors of the slave unit 501 via the control system. The signals actuate a translation transmission system of a translation instrument interface coupled to the slave unit 501, which in turn moves the end effector of the translation instrument interface in pronation-supination, yaw, and pitch degrees of freedom, respectively.

[0198] Similarly, the handle 403″ in FIG. 34D is rotatable about handle axis θ7, handle axis θ8, and handle axis θ9, and rotation of the handle 403″ about the handle axes is detected by one or more sensors 410 which generate signals and send the signals to one or more motors coupled to the slave unit 501 via the control system. The signals actuate a translation transmission system of a translation instrument interface coupled to the slave unit 501, which in turn moves an end effector of the translation instrument interface in pronation-supination, yaw, and pitch degrees of freedom, respectively.

[0199] 35A and 35B, there are shown exemplary slave units of system 100. Each slave unit 501 is identical in structure to slave unit 502, and therefore the following description of slave unit 501 also applies to slave unit 502.

[0200] As described above, the master unit 401 includes a plurality of master links interconnected by a plurality of master joints. The slave unit 501 includes a corresponding plurality of slave links interconnected by a plurality of slave joints, e.g., a first slave link 505a, a second slave link 505b, a third slave link 505c, and a fourth slave link, e.g., a translational instrument interface 503. Thus, a direct mechanical coupling is formed by the slave links and corresponding slave joints of the slave unit 501, which is identical to the dynamic model formed by the corresponding master links and corresponding master joints of the master unit 401. For example, during operation of the hybrid telemanipulator, the first slave link 505a always remains parallel to the first master link 405a, the second slave link 505b always remains parallel to the second master link 405b, the third slave link 505c always remains parallel to the third master link 405c, and the translational instrument interface 503 always remains parallel to the guiding master link 404. Therefore, each macro translational motion applied to the multiple master joints of the master unit 401 is reproduced by a corresponding one of the multiple slave joints of the slave unit 501 via the mechanical transmission 300 and multiple slave links.

[0201] 35A and 35B, the translating instrument interface 503 is coupled to the distal end 504 of the slave unit 501. Translational motion of the handle 403 is transmitted to pulley P9 via mechanical transmission 300. More specifically, initiation of translational motion of the handle 403 causes pulley P9 to transmit motion via the first slave link 505a, the second slave link 505b, the third slave link 505c, and the translating instrument interface 503 to the end effector 512, thereby replicating the translational motion of the slave unit 501. The first slave link 505a, the second slave link 505b, the third slave link 505c, and the translating instrument interface 503 are coupled to pulley P9 via a transmission system including, for example, one or more timing belts 506 routed through one or more pulleys 507. Thus, each of the four pulleys of P9 is operatively coupled to and controls the movement of the first slave link 505a, the second slave link 505b, the third slave link 505c, and the translator interface 503. Alternatively, the transmission system coupling pulley P9 of the slave unit 501 with the multiple slave links and slave joints may include a cable and pulley system and / or rigid transmission links.

[0202] The mechanical limits 408 of the master unit 401 ensure that the first slave link 505 a, the second slave link 505 b, the third slave link 505 c, and the translational instrument interface 503 always rotate about a virtual rest point 509 when the hybrid telemanipulator is operated. For example, the end effector 512 of the translational instrument interface 503 coupled to the slave unit 501 always translates along a longitudinal axis θ4, which corresponds to the longitudinal axis θ1 of the master link 404 near the telemanipulator. In addition, the mechanical limits 408 allow rotation of the end effector 512 about a fifth virtual axis θ5 and a sixth virtual axis θ6, which are perpendicular to each other. The longitudinal axis θ4, the fifth virtual axis θ5, and the sixth virtual axis θ6 of the translational instrument interface 503 coupled to the slave unit 501 always intersect each other at the virtual rest single point 509 near the telemanipulator. During minimally invasive surgical procedures, the virtual rest point 509 aligns with the surgical incision point, reducing patient trauma and improving the cosmetic outcome of the surgery.

[0203] Movement of the handle 403 in an inward / outward direction causes the end effector 512 coupled to the slave unit 501 to reproduce inward / outward movement about the longitudinal axis θ4 via the mechanical transmission 300 and the transmission system connecting the pulley P9 of the slave unit 501 to the multiple slave links and slave joints. Movement of the handle 403 up / down causes the end effector 512 coupled to the slave unit 501 to reproduce upward / downward movement about the longitudinal axis θ5 via the mechanical transmission 300 and the transmission system connecting the pulley P9 of the slave unit 501 to the multiple slave links and slave joints. Movement of the handle 403 left / right causes the end effector 512 coupled to the slave unit 501 to reproduce left / right movement about the longitudinal axis θ6 via the mechanical transmission 300 and the transmission system connecting the pulley P9 of the slave unit 501 to the multiple slave links and slave joints.

[0204] Additionally, motions applied at the handle 403 of the master unit 401 electromechanically, via sensors, motors, and a control system, provide articulation degrees of freedom, such as pitch and yaw, actuation degrees of freedom, such as open / close, and rotational degrees of freedom, such as pronation / supination, of the end effector of the translational instrument interface 503. The translational instrument interface 503 can be configured as described in commonly assigned U.S. Patent Application Publication No. 2018 / 0353252 to Chassot, the entire contents of which are incorporated herein by reference. For example, the translational instrument interface 503 includes a slave hub 510 and a surgical instrument 511. The slave hub 510 can be secured to the distal end 504 of the slave unit 501. The surgical instrument 511 includes an end effector 512 disposed at the distal end of its shaft and can be removably coupled to the slave hub 510. A sterile interface can be disposed between the slave hub 510 and the surgical instrument 511. Additionally, the translating instrument interface 503 includes a translational transmission system extending from one or more motors disposed within the slave hub 510 to components of the end effector 512. For example, the end effector 512 includes multiple end effector links interconnected by multiple end effector joints that are coupled to the translational transmission system of the translating instrument interface 503 such that actuation of the translational transmission system by one or more motors causes movement of the end effector 512 via the multiple end effector links and joints.

