Physician input device for concentric tube surgical robots

Abstract

A highly intuitive physician input device (1) for communicating with a minimally invasive endoscopic concentric tube surgical robot (2) is disclosed. The physician input device (1) may include a user interface handle assembly (10), a user interface linear joint assembly (30), a user interface bearing block assembly, and a user interface base assembly (40), with sensors distributed throughout to measure each of these axes, possibly redundantly for safety reasons. Due to the network of sensors and encoders built into the physician input device (1), movements made on the physician input device (1) can cause corresponding movements of the endoscopic concentric tube robot (2). There are at least four motion controls that the physician input device (1) can communicate to the concentric tube robot (2): translation, pan, tilt, and axial rotation. In some embodiments, a fifth control includes actuation of a tool, such as a gripper.

Description

[Technical Field]

[0001] The present subject matter generally relates to robotic endoscopic surgical instruments and related methods for performing precision surgery. More particularly, the present invention relates to an input device that allows a physician to precisely move and control an endoscopic concentric tube robotic surgical system. [Background technology]

[0002] Over the past several decades, it has become increasingly clear that entering the body in the most minimally invasive manner possible during surgery offers significant benefits to patients. Minimally invasive surgery is a general term used for any surgical procedure that involves entering the body without a large incision. Conventional devices for performing minimally invasive surgery, such as endoscopes and resectoscopes, are generally rigid and include a distal tip that is inserted through an incision or a natural orifice in the patient's body. The distal tip includes an optical lens that allows the surgeon to view a field of view close to the distal tip when positioned within the body. Endoscopes typically have a camera attached to display the field of view on a monitor in the operating room. In some applications, the endoscope includes a camera installed at the distal tip of the endoscope. The device further includes a working channel extending throughout the device. One or more elongated surgical tools can be inserted through the working channel. The surgical tools can include tools such as dissection devices, baskets, or laser optics. The distal end of the surgical tool protrudes from the distal tip of the device, allowing the surgeon to visually observe the operation of the tool within the patient's body during surgery.

[0003] Minimally invasive surgery includes laparoscopic surgery, which uses a tube (i.e., an endoscope) that provides the user with visualization and visibility of the surgical field and long, rigid instruments that pass through small ports inside the body. In traditional laparoscopic surgery, the endoscope is typically used only to visualize the surgical field and does not have tools passing through it. Tools are pivoted through incision ports outside the body to manipulate instruments at the surgical site. Tool manipulation in laparoscopic surgery is achieved by rotating long, rigid shafts through ports inside the body. For surgery in an insufflated abdomen, thoracic cavity, pelvis, or any other anatomical working volume with ample space, this concept often provides an excellent minimally invasive solution for instrument manipulation. However, when the surgical site is down a long, narrow channel, the ability to pivot these long, rigid shafts is reduced. As the access channel becomes longer and / or narrower, the ability to manipulate tools rapidly decreases.

[0004] Minimally invasive surgery also includes endoscopic surgery. While laparoscopic surgery uses an endoscope to provide visualization, endoscopic surgery differs in that surgical instruments are passed through the working channel of the endoscope tube itself. Examples of surgical instruments that can be used during endoscopic surgery include scissors, forceps, laser fibers, monopolar / bipolar cautery, etc. There are both rigid and flexible endoscopes. Rigid endoscopes are used in procedures that allow for a straight, linear path from outside the body to the surgical site, while flexible endoscopes are used when bending through curved anatomical structures is required. Rigid endoscopes are currently used in nearly all fields, including, but not limited to, neurological, pulmonary, orthopedic, urological, and gynecological procedures. While rigid endoscopes are currently used for procedures throughout the body, they are not without their drawbacks. Tools operated through the working channel of a rigid endoscope are similar to laparoscopic tools in that they are typically straight and rigid. Generally, these tools are limited to two degrees of freedom of movement relative to the endoscope: insertion / retraction and axial rotation. In some cases, surgeons may have the ability to pivot / tilt the endoscope outside the body, making the task particularly difficult because the endoscopic field of view moves with each movement. Additionally, the size constraints of the endoscope's working channel often limit surgeons to bringing only one instrument to the surgical site at a time, effectively eliminating the ability for bimanual tasks. The limitation to a single tool at a time, the constantly changing field of view, the limited degrees of freedom, and the lack of dexterity of the instrument at the tip of the endoscope make endoscopic surgery a particularly challenging type of minimally invasive surgery.

[0005] Electromechanical surgical robots are a rapidly developing medical field with great potential for assisting in the manipulation of surgical instruments, due to their particular excellence in precision, spatial reasoning, and dexterity. Surgical robots have become widespread worldwide and have been used in hundreds of thousands of procedures. Most surgical robotic systems designed to assist in instrument manipulation can be broadly categorized into pivoting and flexible tools. Pivoting laparoscopic systems, such as the widely used da Vinci Xi robot manufactured by Intuitive Surgical, Inc., achieve instrument manipulation in the same way as laparoscopic tools: by manual tilting through a port in the body. For surgical applications where tool tilting or pivoting outside the body is not possible, several groups in the research community have developed robotic systems based on flexible elements. These systems are often referred to as robotic continuums or continuously bending robots with elastic structures. There are also concentric tube manipulators, which are a type of small, needle-sized robotic continuum composed of concentric elastic tubes. Concentric tube robots show promise in various types of minimally invasive surgical interventions that require small-diameter robots with articulation within the body. Examples include surgery on the eye, hearing, sinuses, lungs, prostate, brain, and other areas. In most of these applications, a higher curvature is generally desirable to enable the robot to turn "tighter corners" within the human body and maneuver at the surgical site. In endoscopic surgery, the pre-curvature of the concentric tube determines how close the manipulator can work to the tip of the endoscope, which is critical during endoscopic surgery.

