Positioning indicator system and related method for a remotely controllable arm

Abstract

To solve the problems of the prior art. [Solution] A robotic system includes a base movable relative to a floor surface and a controllable arm extending from the base. The arm is configured to support and move a tool. The arm has a powered joint operable to position and / or orient the tool. The robotic system further includes a positioning indicator. The processor activates the positioning indicator to indicate manual repositioning of the base relative to the floor surface while the processor activates the powered joint to maintain the position and / or orientation of the tool during manual repositioning.

Description

Technical Field

[0001] This specification relates to a positioning indicator system for a remotely controllable arm, and more particularly for a remotely controllable arm of a robotic system.

Background Art

[0002] A robotic system can include a robotic arm that manipulates a tool to perform tasks at a work site. The robotic arm can include two or more (two or more) links interconnected by one or more (one or more) joints. The joints can be actively controlled active joints. The joints can also be passive joints that conform to the movement of the active joints when the active joints are actively controlled. Such active and passive joints can be revolute joints or prismatic joints. In that case, the configuration of the robotic arm can be determined by the positions of the joints, the structure of the robotic arm, and the connection of the links.

[0003] Robotic systems include industrial and recreational robotic systems. Robotic systems also include medical robotic systems used for procedures such as diagnosis, non-surgical procedures, and surgical procedures. Specific examples include minimally invasive robotic remote surgery systems, which allow surgeons to operate on patients from a bedside location or remotely. Remote surgery generally refers to surgery performed using a surgical system that manipulates the movement of surgical instruments using some form of remote control device, such as a servo mechanism, rather than the surgeon directly holding and moving the instruments by hand. Robotic surgical systems usable for remote surgery may include remotely controllable robotic arms. An operator can remotely control the movement of the remotely controllable robotic arms. An operator can also manually move components of the robotic surgical system to positions within the surgical environment. For example, a surgeon, surgical assistant, or other operator can push or pull instruments by hand so that they move along the floor surface of the surgical environment. [Overview of the project]

[0004] In one embodiment, the surgical system includes a base movable relative to the floor and a remotely controllable arm extending from the base. The arm is configured to support a surgical tool. The arm has a powered joint that is operable to move the surgical tool when the surgical tool is supported by the remotely controllable arm. The surgical system further includes a positioning indicator and a processor. The processor is communicatively connected to the positioning indicator and the remotely controllable arm. The processor is configured to actuate the positioning indicator to instruct manual repositioning of the base relative to the floor and to actuate the powered joint to maintain the position (and / or orientation) of the distal portion of the remotely controllable arm during manual repositioning.

[0005] In other embodiments, the method includes the step of determining an optimality score based on the posture of a remotely controllable arm of a surgical system. The method further includes the step of refining a human-perceptible indicator to instruct manual repositioning of the base of the remotely controllable arm so that the optimality score is greater than a threshold score. The method also includes the step of controlling the movement of the remotely controllable arm based on remote operator input so that the surgical procedure is performed while the optimality score is greater than a threshold score.

[0006] In other embodiments, a method for operating a robotic system including a robotic arm extending from a base is provided. The method includes the steps of: a processor determining a target base orientation of the base; the processor activating positioning indicators to instruct manual repositioning of the base relative to the floor; and the processor maneuvering the robotic arm to maintain the position (and / or orientation) of the distal portion of the arm during manual repositioning of the base.

[0007] In yet another embodiment, a non-transient machine-readable medium includes a plurality of machine-readable instructions. These instructions are configured to cause one or more processors to perform a method when executed by one or more processors associated with a robotic system. The method may be any of those disclosed herein.

[0008] A particular embodiment includes one or more implementations described herein and elsewhere, including any appropriate combination of the implementations described below.