[0205] Further details regarding the components and operation of the slave hub 510 are described with reference to Figures 36A and 36B. The slave hub 510 of the translation instrument interface 503 fixed to the slave unit 501 includes one or more motors, e.g., a first motor 601a, a second motor 601b, a third motor 601c, and a fourth motor 601d, operably coupled, e.g., by electrical wiring, to a control system via a circuit board 602. The motors 601a-601d receive signals indicative of movement measured by one or more sensors 410 coupled to the handle 403 and actuate the handle 403. These signals are processed by the control system, which then provides signals to the motors that actuate the translation instrument interface 503, thereby replicating the micro-movements corresponding to these inputs at the handle 403. The first motor 601a, the second motor 601b, and the third motor 601c are directly coupled to a translational transmission system 603 of the translational instrument interface 503 to actuate the end effector 512 in the open / close, pitch, and yaw degrees of freedom. The translational transmission system 603 includes a plurality of transmission elements, such as cables and / or lead screws, each coupled at one end to the first motor 601a, the second motor 601b, and the third motor 601c and at the opposite end to the links of the first, second, and third end effectors to move the end effector in the open / close, pitch, and yaw degrees of freedom. The translational transmission system 603 may include a closed loop of lead screws and / or cables. The fourth motor 601d rotates the slave instrument 503 via a pronation-supination timing belt 513. As will be appreciated by those skilled in the art, the slave hub 510 can include any combination of motors 601a-601d, for example, if a non-articulating instrument is used, one or more motors for actuating the end effector 512 in the open / close degree of freedom and only a motor for rotating the end effector 512 in the pronation / supination degree of freedom.

[0206] The circuit board 602 may also include one or more sensors designed to electrically communicate with the first motor 601 a, the second motor 601 b, the third motor 601 c, and the fourth motor 601 d to detect undesired movement of the translation instrument interface 503 and resist such undesired movement.

[0207] According to one aspect of the invention, a control system can identify the kinematics of an end effector 512 of a translating instrument interface 503 by reading an identifier element 516, such as an RFID token embedded in the instrument, shown in FIG. 36C, which contains information about the kinematic configuration of the instrument. In particular, the control system can configure the operation of one or more motors interfacing with the translating instrument interface 503 to operate differently (e.g., simultaneously rotating clockwise, or rotating one clockwise and the other counterclockwise) to actuate the end effector elements based on the information read from the identifier element 516. For example, FIG. 36D shows a forceps-type end effector having parallel-serial instrument kinematics. In this configuration, a first motor 601a can be operably coupled to a first link, e.g., a first blade, of the end effector 512′ via a transmission element 514a of the translational transmission system such that the first motor 601a moves the first link of the end effector 512′ outward / inward. A second motor 601b can be operably coupled to a second link, e.g., a second blade, of the end effector 512′ via a transmission element 514b of the translational transmission system such that the second motor 601b moves the second link of the end effector 512′ outward / inward. Thus, the control system can command the first motor 601a to move the first link of the end effector 512′ outward via the transmission element 514a and simultaneously command the second motor 601b to move the second link of the end effector 512′ outward via the transmission element 514b, thereby opening the end effector 512′ upon actuation of the trigger 412 of the handle 403. Conversely, the control system can command the first motor 601a to move the first link of the end effector 512′ inward via the transmission element 514a and simultaneously command the second motor 601b to move the second link of the end effector 512′ inward via the transmission element 514b, thereby closing the end effector 512′ upon actuation of the trigger 412 of the handle 403.Therefore, the first motor 601a and the second motor 601b can move the end effector 512' with an open / close degree of freedom.

[0208] The control system commands the first motor 601a to move the first link of the end effector 512′ outward via the transmission element 514a and simultaneously commands the second motor 601b to move the second link of the end effector 512′ inward via the transmission element 514b, thereby causing the end effector 512′ to pitch upward based on the rotation of the handle 403 about the handle axis θ9. Conversely, the control system commands the first motor 601a to move the first link of the end effector 512′ inward via the transmission element 514a and simultaneously commands the second motor 601b to move the second link of the end effector 512′ outward via the transmission element 514b, thereby causing the end effector 512′ to pitch downward based on the rotation of the handle 403 about the handle axis θ9. Therefore, the first motor 601a and the second motor 601b can move the end effector 512' with a pitch degree of freedom.

[0209] The third motor 601c can be operably coupled to a third link of the end effector 512′ via a transmission element 514c of the translation transmission system such that the third motor 601c moves the end effector 512′ in a yaw degree of freedom based on rotation of the handle 403 about the handle axis θ8. The fourth motor 601d can be operably coupled to the first motor 601a, the second motor 601b, the third motor 601c, and the surgical instrument 511 via a rotatable pronation-supination timing belt 513 such that the fourth motor 601d rotates the first motor 601a, the second motor 601b, the third motor 601c, and the surgical instrument 511, and thus the end effector 512′, in a pronation-supination degree of freedom based on rotation of the ball 413 of the handle 403.