[0006] In conventional endoscopic procedures, surgeons typically hold an endoscope in one hand and an endoscopic instrument in the other, generally making it impossible for them to simultaneously manipulate two instruments. Due to the potential for human error, whenever a surgeon needs to exchange one endoscopic instrument for another, this can result in clumsy and dangerous movements of the endoscope. However, surgeons often require the ability to precisely and simultaneously manipulate two instruments in certain situations, particularly when attempting to precisely grasp, manipulate, or cut material. Even when an endoscope can simultaneously accommodate more than one tool, the tools can only be oriented straight and parallel to each other, which inhibits proper collaboration between the tools. While surgeons can greatly benefit from the increased precision, dexterity, and vision offered by robotic surgical systems, such conventional systems are limited in their maneuverability.

[0007] Another challenge with conventional surgical robots is that conventional user input consoles are generally not configured for use in a sterile field. Thus, the surgeon operating the input console must stand outside the operating room in a remote, non-sterile environment. This can be inconvenient, especially if the surgeon needs to move back and forth between the sterile field and the user input console during surgery.

[0008] Therefore, there is a need for new and improved endoscopic robotic surgical systems that are intuitive, sophisticated, and accurate. Summary of the Invention

[0009] The present disclosure generally relates to physician input devices and systems for robotically performing minimally invasive surgery. In some embodiments, the invention includes an endoscopic surgery system that provides two robotically controlled concentric tube manipulators that operate to perform surgery from the tip of a rigid endoscope. In some embodiments, a surgeon can manipulate a joystick-like handle of the physician input device to control corresponding movement of one or both of the independently movable robotic concentric tube manipulators that protrude from the tip of the rigid endoscopic element.

[0010] In some embodiments, it is an object of the present disclosure to provide a system that replaces linear tools in nearly every rigid endoscopic procedure, allowing surgeons to grasp, manipulate, and cut tissue with dexterity and precision unmatched by traditional rigid endoscopy.

[0011] Another object of the present disclosure is to provide a physician input device for controlling tubes in a concentric tube array using a handheld controller with tilt and linear in / out degrees of freedom to control corresponding tilt and linear motion. In further embodiments, a third degree of freedom is provided, comprising lateral panning. In some embodiments, a fourth degree of freedom includes rotation about the longitudinal axis.

[0012] Another object of the present disclosure is to provide a physician input device that a surgeon can use to safely control endoscopic tools during surgical procedures using a rigid endoscope, benefiting from an attached camera lens for real-time observation of the workspace. The endoscopic camera can communicate with an operating room monitor to provide live visual endoscopic feedback of the internal surgical site, allowing the surgeon to observe it while performing the procedure. The endoscopic elements can be delivered via two robotically controlled concentric tube manipulator arms and an optical lens attached to them. In particular, the concentric tube arms can be made from nitinol due to its high recoverable strain and ability to be shaped into desired curves while maintaining superelasticity. The manipulators at the ends of the concentric tube arms can be equipped with a number of surgical tools, including, but not limited to, graspers, forceps, knives, brushes, scalpels, biopsy devices, electrocautery devices, and tissue scissors and cutters.

[0013] It is a further object of the present disclosure to provide a physician input device for robotic control of the concentric tubes of an endoscopic surgical robot in a highly safe and intuitive manner.

[0014] Another object of the present disclosure is to provide a physician input device configured to control a surgical robot that can be positioned in a sterile field during a surgical procedure. In some embodiments, the present disclosure provides a physician input device with a user input portion configured to be operated by a surgeon cleaned in or near the sterile field with one or more drapes, or to be used in a remote environment outside the sterile field.

[0015] Numerous other objects, advantages and novel features of the present invention will become readily apparent to those skilled in the art upon reading the following disclosure in conjunction with the accompanying drawings and claims. [Brief explanation of the drawings]

[0016] [Figure 1]FIG. 1 illustrates a schematic perspective view of one embodiment of an endoscopic concentric tube robotic-assisted precision surgery system. [Figure 2] 1 illustrates a perspective view of one embodiment of a physician input device. [Figure 2A] 1 illustrates a perspective view of one embodiment of a user interface handle assembly and a view of a concentric tube assembly showing translational degrees of freedom. [Figure 2B] 1 illustrates a perspective view of one embodiment of a user interface handle assembly and a view of a concentric tube assembly showing tilt degrees of freedom. [Figure 2C] 1 illustrates a perspective view of one embodiment of a user interface handle assembly and a view of a concentric tube assembly showing the pan degree of freedom. [Figure 3] 3 illustrates a perspective view of the embodiment of the user interface handle assembly of FIG. 2. [Figure 4] 4 illustrates a perspective view of the embodiment of the contact point assembly of FIG. 3. [Figure 5] 5 illustrates a perspective view of the embodiment of the capacitive user interface assembly of FIG. 4. [Figure 6] 4 illustrates an exploded view of the embodiment of the handle bearing assembly of FIG. 3. [Figure 7] 4 illustrates an exploded view of the embodiment of the sensor housing assembly of FIG. 3. [Figure 8] FIG. 8 illustrates a perspective view of an embodiment of a magnetic sensor gear assembly as shown in FIG. [Figure 9] 4 illustrates an exploded view of an embodiment of a shaft axle assembly as shown in FIG. 3. [Figure 10] FIG. 10 illustrates a perspective view of an embodiment of a capsule slip ring as shown in FIG. [Figure 11] 3 illustrates a perspective view of an embodiment of a user interface linear joint assembly as shown in FIG. 2. [Figure 12] 3 illustrates a perspective view of an embodiment of a user interface pan / tilt assembly as shown in FIG. 2. [Figure 13] 13 illustrates a perspective view of an embodiment of a magnetic sensor mount as depicted in FIG. 12. [Figure 14] 13 illustrates a perspective view of an embodiment of a tilt axis circuit board as shown in FIG. 12. [Figure 15] 3 illustrates a perspective view of an embodiment of a user interface base assembly as shown in FIG. 2. [Figure 16] 16 illustrates a perspective view of an embodiment of a ring LED printed circuit board and housing assembly as shown in FIG. 15. [Figure 17] 17 illustrates a perspective view of an embodiment of a ring LED printed circuit board as shown in FIG. 16. [Figure 18] 1 illustrates a perspective view of one embodiment of a surgical system including first and second input devices and first and second concentric tube assemblies. [Figure 19] 1 illustrates a perspective view of one embodiment of a physician input console including first and second physician input devices. [Figure 20] 1 illustrates a detailed perspective view of one embodiment of a physician input device with a surgical drape. DETAILED DESCRIPTION OF THE INVENTION