[0009] In some implementations, the processor is configured to operate a powered joint to maintain the position (and / or orientation) of the distal portion of a remotely controllable arm during manual repositioning, by (1) operating the powered joint to maintain the position (and / or orientation) of the distal portion relative to a reference, (2) operating the powered joint to maintain the position (and / or orientation) of the cannula held by the distal portion of the arm relative to a reference, or (3) operating the powered joint to maintain the position (and / or orientation) of the surgical tool relative to a reference. In some implementations, the reference is a reference point, such as a point corresponding to the location of a patient's access port into which or to which the surgical tool is inserted. In some implementations, the reference includes one or more reference directions but does not include a reference location. For example, one or more reference directions may be based on the three-dimensional orientation of the distal portion immediately before the start of the repositioning process. In some implementations, the reference includes both a reference location and one or more reference directions when the position and one or more orientations are maintained. In some implementations, the reference includes a full reference frame sufficient to define the location and orientation in three-dimensional space.

[0010] In some implementations, the surgical system includes a setup assembly that attaches a base to a table, the table configured to support the patient above the floor. In some implementations, the surgical system includes a cart supported on the floor. The cart supports the base above the floor, for example. In some cases, the surgical system further includes a setup assembly that connects the cart to the base, the setup assembly including a passive joint. In some implementations, a positioning indicator is further controlled by a processor to instruct manual repositioning, for example, while the cart is movable relative to the floor and the base is movable relative to the cart. In some cases, the surgical system further includes a braking mechanism coupled to the cart. The braking mechanism is controlled by a processor to prevent the base from moving away from the optimal base position envelope, for example.

[0011] In some implementations, the powered joint is a first powered joint. The arm further includes a second powered joint connected to the first powered joint, for example, by a linkage. The first and second powered joints are configured to move, for example, a surgical tool, a cannula, or the distal portion of the arm. A positioning indicator is further controlled by the processor to instruct manual repositioning of the base while the processor is activating the first and second powered joints to maintain the position (and / or orientation) of the surgical tool, cannula, or the distal portion of the arm. The position (and / or orientation) may be maintained relative to any suitable reference, including, for example, a reference point, one or more reference directions, or a reference system.

[0012] In some implementations, the surgical system further includes a selectively releaseable passive joint. The passive joint is connected to the base, for example, by a linkage, and supports the base above the floor surface. Positioning indicators are further controlled by the processor to instruct manual repositioning of the base while the processor is activating the powered joint and the selectively releaseable passive joint to maintain the position (and / or orientation) of the distal portion of the surgical tool, cannula, or arm (for example, relative to a reference point, one or more reference directions, or a reference system).

[0013] In some implementations, the positioning indicator is further controlled by the processor to instruct manual repositioning of the base based on a target range of joint states determined by the processor.

[0014] In some implementations, the positioning indicator includes indicator lights that can be selectively activated by the processor. Each indicator light is positioned, for example, to indicate the corresponding repositioning direction for manual repositioning of the base.

[0015] In some implementations, the positioning indicator is controlled by a processor to direct (direct) manual repositioning by projecting light toward the floor surface that indicates the repositioning direction for manual repositioning of the base.

[0016] In some implementations, the surgical system further includes sensors that generate signals indicating the arm position of the arm relative to the base position of the base, and a processor is configured to receive signals instructing manual repositioning of the base.

[0017] In some implementations, the surgical system further includes sensors configured to generate signals indicating the respective positions of the base and the arm. The sensors include, for example, at least one of proximity sensors, force sensors, and pressure sensors.

[0018] In some implementations, the surgical system further includes actuators connected to a powered joint and controlled by a processor to drive the powered joint. Positioning indicators are controlled by the processor to, for example, indicate manual repositioning of the base while selectively driving the actuators. In some cases, the positioning indicators include actuators. Positioning indicators are controlled by the processor to, for example, restrict the movement of the powered joint during manual repositioning of the base.

[0019] In some implementations, the positioning indicator includes a braking mechanism controlled by a processor to provide a tactile indication that directs manual repositioning of the base. In some cases, the powered joint is movable through a range of articulated states. The braking mechanism is controlled by a processor to direct manual repositioning of the base, for example, by restricting the movement of the powered joint beyond the range of articulated states.