[0210] 36E, an end effector having series-series instrument kinematics is shown. For example, a first motor 601a can be operably coupled to a first link of the end effector 512'' via a transmission element 515a of a translation transmission system to move the end effector 512'' with an open / close degree of freedom based on actuation of the trigger 412 of the handle 403. A second motor 601b can be operably coupled to a second link of the end effector 512'' via a transmission element 515b of a translation transmission system to move the end effector 512'' with a pitch degree of freedom based on rotation of the handle 403 about the handle axis θ9. A third motor 601c can be operably coupled to a third link of the end effector 512″ via a transmission element 515c of a translation transmission system such that the third motor 601c moves the end effector 512″ in a yaw degree of freedom based on rotation of the handle 403 about the handle axis θ8. A fourth motor 601d can be operably coupled to the first motor 601a, the second motor 601b, the third motor 601c, and the surgical instrument 511 via a rotatable pronation-supination timing belt 513 such that the fourth motor 601d rotates the first motor 601a, the second motor 601b, the third motor 601c, and the surgical instrument 511, and thus the end effector 512″, in a pronation-supination degree of freedom based on rotation of the ball 413 of the handle 403.

[0211] According to one aspect of the present invention, a control system can identify the kinematics of the end effector 512 of a translational instrument interface 503 by reading information stored on an identifier element 516, e.g., an RFID token, embedded in the instrument, as outlined in method step 700 listed in FIG. 37 . At step 701, a user selects a surgical instrument having an end effector to be used with a hybrid telemanipulator. For example, the surgical instrument may have an end effector having the parallel-serial instrument kinematics shown in FIG. 36D or the serial-serial instrument kinematics shown in FIG. 36E . The surgical instrument can then be coupled to a slave unit of the hybrid telemanipulator. At step 702, the control system detects information about the kinematic configuration of the selected end effector. For example, the control system can read an RFID token embedded in a surgical instrument 511 that contains information about the kinematic configuration of the selected end effector, e.g., whether the selected end effector has parallel-serial instrument kinematics or serial-serial instrument kinematics. The RFID token may be, for example, an inductively readable microchip containing identification information that can be scanned by a reader located on the slave hub and operably coupled to the control system. Alternatively, the functionality of identifier element 516 may be provided by an optical tag, such as a barcode, QR code, Datamatrix, Aztec code, or Semacode, located on the surgical instrument 511, which is read by the slave hub. If the surgical instrument is not yet coupled to the slave unit of the hybrid telemanipulator, after step 702, the surgical instrument may be coupled to the slave unit of the hybrid telemanipulator.

[0212] In step 703, the control system identifies the kinematics of the selected end effector based on the information detected in step 702 to determine which type of end effector is coupled to the slave unit of the hybrid telemanipulator. In step 704, the control system adjusts its parameters based on the identification information of the selected end effector so that the hybrid telemanipulator can be operated appropriately. For example, if the end effector has parallel-serial instrument kinematics, the control system has parameters to command the first motor 601a and the second motor 601b to simultaneously actuate the first and second end effector links to move the end effector with open / closed and pitch degrees of freedom, as described above. If the end effector has serial-serial instrument kinematics, the control system has parameters to command the first motor 601a to actuate the end effector with open / closed degrees of freedom and the second motor 601b to actuate the end effector with pitch degrees of freedom, as described above.

[0213] Referring to FIG. 38 , an alternative exemplary embodiment of a teleoperated surgical robotic system is shown in which all degrees of freedom are electromechanically controlled. While all seven degrees of freedom—medial / lateral, superior / inferior, left / right, yaw, pitch, open / close, and pronation / supination—are electromechanically controlled via a system of sensors, motors, and control systems, the system 800 maintains the above-mentioned mechanical constraints in the master unit, thereby creating a single virtual rest point, e.g., a remote center of motion, in the slave unit. Thus, the system 800 does not require coordinate transformations and complex control systems to align the slave unit 1001 with the incision. The mechanical constraints and corresponding remote center of motion ensure this design is much simpler and safer than using a typical robotic arm.

[0214] 39, master unit 901 is configured similarly to master unit 401 of FIGS. 34A and 34B, except that instead of multiple cables and pulleys of a mechanical transmission coupled to pulley P1, master unit 901 includes one or more sensors, e.g., sensor 902a, sensor 902b, sensor 902c, and sensor 902d, operably coupled to each of pulley P1's four pulleys. Sensors 902a-902d measure rotational motion by measuring the angle and position of pulley P1 in response to movement applied to handle 903 of master unit 901 via multiple master links, joints, and cables. Each of the four sensors measures movement of a joint of master unit 901 via each of pulley P1's four pulleys, thereby measuring movement of master unit 901 in four degrees of freedom. However, the mechanical limiter restricts the movement of the master unit 901 by eliminating one degree of freedom of movement, which results in the movement of the slave unit 1001 being three degrees of freedom of movement, for example, inward / outward, upward / downward, and left / right.

[0215] The handle 903 is configured similarly to the handle 403 of Figures 34A and 34B. For example, the handle 903 includes one or more sensors 410 and a circuit board 411 such that micro-movements applied by the handle 903 can be transmitted to the end effector of the slave unit 1001 via one or more motors coupled to the one or more sensors 410 and the end effector of the slave unit 1001, thereby moving the end effector with the degrees of freedom of open / close, pitch, yaw, and pronation / supination.

[0216] With respect to transmitting macro-motion, sensors 902a, 902b, 902c, and 902d generate signals indicative of the rotation of pulley P1 measured by their respective sensors and transmit these signals via the control system to one or more motors coupled to slave unit 1001, thereby replicating the macro-translational motion applied by handle 903 coupled to master unit 901. For example, an electrical cable can run from master unit 901 to the control system, e.g., a unit containing control electronics, and additional electrical cables can run from the control system to one or more motors coupled to slave unit 1001.