[0017] While the making and use of various embodiments of the present invention are described in detail below, it should be understood that the present invention provides many applicable inventive concepts that can be embodied in a wide variety of specific contexts. The specific embodiments described herein are merely illustrative of specific ways to make and use the invention and do not limit the scope of the invention. Those skilled in the art will recognize numerous equivalents to the specific devices and methods described herein. Such equivalents are considered to be within the scope of the present invention and are covered by the following claims.

[0018] Referring now to the drawings, various views of embodiments of devices for performing minimally invasive surgery are shown. In the drawings, for clarity, not all reference numbers are included in each drawing. The devices shown in the figures are not intended to describe every possible embodiment of the claimed invention, but rather are included as examples. Those skilled in the art will understand that the devices and methods of the claimed invention may include different configurations and orientations not shown in the figures.

[0019] The present disclosure provides a physician input device for robotically performing minimally invasive surgery. An overview of one embodiment of an endoscopic concentric tube robot-assisted precision surgery system can be seen in Figure 1, where a physician input device 1 is in direct communication with an endoscopic concentric tube robot 2, which is in direct communication with an operating room monitor 3.

[0020] A more detailed view of one embodiment of physician input device 1 is shown in Figure 2. Physician input device 1 can include a user interface handle assembly 10, a user interface pan / tilt assembly 20, a user interface linear joint assembly 30, a user interface base assembly 40, and a rotary encoder 50. In some embodiments, assemblies 10, 20, 30, and 40 can each contain various types of sensors that communicate with each other and continuously track any movement of physician input device 1.

[0021] The physician input device, in some embodiments, includes three degrees of freedom for controlling corresponding movement of a surgical tool at the distal tip of the concentric tube assembly. For example, in use, certain embodiments of the physician input device 1 can cause (1) translational movement of the endoscopic concentric tube robot 2 by retracting or pushing outward the user interface handle assembly 10, (2) panning movement of the concentric tube robot 2 by moving the user interface handle assembly 10 laterally, i.e., from side to side, and (3) tilting movement of the concentric tube robot 2 when moving the user interface handle assembly 10 up and down. In further embodiments, a fourth degree of freedom controls (4) axial movement of the concentric tube robot 2 by pivoting the user interface assembly 110 portion of the contact point assembly 100.

[0022] Referring to FIG. 2A , the first degree of freedom involves linear translation of the contact point assembly 100, i.e., the handle, by the user's hand. When the handle is translated forward toward the pan / tilt assembly 20 and the UI linear joint assembly 30, a translation sensor detects the translation and sends a control signal to a driver coupled to a first tube assembly 119. The first tube assembly 119 includes a guide tube 116 and an inner tube 114 positioned inside the guide tube 116. The inner tube 114 is capable of longitudinal translation inside the guide tube 116. The guide tube 116 includes a curved distal tip that guides the inner tube 114 in a desired direction. The guide tube can rotate within a channel within the endoscope. When the handle of the input device 1 is translated along the translation axis 118a, the inner tube 114 moves in a corresponding motion, thereby translating the inner tube 114 linearly into or out of the distal tip of the guide tube 116. For example, when the handle 100 is pushed inward toward the UI linear joint assembly 30, a corresponding extension of the inner tube 114 occurs within the tube assembly 119 relative to the guide tube 116. Similarly, when the handle 100 is pulled back along the translation axis 118a by the user, a corresponding retraction of the inner tube 114 occurs relative to the guide tube 116. By mapping the in and out translation of the handle 100 to a corresponding movement of the inner tube 114, the input device 1 provides a user-friendly and intuitive interface for extending and retracting the tool 115 within the tissue workspace.

[0023] Referring to FIG. 2B , the second degree of freedom includes an up-down tilt function. As the handle 100 moves angularly about the horizontal reference axis 118b relative to the UI pan / tilt assembly 20, one or more sensors detect the movement and send a control signal to a driver to impart a corresponding movement to the tube assembly 119. For example, as shown in FIG. 2B , as the handle 100 tilts upward about the horizontal axis 118b, the inner tube 114 translates within the surgical field with a corresponding upward movement. Similarly, as the handle 100 tilts downward about the horizontal axis 118b, the inner tube 114 translates within the surgical field with a corresponding downward movement. This allows a user to directly map the movement of the handle 100 to the corresponding movement of the inner tube 114 and tool 115 within the tissue workspace.

[0024] Some users prefer to have an inverse correlation between input direction and tilt movement of the tool within the workspace. Because movement of the up / down tilt function relative to the physician's input is mapped using software and electronic signals to a driver that controls movement of the tube assembly, in some embodiments, the instrument can be provided in an inverted configuration. For example, in an inverted configuration, when the handle 100 is tilted upward and angularly about the horizontal reference axis 118b relative to the UI pan / tilt assembly 20, the inner tube 114 translates within the surgical field with a corresponding downward movement. Similarly, in an inverted configuration embodiment, when the handle 100 is tilted downward about the horizontal axis 118b, the inner tube 114 translates within the surgical field with a corresponding upward movement.

[0025] 2C, the third degree of freedom includes a lateral pan function. As the handle 100 moves angularly relative to the reference vertical axis 118c, a corresponding movement of the tube assembly 119 allows the inner tube 114 and tip 115 to move laterally within the field of view. For example, as the handle 100 is panned to the left in a pivotal movement about the reference vertical axis 118c, the inner tube 114 moves to the left in a corresponding movement within the field of view. Similarly, as the handle 100 is panned to the right in a pivotal movement about the reference vertical axis 118c, the inner tube 114 moves to the right in a corresponding movement within the field of view.

[0026] Additionally, some users prefer to have an inverse correlation between input direction and lateral panning of the surgical tool within the workspace. Because the movement of the lateral pan function relative to the surgeon's input is mapped using software and electronic signals to a driver that controls the movement of the tube assembly, in some embodiments, the instrument can be provided in an inverted configuration. For example, in an inverted configuration, as the handle 100 is panned left and right about the vertical reference axis 118c, the inner tube 114 is panned within the surgical field with a corresponding left-right movement. Similarly, in an inverted configuration embodiment, as the handle 100 is panned left and right about the vertical reference axis 118c, the inner tube 114 is panned within the surgical field with a corresponding right-left movement.

[0027] The fourth degree of freedom, in some embodiments, provides a rotational function. Angular rotation of the handle 100 about the translation axis 118a produces a corresponding roll or rotation of the inner tube 114 and tool 115 within the field of view. This function is desirable when the tool 115 includes a gripper device or other tool that requires angular orientation about its longitudinal axis.

[0028] In some embodiments, multiple degrees of freedom may cooperate and be used simultaneously to control movement of the inner tube 114 within the field of view. For example, a user may simultaneously rotate, tilt, pan and extend or retract the handle 100, causing corresponding movement of the inner tube 114 and tool 115 within the field of view. In some embodiments, the input device 1 forms a gimbal with three degrees of freedom, including angular pan, angular tilt, and linear translation.

[0029] As shown in Figure 3, one embodiment of a handle assembly may include a contact point assembly 100, a handle bearing assembly 200, a magnetic sensor housing assembly 300, and a shaft assembly 400, all directly connected to each other. In some embodiments, as shown in Figure 4, the contact point assembly 100 includes a contact point shaft 101, a friction gasket 102, a flat washer 103, and a touch-sensitive user interface assembly 110.

[0030] In other embodiments, the contact point assembly 100 can additionally include at least one contact sensor or sensor array capable of detecting whether and when the physician makes hand contact with the contact point assembly 100. In such embodiments, the contact sensor acts as a safety mechanism to prevent unintended movement of the tube assembly. For example, the contact sensor can intervene to prevent corresponding movement of the endoscopic concentric tube robot 2 in the event of an accidental bump of the input or workstation. Additionally, the contact sensor can serve to establish a direct connection between the physician input device 1 and the endoscopic concentric tube robot 2 only upon detecting a set amount of contact between the physician's hand and the contact point assembly 100.

[0031] In one embodiment shown in FIG. 5 , the touch-sensitive user interface assembly 110 portion of the touch point assembly 100 can further include a touch point capacitive end cap 111, a touch point capacitive body 112, and a panel mount 113 that defines a hollow interior portion of the capacitive body 112. In certain embodiments, the touch point capacitive body 112 is one of many regions of the input device 1 that can house one or more contact sensors that function as safety mechanisms in the manner described above. For example, in some embodiments, a first sensor 112 a and a second sensor 112 b are positioned on the body 112. The input device is configured to prevent actuation of the tube assembly unless both the first and second sensors 112 a, 112 b are contacted by a user's hand. The first and second sensors can include any suitable sensors known in the art, such as capacitive contact sensors, pressure sensors, or switches.

[0032] 5 , in some embodiments, the user interface assembly 110 includes an array of contacts or pads 112 positioned around the periphery of the handle. Each contact or pad 112a, 112b, etc., is connected to a central multi-channel sensor. For example, a first pad 112a is connected to a first channel on the sensor, a second pad 112b is connected to a second channel on the sensor, and additional pads positioned on the handle are each connected to a separate channel on the sensor. In some embodiments, the sensor includes a multi-channel sensor with eight channels, each connected to a corresponding pad positioned around the periphery of the handle. The system can be programmed to inhibit movement of the tube array unless a predetermined combination of different pads at different locations are simultaneously touched by the user's hand.

[0033] Some embodiments of the physician input device and associated methods include redundant sensing along multiple degrees of freedom to provide additional safety. For example, in some embodiments, the input device 1 includes a first degree of freedom that includes linear translation along the reference axis 118a. The first and second translation sensors both detect linear movement of the handle 100 along the reference axis 118a. If the translation data related to the linear translation of the handle 100 acquired by both the first and second sensors are not within a predetermined threshold range of similarity, the system may prevent corresponding movement of the tube array within the workspace.