[0217] 40A and 40B, the slave unit 1001 is configured similarly to the slave unit 501 of Figures 35A and 35B. For example, the slave unit 1001 includes a first motor 601a, a second motor 601b, a third motor 601c, and a fourth motor 601d operably coupled to the end effector of the slave unit 1001 such that micro-movements applied by a handle 903 can be transmitted to the end effector of the slave unit 1001 via one or more sensors 410 and the first motor 601a, the second motor 601b, the third motor 601c, and the fourth motor 601d to move the end effector with the degrees of freedom of open / close, pitch, yaw, and pronation / supination. The slave unit 1001 differs from the slave unit 501 in that instead of the multiple cables and pulleys of a mechanical transmission coupled to pulley P8, the slave unit 1001 includes one or more motors, e.g., a first motor 1002a, a second motor 1002b, a third motor 1002c, and a fourth motor 1002d, operatively coupled to each of the four pulleys of pulley P8. The one or more motors are coupled to a circuit board for receiving signals indicative of the rotation of pulley P1 measured by sensors 902a, 902b, 902c, and 902d in response to movements applied to a handle 903 of the master unit 901, thereby actuating pulley P8 to replicate the macro translational motion applied to the handle 903 of the master unit 901 in the slave unit 1001 via a system of multiple slave links, joints, timing belts, and / or cables and pulleys. For example, a first motor 1002a is operably coupled to the first slave link 505a to control its movement, a second motor 1002b is operably coupled to the second slave link 505b to control its movement, a third motor 1002c is operably coupled to the third slave link 505c to control its movement, and a fourth motor 1002d is operably coupled to the translation instrument interface 503 to control its movement, via pulley P8 and a number of slave joints, timing belts, and / or a system of cables and pulleys.

[0218] Because the mechanical limits of the master unit 901 limit the movement of the master unit 901 to three degrees of freedom, e.g., inward / outward, upward / downward, and left / right, the movement of the first slave link 505a, the second slave link 505b, the third slave link 505c, and the translational instrument interface 503 of the slave unit 1001 by the first motor 1002a, the second motor 1002b, the third motor 1002c, and the fourth motor 1002d, respectively, is limited to three degrees of freedom, e.g., inward / outward, upward / downward, and left / right movement about a virtual rest point 1005, e.g., a remote center of motion.

[0219] The slave unit 1001 can include a temporary incision pointer 1004 that points to a virtual rest point 1005, e.g., a remote center of motion, formed by a mechanical constraint in the master unit 1001 so that the virtual rest point 1005 can coincide with the surgical incision point, reducing patient trauma and improving the cosmetic outcome of the surgery. The temporary incision pointer 1004 is removably coupled to a joint of the slave unit 1001 so that the temporary incision pointer 1004 points to the virtual rest point 1005 and can be removed prior to operation of the surgical robotic system 800.

[0220] 40C and 40D, an alternative exemplary embodiment of a dissection pointer for use with the system shown in FIGS. 1-30 and described herein is shown. Similar to dissection pointer 1004, dissection pointer 1004' can be removably coupled to a joint (e.g., the distal end of link 63 described above) of slave unit 1001 such that temporary dissection pointer 1004 points to a virtual center of motion, e.g., virtual rest point 1005, thereby identifying the remote center of motion of the surgical instrument. For example, dissection pointer 1004' can be removably coupled to the slave console using structures including, but not limited to, magnets, friction, Velcro surfaces, matching shapes, hooks, etc. Dissection pointer 1004' can be formed from ferritic stainless steel and illustratively includes a magnetic head 1006 at its proximal end for magnetically coupling with a corresponding surface of the slave console (e.g., a receptacle of a joint of slave unit 1001).

[0221] As shown in FIG. 40C , the magnetic head 1006 may have a convex spherical surface whose center is aligned with the distal tip of the dissecting pointer 1004′. Accordingly, the receptacle of the joint of the slave unit 1001 may have a corresponding concave spherical surface for engaging with the convex spherical surface of the dissecting pointer 1004′. As will be understood by those skilled in the art, the magnetic head 1006 of the dissecting pointer 1004′ may have a concave spherical surface, and the receptacle of the joint of the slave unit 1001 may have a convex spherical surface. The dissecting pointer 1004′ may function with or without a sterile drape attached to the slave unit 1001. FIG. 40E shows the dissecting pointer 1004′ inserted into a trocar 1007 so that the distal tip of the dissecting pointer 1004′ is aligned with the patient's body wall, e.g., with a virtual rest point 1005 about which the instrument rotates. The dissection pointer 1004' can be removed from the receptacle of the joint of the slave unit 1001 after the surgical instrument has been inserted and before operation of the surgical robotic system.

[0222] According to one aspect of the present invention, the incision pointer 1004′ can be removably coupled to a joint, e.g., link 63, of the slave unit 1001, and the clinician can move the joint of the slave unit 1001, and thus the adjacent slave links and slave joints, until the distal tip of the incision pointer 1004′ is aligned with and points to a desired location on the patient's body, e.g., an incision site on the patient's body. Once the joints of the slave unit 1001 and the incision pointer 1004′ are pointing to the desired location, the clinician can set the desired location as a virtual rest point 1005 via the control system based on the alignment of the joints of the slave unit 1001. Thus, all movements of the surgical instrument by the slave console during operation of the surgical robotic system always rotate about the virtual rest point 1005, even without mechanical constraints at the master console, as described in more detail below with reference to FIG. 43 . In this way, the system's controller ensures that the surgical instrument never translates away from the virtual rest point 1005 for safe surgical procedures through a trocar. The aligned link (eg, link 63) preferably points to the surgical site (eg, opening through a trocar) at all times during the surgical procedure so that the movement of the surgical instrument is constrained about a virtual rest point.