[0034] In some embodiments, similar redundancy is provided for each additional axis. For example, first and second tilt sensors positioned on the device detect up and down angular movement of the handle 100 relative to the reference horizontal axis 118b shown in FIG. 2B. If the angular position data acquired by each of the first and second sensors is not within a predetermined threshold range of similarity, the system may prevent corresponding movement of the tube array within the workspace. Also, first and second pan sensors positioned on the device detect lateral angular movement of the handle 100 relative to the reference vertical axis 118c shown in FIG. 2C. If the angular position data acquired by each of the first and second pan sensors is not within a predetermined threshold range of similarity, the system may prevent corresponding lateral pan movement of the tube array within the workspace. Finally, first and second roll sensors positioned on the device detect angular movement of the handle 100 in a rolling motion about the translation axis 118a. If the angular position data acquired by each of the first and second roll sensors is not within a predetermined threshold range of similarity, the system may prevent corresponding rolling movement of the tube array within the workspace. In some embodiments, redundant sensors may be provided along each axis to prevent unintentional movement of the tube array within the workspace.

[0035] Referring to FIG. 6, the handle bearing assembly 200 can be comprised of an interconnected series of flat washers 201, friction gaskets 202, ball bearings 203, and a handle bearing block 204. As shown in FIG. 7, in certain embodiments, the magnetic sensor housing assembly 300 includes a magnetic sensor housing body 302. Housed within the body 302 can be a plurality of magnetic rotary encoders 301 attached to a corresponding plurality of magnetic sensor gear assemblies 310. The magnetic sensor gear assembly 310 can further include a magnetized gear 311, a magnet 312, a chemical-resistant dry-running sleeve bearing 313 inside the magnetic sensor gear assembly, and a retaining ring 314, as shown in FIG. 8. These features detect the rotation of the handle and control the corresponding rotation of the tube assembly.

[0036] 9 and 10 , one embodiment of a hex shaft axis assembly 400 can include a hex shaft 401, a hex shaft mount 402, a capsule slip ring 410, and a slip ring adapter 403, where the capsule slip ring 410 further includes a rotating slip ring 411 and a stationary slip ring 412. In some embodiments, the slip ring adapter 403 can be aligned with and fit directly around the tip of the contact point shaft 101. In this arrangement, the capsule slip ring 410 can pass conductors to the rotatable contact point assembly 100. Furthermore, in certain embodiments, the axis rotation control has an approximately 1:1 ratio of the corresponding movement in the endoscopic concentric tube robot 2, although such ratio can be increased or decreased in other embodiments as required for a particular application.

[0037] 11 , one embodiment of a user interface linear joint assembly 30 can include an input shaft channel 31, an end cap 32, a plurality of friction bearings 33 lining the inside of the input shaft channel 31, a body cover 34, a potentiometer 35 housed inside the body cover 34, an incremental magnetic encoder 36 in direct contact with the potentiometer 35, an MS05-A-L60 37, a counterweight 38 housed inside a second end of the user interface linear joint assembly 30, a body cover extension 39, and a tilt axis 320 about which the user interface linear joint can pivot up and down. In such an embodiment, the user interface handle assembly 10 is coupled to the user interface linear joint assembly 30 by a mating interconnection between a shaft 401 and the friction bearings 33, with the tip of the shaft 401 fitting into the potentiometer 35. In this configuration, the incremental magnetic encoder 36 can sense when translational movement is made in the user interface handle assembly 10, thereby causing a corresponding translational movement in the tube assembly. The potentiometer 35 provides a first translation sensor, and the incremental magnetic encoder 36 provides a second translation sensor. Together, the first and second translation sensors detect linear movement of the handle 100 along the translation axis 118a. Although the first and second sensors operate differently, they provide redundant position sensing for the translation of the handle 100, thereby providing a backup safety feature to prevent unintentional movement of the tube array within the workspace.

[0038] In some embodiments, as the user interface handle assembly 10 is translated relative to the linear joint assembly, position data is obtained via the first and second translation sensors and a translation control signal is sent to a driver coupled to the tube assembly. The translation control signal may be sent to the driver via a wired connection or, in some embodiments, via a wireless transceiver or transmitter.

[0039] Due to the internal friction bearing 33, there is a significant amount of resistance when the physician translates the handle assembly 10. Such resistance is a desirable and intentional feature that can help increase patient safety, as it helps the surgeon better feel the movement as if they were moving the tool themselves through the endoscope and without a robotic interface. Resistance along the translation axis can also be provided by one or more motors on a low-friction device, providing a sense of resistance as the handle translates linearly along the translation axis 118a. Furthermore, in some embodiments, the translation control has an approximately 2-to-1 ratio of corresponding movement in the tube assembly, although this can be adjusted as needed in other embodiments.

[0040] The input device 1 further includes a mount, or user interface pan / tilt assembly 20, for providing pan and tilt capabilities. One embodiment of the user interface pan / tilt assembly 20 is shown in FIGS. 12-14. In this embodiment, the user interface pan / tilt assembly 20 may be U-shaped and may include two opposing blocks 21 housed within two block covers 22, a stainless steel ball bearing 23 inside each of the blocks 21, a magnetic sensor mount 210 housed inside each of the blocks 21, and a tilt axis circuit board 220 connected to one of the blocks 21. In such an embodiment, each of the magnetic sensor mounts 210 further includes a magnetic rotary encoder 211, and the tilt axis circuit board 220 further includes a plurality of connectors for transmitting electrical signals to and from the pan / tilt assembly 20.

[0041] Also, in such an embodiment, the interconnected user interface handle assembly 10 and user interface linear joint assembly 30 are further connected to the user interface pan / tilt assembly 20 by a pair of tilt axis fasteners customized to connect each of the tilt axis 320 portions of the linear joint assembly 30 to each of the two stainless steel ball bearings 23. In this arrangement, the magnetic rotary encoder 211 can sense when there is up or down tilt movement of the interconnected handle / linear joint / pan / tilt assembly about the tilt axis 320, thereby causing a corresponding tilt movement in the tube assembly within the field of view. Furthermore, while in certain embodiments the tilt control has an approximately 1:1 ratio of corresponding angular movement in the tube assembly, in other embodiments such ratio can be adjusted higher or lower as needed.

[0042] One embodiment of a user interface base assembly 40 is illustrated in Figures 15-19. In some embodiments, the user interface base assembly can include a base plate 41, a base housing 42 elevated above the base plate 41 by a plurality of spacer legs 44, two ball bearings 43 nested together and housed inside the base housing 42, a plurality of sleeve bearing carriages mounted to the bottom surface of the base plate 41, a ring LED assembly 46 mounted to the top of the base housing 42, a lead nut housing 47 mounted above the base plate 41, a lead nut (or equivalent) 48 contained within the lead nut housing 47, and an off-axis rotary absolute magnetic encoder 49 mounted to the bottom of the base housing 42. In such embodiments, the ring LED assembly 46 includes a ring LED housing 460, a ring LED cover 461, and a SW LED ring 462, which can further include a ring LED printed circuit board 465.

[0043] As seen in the embodiment of physician input device 1 of FIG. 2 , redundant off-axis rotary absolute magnetic encoder 50 comprises an elastoferrite upper ring layer 51 and a lower ring layer and is mounted to the bottom of base housing 42, further below encoder 49. In such an embodiment, user interface base assembly 40 is interconnected to U-shaped user interface pan / tilt assembly 20 by a “main shaft” that extends from the base of U-shaped pan / tilt assembly 20 through ring LED assembly 46 and is stacked with ball bearings 43 and base housing 42 of base assembly 40. In this embodiment, user interface handle assembly 10, U-shaped user interface pan / tilt assembly 20, user interface linear joint 30, user interface base assembly 40, and redundant off-axis rotary absolute magnetic encoder 50 form a single interconnected unit. In this arrangement, off-axis rotary absolute magnetic encoder 49 and redundant off-axis rotary absolute magnetic encoder 50 can sense when there is lateral panning movement of the interconnected handle / linear joint / pan / tilt assembly about the "main shaft," thereby causing a corresponding panning movement in the tube assembly. Furthermore, in certain embodiments, the pan control has an approximately 1:1 ratio of corresponding movement in the tube assembly, although in other embodiments such ratio can be adjusted higher or lower as desired.

[0044] The rotary encoder detects the angular position of the user interface pan / tilt assembly 20 as it rotates about the reference vertical axis 118c relative to the user interface base assembly 40 and generates a position signal. The position signal is used to generate a pan control signal that is forwarded to a driver to cause a corresponding lateral pan movement in the tube assembly. The pan control signal is sent to the driver via a wired or wireless connection. In some embodiments, the pan signal transmitted from the user interface 1 includes angular position data obtained via the rotary encoder 50. In other embodiments, the pan signal transmitted from the user interface 1 includes an additional component calculated to drive a corresponding movement of the tube assembly.

[0045] In some embodiments, the user input device 1 provides a translation stroke of approximately 50 mm to approximately 60 mm. This range can be adjusted higher or lower depending on the application. In some embodiments, this range of stroke distance provides a corresponding stroke range of the inner tube 114 of approximately 30 mm to approximately 40 mm. The ratio between the input movement at the handle 100 and the effective movement of the inner tube 114 along each degree of freedom can be adjusted in some embodiments as software-based gain factors that can be precisely controlled to adjust the sensitivity of the device.

[0046] User interface 1 provides a pan / tilt pivot point that is fixed in three-dimensional space due to the interface being mounted to a stationary console or stand. This configuration provides a desirable feel to the surgeon when tilting a tool against a constrained center of motion. This layout creates an experience similar to manually manipulating / tilting a tool through a port in a patient's body wall during laparoscopic surgery. The pivot point can be implemented mechanically via a pan / tilt gimbal, or in other embodiments, the pivot point can be implemented electronically via a haptic system.

[0047] Another feature of the user interface 1 is that it provides a system that does not require a "clutch" when it is desired to move the tip 115. Because the entire workspace of the tube assembly manipulator is contained within the available range of motion and workspace of the input device, there is no need to decouple the user input from the tube assembly and reposition the user input during a surgical procedure, as is required with other conventional surgical robotic inputs.

[0048] An additional feature of the user interface 1 is providing a system that can be easily calibrated or returned to a zero position at the beginning of a procedure. At the start of a surgical procedure, once the guide tube 116 and inner tube 114 are fully retracted, the handle 100 can also be manually retracted along the translation axis to its mechanical limit. From this position, both the tube assembly and the handle 100 can be translated forward along the translation axis into a workspace cone defined by the field of view and the range of available motion of the tube assembly. In this way, alignment of the handle 100 and the tube assembly can be easily performed at the start of each operation.