[0223] Thus, the system controller can execute instructions to set a virtual rest point 1005 based on the alignment of link 63 with the desired location of the surgical site on the patient's body such that movement of the surgical instrument is constrained about virtual rest point 1005 to maintain alignment of link 63 (and its longitudinal axis ω5) with the incision site during the surgical procedure.

[0224] 41A and 41B, an alternative embodiment of a control system for a surgical robotic system is shown. The control system 1100 of FIG. 41A, which can be integrated with the system 100, includes a non-transitory computer-readable medium, e.g., memory 1101, having stored thereon instructions that, when executed by a processor 1102 of the control system 1100, enable operation of a hybrid telemanipulator. Additionally, the control system 1100 can communicate wirelessly or via an electrical cable with an identifier element reader 517 of the slave unit 501, such that the memory 1101 can store identification information of the end effector's kinematic configuration read from the identifier element 516. Thus, when executed by the processor 1102, the instructions actuate motors for controlling the end effector with open / closed and pitch degrees of freedom according to the selected end effector type. The control system 1100 is electrically coupled to the circuit board of the master unit 401, wirelessly or via an electrical cable, and is thus coupled to one or more sensors 410 for receiving signals indicative of micro-movements applied at the handle 403. Additionally, the control system 1100 is electrically coupled to the circuit board of the slave unit 501, either wirelessly or using an electrical cable, and is thus coupled to the first motor 601a, the second motor 601b, the third motor 601c, and the fourth motor 601d for effecting micro-movements of the end effector, for example, in open / close, pitch, yaw, and pronation / supination degrees of freedom.

[0225] 41B, which may be integrated with system 800, includes a non-transitory computer-readable medium, e.g., memory 1111, having stored thereon instructions that, when executed by a processor 1112 of the control system 1110, enable operation of the hybrid telemanipulator. Additionally, the control system 1110 may communicate wirelessly or using an electrical cable with the identifier element reader 517 of the slave unit 1001, and the memory 1111 may store identification information of the kinematic configuration of the end effector read from the identifier element 516, such that, when executed by the processor 1112, the instructions move motors for controlling the end effector with open / close and pitch degrees of freedom according to the type of end effector selected. The control system 1110 is electrically coupled to the circuit board of the master unit 901, either wirelessly or using an electrical cable, and is therefore coupled to one or more sensors 410 for receiving signals indicative of micro-movements applied at the handle 903, and to sensors 902a, 902b, 902c, and 902d for receiving signals indicative of macro-movements applied at the handle 903. In addition, the control system 1110 is electrically coupled to the circuit board of the slave unit 1001 wirelessly or using an electrical cable, and is therefore coupled to the first motor 601 a, the second motor 601 b, the third motor 601 c, and the fourth motor 601 d for actuating micro-movements of the end effector, e.g., in the open / close, pitch, yaw, and pronation / supination degrees of freedom, and to the first motor 1002 a, the second motor 1002 b, the third motor 1002 c, and the fourth motor 1002 d for actuating macro-movements of the end effector, e.g., in the medial / lateral, superior / inferior, and inferior / lateral degrees of freedom.

[0226] 42A and 42B, alternative applications of the principles of the present invention can be applied to alternative telemanipulator designs. For example, a telemanipulator configured as described in U.S. Patent No. 9,696,700 to Beira shown in FIG. 42A can be modified to include a handle and translation instrument interface for electromechanically controlling the micro-movements of the end effector, e.g., open / close, pitch, yaw, and pronation / supination degrees of freedom, while the macro-translational movements of the end effector, e.g., superior / inferior, medial / lateral, and left / right degrees of freedom, are mechanically controlled by a mechanical transmission system. A teleoperated surgical robotic system 1200 includes a master unit 1201 mechanically coupled directly to a slave unit 1202, a handle 1203 coupled to the master unit 1201, a translation instrument interface 1204 coupled to the slave unit 1202, and a mechanical limiter 1205. The handle 1203 can be configured similarly to the handle 403 of FIGS. 34A and 34B , and the translation instrument interface 1204 can also be configured similarly to the translation instrument interface 503 of FIGS. 35A and 35B . For example, the handle 1203 includes one or more sensors such that micro-motions applied thereto can be transmitted to the end effector of the translation instrument interface 1204 via one or more sensors and one or more motors coupled to the end effector of the slave unit 1202, thereby moving the end effector with the following degrees of freedom: open / close, pitch, yaw, and pronation / supination. Thus, macro-translational motions applied by the handle 1201 are reproduced by the translation instrument interface 1204 with three degrees of freedom, e.g., medial / lateral, superior / inferior, and left / right, via the mechanical constraints 1203. Alternatively, the teleoperated surgical robotic system 1200 can have seven electromechanically actuated degrees of freedom.

[0227] Referring to FIG. 42B, an alternative telemanipulator is shown. For example, a telemanipulator configured as described in U.S. Patent Publication No. 2017 / 0245954 to Beira can be modified with a handle and translational instrument interface for electromechanically controlling the micro-movements of the end effector, e.g., open / close, pitch, yaw, and pronation / supination degrees of freedom, while the macro-translational movements of the end effector, e.g., superior / inferior, medial / lateral, and left / right degrees of freedom, are mechanically controlled by a mechanical transmission system. The teleoperated surgical robotic system 1210 includes a master unit 1211 mechanically coupled to a slave unit 1212, a handle 1213 coupled to the master unit 1211, a translational instrument interface 1214 coupled to the slave unit 1212, and a mechanical limiter 1215. The handle 1213 is configured similarly to the handle 403 of FIGS. 34A and 34B , and the translation instrument interface 1214 is configured similarly to the translation instrument interface 503 of FIGS. 35A and 35B . For example, the handle 1213 includes one or more sensors such that micro-motions applied thereto can be transmitted to the end effector of the translation instrument interface 1214 via one or more sensors and one or more motors coupled to the end effector of the slave unit 1212, thereby moving the end effector with the following degrees of freedom: open / close, pitch, yaw, and pronation / supination. Thus, macro-translational motions applied at the handle 1213 are replicated by the end effector of the translation instrument interface 1214 with three degrees of freedom, e.g., medial / lateral, superior / inferior, and left / right, via the mechanical constraints 1213. Alternatively, the teleoperated surgical robotic system 1210 may have seven electromechanically actuated degrees of freedom.

[0228] Referring now to Figure 43, another exemplary master console constructed in accordance with the principles of the present invention is shown. The master console 20' is configured similarly to the master console 20 of Figure 2A, except that the master remote manipulator of the master console 20' does not include a mechanical limiter designed to limit the movement of at least one of the master links, as described above. For example, the master remote manipulator of the master console 20' includes a base portion having telescopic bases 1008 and 1009 for adjusting the vertical height of the master remote manipulator, and a base cap 1010 fixed on the telescopic bases 1008 and 1009 and rotatably coupled to link 26 via joint 25.

[0229] Unlike the master console 20 of FIG. 2A, the master telemanipulator of the master console 20′ comprises link 1014 coupled to link 1012 via joint 1013, and link 1016 coupled to link 1014 via link 1015 and further coupled to handle portion 1018 via joint 1017. As shown in FIG. 43, neither link 1014 nor 1016 passes through link 1012. Instead, once a virtual rest point, e.g., a remote center of motion, is established by the control system as described above with reference to FIGS. 40C-40E, movements applied to the master telemanipulator by the surgeon are effected by the slave links and slave joints of the slave console in a corresponding manner with respect to the virtual rest point.

[0230] Advantageously, the master console 20 allows the surgeon to approach the handle grips of the handle portion 1018 from above (rather than from below or horizontally as with other surgical robots). Additionally, the master console 20 shares the same orientation as the surgeon's arms, such that the bases of the master arms are positioned to the sides of the surgeon's body rather than in front of the area of the center post of the master console 20. Because the sterile master arms of the master console 20 are positioned off the ground in this configuration, the sterility of the master console 20 is better maintained during use of the surgical system. Furthermore, this configuration reduces the depth of the surgeon console, thereby preserving valuable operating room floor space.

[0231] 43, the master console 20′ can include a master arm brake release button 1019 and a height adjustment button 1020. For example, actuation of the master arm brake release button 1019 allows a user to readjust the master links and master joints until the master telemanipulator is in a configuration desired for use by the surgeon, and actuation of the height adjustment button 1020 allows a user to adjust the vertical height, e.g., up or down, of the master telemanipulator via the telescoping bases 1008 and 1009.