[0049] 21 , in some embodiments, the surgical system includes a first input device 1a and a second input device 1b. The first input device 1a is configured to acquire linear translation, pan, and tilt data associated with movement of a handle. The acquired data is communicated to a first driver 230a mechanically coupled to the first concentric tube array 117a via a wired or wireless interface. The first driver 230a controls the movement of the first concentric tube array 117a within the field of view corresponding to the position data acquired by the first input device 1a. The second input device 1b is configured to acquire linear translation, pan, and tilt data associated with movement of a handle on the second input device 1b. The acquired data is communicated to a second driver 230b mechanically coupled to the second concentric tube array 117b via a wired or wireless interface. The second driver 230b controls the movement of the second concentric tube array 117b within the field of view corresponding to the position data acquired by the second input device 1b.

[0050] In a further embodiment, the present disclosure provides a method for controlling a concentric tube assembly for performing surgery, the method including: (a) providing three degrees of freedom, including translation, tilt, and pan, to a user input; (b) acquiring linear position data representing translation of the user input device relative to a linearly fixed reference frame; (c) acquiring tilt angular position data corresponding to angular movement about a fixed horizontal reference axis; (d) acquiring pan angular position data corresponding to angular movement about a fixed vertical reference axis; and (e) mapping the acquired linear position data, tilt angular position data, and pan angular position data to corresponding movement of a surgical tool within a remote concentric tube array.

[0051] In some embodiments, the method further includes providing a handle with a user input including a first sensor and a second sensor, and the device is inoperable unless both the first sensor and the second sensor are activated. In some embodiments, the first and second sensors are capacitive contact sensors.

[0052] In some embodiments, the method further includes providing a first user input device configured for use with a user's right hand and a second user input device configured for use with a user's left hand. The first and second user input devices are electronically connected to the first and second concentric tube assemblies, respectively, for performing surgery. Each user input device includes at least three degrees of freedom, including linear translation, pan, and tilt, and movement of each device causes corresponding movement of a respective concentric tube array along each degree of freedom.

[0053] 19-20 , in some embodiments, a surgeon input console 500 includes a first user input device 501a and a second user input device 501b. The first and second input devices 501a, 501b are mounted on a frame 502. In some embodiments, the frame 502 is configured so that the distance between the first and second input devices 501a, 501b is variable and can be adjusted to accommodate surgeons with different physical attributes, such as shorter or longer arms and / or different hand sizes. The frame 502 is positioned atop a shaft 504 that extends upward from a base 506. The frame 502, in some embodiments, includes a user display screen 520 and a user control panel 522. The shaft 504, in some embodiments, is selectively extendable to accommodate surgeons in a seated or standing position, or to accommodate surgeons of different heights or arm lengths. The base 506 includes a plurality of wheels disposed thereon, allowing the console 500 to be rolled on a hard surface, such as a hospital floor. A plurality of wires 510 extend from the console 500 to surgical instruments, which include concentric tube assemblies for performing surgery. The wires 510 transmit and receive signals between the surgical instruments and the console 500. In some embodiments, communication between the surgical instruments and the console 500 is via wireless communication.

[0054] 19 and 20 , in some embodiments, the console 500 is specifically adapted for use with a surgical drape 512. The drape 512 provides a sterile barrier and allows the console 500 to be used on the surgical field in an operating room. In some embodiments, the drape 512 covers the console 500, the frame 502, the first and second user input devices 501 a, 501 b, and the shaft 504. Each user input device 501 a, 501 b is specifically designed to allow a surgeon to manually operate the device while the surgical drape is in place.

[0055] 19 , console 500 includes a drape support 518 that extends upwardly above frame 502 and, in some embodiments, above first and second user input devices 501 a, 501 b. In some embodiments, drape support 518 includes a horizontal bar that spans at least the distance between first and second user input devices 501 a, 501 b and is offset toward first and second user input devices 501 a, 501 b away from display screen 520. Drape support 518 allows drape 512 to form a tent over input devices 501 a, 501 b, thereby allowing the input devices to move with a relatively free range of motion within the tent formed by drape 512. Drape 512 generally fits loosely into the console, thereby allowing the user input devices to be freely manipulated and repositioned on the frame as needed. The drape 512 may be secured to the console 500 using one or more fasteners, such as tape or magnets, to secure the drape 512 in a desired position on the console 500 .

[0056] Also, as shown in FIG. 20 , a drape 512 including a pocket 514 can be mounted on a handle 516 on the user input device 501a. Due to the mechanical configuration of the user input device handle, pan-tilt assembly, and base assembly, when the device is equipped with the drape 512, the surgeon can still achieve manipulation of the handle 516 along all degrees of freedom, including rotation. The configuration of the input device enables use of the device in the surgical field. For example, in some embodiments, the drape 512 includes a pocket 514 around the handle 516 that is separate from the main body of the drape 512, thereby allowing the handle 516 to freely rotate with its independent pocket 514. In some embodiments, a seal is provided between the pocket 514 and the drape main body 512 to prevent contamination. Additionally, the drape 512 can be secured to the shaft 504 using a fastener, such as tape, to secure the lower end of the drape 512 to the console.

[0057] Thus, while specific embodiments of the novel and useful physician input device of the present invention for controlling a concentric tube robot during minimally invasive surgery have been described herein, such references are not intended to be construed as limiting the scope of the invention except as set forth in the claims.

Claims

1. a linear joint assembly including a bore and a linear encoder; a user input assembly including a handle and a shaft extending from the handle into the bore, the shaft movable along a linear translation axis relative to the linear encoder, the linear encoder obtaining translation position data of a linear position of the shaft relative to the linear joint assembly; a pan-tilt assembly supporting the linear joint assembly, the linear joint assembly being pivotable relative to the pan-tilt assembly about a reference horizontal axis; a base assembly supporting the pan-tilt assembly, the pan-tilt assembly being rotatable relative to the base assembly about a reference vertical axis; An input device for controlling a concentric tube assembly, wherein the handle is movable relative to the base assembly in at least three degrees of freedom.