[0232] While various illustrative embodiments of the present invention have been described above, it will be apparent to those skilled in the art that various changes and modifications can be made within the scope of the invention without departing from the scope thereof. It is intended that the appended claims cover all such changes and modifications that fall within the true scope of the invention. The present application provides the following aspects of the invention. (Aspect 1) 1. A system for remote operation for performing a surgical procedure, comprising: a patient console having a plurality of patient links coupled to a base; a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a surgical site on a patient to perform robotic surgery; and a control device; The control device: instructions to, in a surgical mode, move at least one of the plurality of patient links in response to movements applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform robotic surgery; and the system is configured to execute instructions to transition the patient console from the surgical mode to a laparoscopic mode in which the plurality of patient links are pulled away from the patient while the patient console base remains stationary, exposing the surgical site and allowing a surgeon to perform non-robotic surgery at the surgical site without being obstructed by the plurality of patient links. (Aspect 2) the control device: an instruction to determine that the surgical instrument has been removed from the patient at the surgical site; and 2. The system of embodiment 1, further configured to execute instructions to transition the patient console from the surgical mode to the laparoscopic mode only if the surgical instrument is removed. (Aspect 3) 3. The system of claim 2, wherein the controller determines that the surgical instrument is removed from the patient by determining that the surgical instrument is removed from the patient console. (Aspect 4) 2. The system of claim 1, wherein the controller transitions the patient console from the surgical mode to the laparoscopic mode in response to a user input received at the patient console. (Aspect 5) The system of embodiment 1, wherein the handle is removably coupled to the surgeon console so as to be sterile during the surgical procedure and sterilizable while removed for additional surgical procedures. (Aspect 6) The system of embodiment 5 further comprises a sterile drape interface having a ring defining an opening, the handle holding the ring in place when coupled to the surgeon console so that a sterile drape of the sterile drape interface covers a portion of the surgeon console. (Aspect 7) The system of aspect 1, wherein the control device is configured to execute instructions to move at least one of the plurality of patient links at a scaled degree in the surgical mode in response to movement applied at a handle of the surgeon console. (Aspect 8) The system of aspect 7, wherein the control device is configured to execute commands in the surgical mode to cause scaled micro-movements of micro degrees of freedom to the surgical instrument in response to corresponding movements applied at the handle of the surgeon console. (Aspect 9) The system of embodiment 8, wherein the micro-movements applied by the surgical instrument are independently scalable for each of the micro-degrees of freedom such that the scaled micro-movement of the micro-degree of freedom is on a different scale than a second scaled micro-movement of a second micro-degree of freedom of the surgical instrument. (Aspect 10) The system of aspect 1, wherein the surgeon's console comprises a clutch that, when actuated, is configured to prevent micro-movements in the surgical instrument in response to micro-movements applied at the handle of the surgeon's console. (Aspect 11) 1. A method for remotely performing a surgical procedure, comprising: coupling a surgical instrument to a patient console including a plurality of patient links coupled to a base; inserting a distal region of the surgical instrument into a surgical site on a patient to perform robotic surgery; in a surgical mode, moving at least one of the plurality of patient links in response to a movement applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform the robotic surgery; and transitioning the patient console from the surgical mode to a laparoscopic mode, wherein the plurality of patient links are moved away from the patient while the base of the patient console remains stationary to expose the surgical site and enable a surgeon to perform non-robotic surgery at the surgical site without interference from the plurality of patient links. (Aspect 12) 12. The method of claim 11, further comprising determining that the surgical instrument has been removed from the surgical site on the patient, wherein transitioning the patient console from the surgical mode to the laparoscopic mode occurs only when the surgical instrument has been removed. (Aspect 13) 13. The method of embodiment 12, wherein determining that the surgical instrument has been removed from the surgical site on the patient comprises determining that the surgical instrument has been removed from the patient console. (Aspect 14) 12. The method of claim 11, further comprising receiving a user input at the patient console, wherein transitioning the patient console from the surgical mode to the laparoscopic mode is in response to the user input received at the patient console. (Aspect 15) 12. The method of embodiment 11, wherein the handle is removably coupled to the surgeon console, the method further comprising removing the handle for sterilization between surgical procedures. (Aspect 16) 1. A system for remote operation for performing a surgical procedure, comprising: a patient console comprising a plurality of patient links coupled to a matching joint and a base; a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a surgical site on a patient to perform robotic surgery; and a control device; The control device: instructions to set a virtual center of motion based on the alignment of the alignment joint and the surgical site; and configured to move at least one of the plurality of patient links in response to movements applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to execute commands to perform the robotic surgery; The system wherein motion of the surgical instrument is constrained about a virtual remote center of motion to maintain alignment of the patient joint and the surgical site during the surgical procedure. (Aspect 17) 17. The system of embodiment 16, further comprising a dissection pointer configured to be removably coupled to the alignment joint to enable alignment of the alignment joint with the surgical site. (Aspect 18) 18. The system of embodiment 17, wherein the dissection pointer is configured to be removably coupled to the alignment joint via a magnetic attachment. (Aspect 19) 17. The system of claim 16, wherein the virtual center of motion is set based on the alignment of the alignment joint with a trocar placed within the surgical site of the patient. (Aspect 20) The system of embodiment 16, wherein the handle is removably coupled to the surgeon console so that the handle is sterile during the surgical procedure and can be sterilized while removed for additional surgical procedures. (Aspect 21) 1. A method for remotely performing a surgical procedure, comprising: aligning a patient joint of a plurality of patient joints of a patient console with a trocar insertion site, the plurality of patient joints being interconnected by the plurality of patient links, the patient console being operably coupled to a surgeon console and configured to move in response to movement applied at a handle of the surgeon console; establishing a virtual remote center of motion based on the alignment of the patient joint and the trocar insertion site; and moving at least one of the plurality of patient links in response to movement applied at the handle to move a surgical instrument coupled to the patient console to perform the surgical procedure; The method, wherein movement of the surgical instrument is constrained about the virtual remote center of motion to maintain alignment of the patient joint and the trocar insertion site during the surgical procedure. (Aspect 22) 22. The method of claim 21, further comprising coupling an incision pointer to the alignment joint, wherein aligning the patient joint of the plurality of patient joints of the patient console with the trocar insertion site comprises aligning the incision pointer with the trocar insertion site. (Aspect 23) 23. The method of embodiment 22, wherein said step of coupling said dissection pointer to said alignment joint comprises coupling said dissection pointer to said alignment joint via a magnetic attachment. (Aspect 24) 22. The method of embodiment 21, further comprising the step of removing the handle for sterilization between surgeries. (Aspect 25) 1. A system for remote operation for performing a surgical procedure, comprising: a patient console having a plurality of patient links coupled to a base; a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a surgical site on a patient to perform robotic surgery; and a control device; The control device: configured to execute commands in a surgical mode to cause scaled micro-movements of micro degrees of freedom in the surgical instrument in response to corresponding movements applied at a handle of a surgeon console; The system wherein the scaled micro-movement of the micro-degree of freedom at the surgical instrument is greater than the corresponding movement applied at the handle of the surgeon's console. (Aspect 26) 26. The system of claim 25, wherein the micro-movements applied by the surgical instrument are independently scalable for each of the micro-degrees of freedom such that a scaled micro-movement of a first micro-degree of freedom is on a different scale than a second scaled micro-movement of a second micro-degree of freedom of the surgical instrument. (Aspect 27) 26. The system of claim 25, wherein the surgeon console comprises a clutch that, when actuated, is configured to prevent micro-movements in the surgical instrument in response to micro-movements applied at the handle of the surgeon console. (Aspect 28) 28. The system of claim 27, wherein the end effector of the surgical instrument is movable to a first position via the handle, then the clutch is actuated, the handle is movable to a second position while the end effector remains stationary, and then the clutch is released, causing the patient console to resume relative micro-motion from the handle to the end effector of the surgical instrument. (Aspect 29) 26. The system of claim 25, wherein the scaled micro-movement of the roll degree of freedom of the micro-degree of freedom in the surgical instrument is at least twice the corresponding movement of the roll degree of freedom applied at the handle of the surgeon console.

Claims

1. 1. A system for remote operation for performing a surgical procedure, comprising: a patient console having a plurality of patient links coupled to a base; a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a surgical site on a patient to perform robotic surgery; and a control device; The control device: instructions to, in a surgical mode, move at least one of the plurality of patient links in response to a movement applied at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform the robotic surgery on the patient; instructions to determine whether the surgical instrument has been removed from the patient at the surgical site; instructions to authorize operation of a laparoscopic surgical configuration command after determining that the surgical instrument has been removed from the patient; and In response to operation of the laparoscopic surgery configuration command, the system is configured to execute instructions to move the plurality of patient links away from the patient while keeping the patient console base stationary, exposing the surgical site and enabling a surgeon to perform non-robotic surgery at the surgical site without being obstructed by the plurality of patient links.

2. 10. The system of claim 1, wherein the controller is configured to execute instructions to determine whether the surgical instrument is removed from the patient by determining whether the surgical instrument is removed from the patient console.

3. 10. The system of claim 1, wherein the handle is removably coupled to the surgeon console such that the handle is sterile during the surgical procedure and sterilizable while removed for additional surgical procedures.

4. 4. The system of claim 3, further comprising a sterile drape interface having a ring defining an opening, the handle holding the ring in place when coupled to the surgeon console such that a sterile drape of the sterile drape interface covers a portion of the surgeon console.

5. 10. The system of claim 1, wherein the controller is configured to execute instructions in the surgical mode to move the at least one of the plurality of patient links at a scaled degree in response to a movement applied at a handle of the surgeon console.

6. 6. The system of claim 5, wherein the control device is configured to execute commands in the surgical mode to cause scaled micro-movements of micro degrees of freedom to the surgical instrument in response to corresponding movements applied at a handle of the surgeon console.

7. 7. The system of claim 6, wherein the micro-motions applied by the surgical instrument are independently scalable for each of the micro-degrees of freedom such that the scaled micro-motion of one micro-degree of freedom is on a different scale than a second scaled micro-motion of a second micro-degree of freedom of the surgical instrument.

8. 10. The system of claim 1, further comprising a clutch configured, when actuated, to prevent micro-movements in the surgical instrument in response to micro-movements applied at a handle of the surgeon's console.

9. the patient console further comprising an alignment joint; and the controller is further configured to execute instructions to set a virtual remote center of motion based on the alignment of the alignment joint and the surgical site; 10. The system of claim 1, wherein movement of the surgical instrument is constrained about the virtual remote center of motion to maintain alignment of the alignment joint with the surgical site during the surgical procedure.

10. 10. The system of claim 9, further comprising a dissection pointer configured to be removably coupled to the alignment joint to enable alignment of the alignment joint with the surgical site.

11. The system of claim 10 , wherein the dissection pointer is configured to be removably coupled to the alignment joint via a magnetic attachment.

12. 10. The system of claim 9, wherein the virtual remote center of motion is established based on alignment of the alignment joint with a trocar placed within the patient's surgical site.

13. 7. The system of claim 6, wherein the scaled micro-movement of the micro-degree of freedom at the surgical instrument is greater than a corresponding movement applied at a handle of the surgeon's console.

14. the control device: instructions to, in the surgical mode, when the clutch is not actuated, move at least one of the plurality of patient links in response to a movement applied at a handle of the surgeon console, thereby moving an end effector of the surgical instrument to a first position; and 10. The system of claim 8, further configured to execute, in the surgical mode, instructions to, when the clutch is actuated, cause the end effector to be stationary while the handle remains movable to a second position.

15. 14. The system of claim 13, wherein the scaled micro-movement of the roll degree of freedom of the micro-degree of freedom at the surgical instrument is at least twice the corresponding movement of the roll degree of freedom applied at the handle of the surgeon console.

16. 10. The system of claim 9, wherein a longitudinal axis of at least one of the plurality of patient links remains aligned with the virtual remote center of motion when the plurality of patient links is pulled away from the patient in response to actuation of the laparoscopic configuration command.

17. the plurality of patient links are interconnected by a plurality of patient joints, including at least one proximally disposed patient link of the plurality of patient links; and 17. The system of claim 16, wherein the controller is configured to execute, in response to operation of the laparoscopic configuration command, instructions to move the plurality of patient links away from the patient by rotating the patient link and the at least one of the plurality of patient links distal to the patient link about an axis at the patient joint.

18. 10. The system of claim 1, wherein the control device is further configured to execute instructions to, in response to operation of a home configuration command, place the plurality of patient links in a home position where an end effector of the surgical instrument can be placed within a trocar inserted into a surgical site on the patient.

19. 20. The system of claim 18, wherein the controller is further configured to execute instructions to move at least one of the plurality of patient links in response to a movement applied at a handle of the surgeon console after the end effector is positioned within the trocar, thereby inserting a distal region of the surgical instrument into the patient.

20. 20. The system of claim 18, wherein the patient console further comprises a vertical post configured to adjust a height of the plurality of patient links, and wherein the controller is further configured to, in response to actuation of a stop position command, execute instructions to retract the vertical post to a minimum height and until a brake on the patient console is released, and collapse the plurality of patient links into a collapsed position.

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