2. 10. The apparatus of claim 1, further comprising a tilt sensor disposed between the linear joint assembly and the pan-tilt assembly, the tilt sensor acquiring inclination position data indicative of an angular position of the linear joint assembly about a horizontal reference axis relative to the pan-tilt assembly.

3. 3. The apparatus of claim 2, further comprising a pan sensor disposed between the pan-tilt assembly and the base assembly, the pan sensor acquiring pan position data indicative of an angular position of the pan-tilt assembly about a vertical reference axis relative to the base assembly.

4. The instrument of claim 3 , further comprising a concentric tube array comprising a guide tube and an inner tube housed inside the guide tube, the inner tube being translatable relative to the guide tube.

5. 5. The instrument of claim 4, wherein the concentric tube array is electronically coupled to the user input assembly such that movement of the handle causes corresponding movement in the concentric tube array via the translation, tilt, and pan position data.

6. a user interface handle assembly having first and second ends; a user interface linear joint assembly; a user interface pan-tilt assembly, the user interface linear joint assembly being pivotable relative to the user interface pan-tilt assembly about a reference horizontal axis; a user interface base assembly, wherein the user interface pan-tilt assembly and the user interface linear joint assembly are pivotable relative to the user interface base assembly about a reference vertical axis; 1. A physician input device for controlling a concentric tube assembly, comprising:

7. a linear encoder disposed on the user interface linear joint assembly; The apparatus of claim 6 , wherein the linear encoder is configured to output a translational position signal representative of a position of the user interface handle assembly.

8. the user interface handle assembly: a contact point assembly located at the first end of the user interface handle assembly; a handle bearing assembly; a shaft assembly extending along a linear translation axis and located at the second end of the user interface handle assembly; The input device of claim 7 further comprising:

9. The input device of claim 8 , wherein the contact point assembly further comprises a touch-sensitive user interface assembly located at the first end of the user interface handle assembly.

10. the user interface linear joint assembly The input device of claim 9 , further comprising a translation sensor for detecting movement of the shaft axle assembly along the linear translation axis.

11. The input device of claim 10 , wherein the user interface handle assembly is connected to the user interface linear joint assembly by a mating interconnection with the shaft axle assembly located at the second end of the user interface handle assembly.

12. 12. The input device of claim 11, wherein the user interface pan-tilt assembly is pivotally attached to the user interface linear joint assembly so that the angle of the shaft shaft assembly can be tilted up and down about a reference horizontal axis, and is further pivotally mounted to the user interface base assembly so that the angle of the shaft shaft assembly can be panned left and right about the reference vertical axis.

13. the user interface base assembly A base plate and at least one rotation sensor configured to measure the angular position of the user interface pan-tilt assembly relative to the user interface base assembly; The input device of claim 12 further comprising:

14. An input device as described in claim 13, wherein the at least one rotation sensor includes first and second rotation sensors that each independently detect the angular position of the user interface pan-tilt assembly relative to the user interface base assembly.

15. 15. The input device of claim 14, wherein the user interface pan-tilt assembly is rotatable relative to the user interface base assembly about the reference vertical axis.

16. An input device as described in claim 15, wherein the interconnected user interface handle assembly, user interface linear joint assembly, user interface pan-tilt assembly, and user interface base assembly provide signals for controlling the concentric tube assembly.

17. The input device of claim 16 , wherein the input device is configured such that angular rotation of the user interface handle assembly causes a corresponding rotation in the concentric tube assembly.

18. 18. The input device of claim 17, wherein the translation sensor of the user interface linear joint assembly is capable of sensing translational movement of the shaft axis assembly sliding along the linear translation axis, thereby causing corresponding translational movement in the concentric tube assembly.

19. An input device as described in claim 18, wherein the first rotational sensor is operable to sense up and down tilting movement about a tilt axis in the interconnected user interface handle assembly and user interface linear joint assembly, thereby causing a corresponding tilting movement in the concentric tube assembly.

20. 20. The input device of claim 19, wherein the second rotational sensor is operable to sense lateral panning movement of the user interface pan-tilt assembly about the reference vertical axis, thereby causing a corresponding panning movement in the concentric tube assembly.

21. (a) providing a user input device including a base, a bearing block pivotally mounted to the base and rotatable relative to the base about a vertical reference axis, a linear joint pivotally mounted to the bearing block about a horizontal reference axis, and a handle linearly translatable relative to the linear joint, the user input device including a linear encoder between the handle and the linear joint, a first rotation sensor between the bearing block and the linear joint, and a second rotation sensor between the base and the bearing block; (b) obtaining translation data from the linear encoder, tilt angle position data from the first rotation sensor, and pan angle position data from the second rotation sensor; (c) generating a control signal based on the obtained translation data, tilt angle position data, and pan angle position data; (d) transmitting the control signal to a driver coupled to the concentric tube assembly; (e) controlling, via the driver, movement of the concentric tube assembly within a field of view such that movement of the concentric tube assembly within the field of view corresponds to movement of the user input device along three degrees of freedom; 1. A method for controlling concentric tubes for performing robotic surgery, comprising:

22. (f) translating the handle toward the linear joint; (g) simultaneously extending the inner tube of the concentric tube assembly relative to the guide tube of the concentric tube assembly within the field of view; 22. The method of claim 21 further comprising:

23. (f) covering the user input device in a surgical drape; (g) operating the user input device within the surgical field; 22. The method of claim 21 further comprising:

Images