[0020] In some implementations, the positioning indicator is further controlled by the processor to instruct manual repositioning of the base based on an optimal base location envelope above the floor plane, as determined by the processor. In some cases, the positioning indicator is controlled by the processor to warn the operator during manual repositioning of the base if the base is within the optimal base location envelope. In some cases, the positioning indicator is controlled by the processor to warn the operator during manual repositioning of the base if the base is outside the optimal base location envelope. In some cases, the surgical system further includes a sensor positioned on the base and configured to generate a signal indicating the base posture relative to the optimal base location envelope. The positioning indicator is further controlled by the processor to instruct manual repositioning of the base based on a signal indicating the base posture, for example.

[0021] In some implementations, the surgical system further includes sensors that generate signals indicating manual demonstration of the desired range of motion of the arm. Positioning indicators are further controlled by a processor to, for example, instruct manual repositioning of the base based on the signals indicating manual demonstration.

[0022] In some implementations, the reference point corresponds to the location of the patient's access port into which the surgical tool is inserted.

[0023] In some implementations, the positioning indicator is further controlled by a processor to instruct manual repositioning of the base based on the location of obstacles on the floor surface relative to the base.

[0024] In some implementations, the arm is a first arm. The reference is, for example, a first reference. The surgical system further includes a second remotely controllable arm, for example, configured to support a surgical tool and to position (and / or orient) the surgical tool. The second arm has a powered joint that is movable to position (and / or orient) the surgical tool of the second arm relative to a second reference. The positioning indicator is further controlled by the processor to instruct manual repositioning of the base, for example, by activating the powered joint of the first arm and the powered joint of the second arm to maintain the position (and / or orientation) of the distal portion of the first arm relative to the first reference and the position (and / or orientation) of the distal portion of the second arm relative to a second reference. In some cases, the positioning indicator is further controlled by the processor to instruct manual repositioning of the base based on the orientation of the first arm relative to the orientation of the second arm. In some cases, the base is a first base. The surgical system further includes, for example, a second base connected to a second arm. A positioning indicator is further controlled by a processor to instruct manual repositioning of the first base while activating a powered joint of the first arm to maintain the position (and / or orientation) of the distal portion of the first arm (such as with respect to a first reference). The positioning indicator is further controlled by a processor to instruct manual repositioning of the second base while activating a powered joint of the second arm to maintain the position of the distal portion of the second arm (such as with respect to a second reference). In some cases, the second arm extends from the base from which the first arm extends.

[0025] In some implementations, the positioning indicator is controlled by a processor to instruct a first manual repositioning of the base while operating a powered joint to maintain the position (and / or orientation) of the distal portion relative to a first reference before the surgical tool is inserted into the patient access port. The positioning indicator is controlled by a processor, for example, to instruct a second manual repositioning of the base while operating a powered joint to maintain the position (and / or orientation) of the distal portion relative to a second reference after being inserted into the surgical tool access port. The second reference can include a point corresponding to the position (and / or orientation) of the access port.

[0026] In some implementations, the positioning indicator is controlled by a processor to instruct a first manual repositioning of the base based on a first optimal base location envelope determined by the processor before the arm is controlled for performing a surgical procedure. The positioning indicator is further controlled by a processor, for example, to instruct a second manual repositioning of the base based on a second optimal base location envelope determined by the processor after inserting the surgical tool into the access port.

[0027] In some implementations, the surgical system further includes a movable table configured to support the patient above the floor surface. The positioning indicator is controlled by a processor, for example, to instruct a manual repositioning of the movable table and a manual repositioning of the base while operating a powered joint to maintain the position (and / or orientation) of the distal portion. In some cases, the movable table is connected to the base.

[0028] In some implementations, the surgical system further includes a console that receives operator input and wirelessly transmits commands to the arm to cause movement of the powered joint based on the operator input.

[0029] In some implementations, actuating a positioning indicator to indicate manual repositioning of the base relative to the floor surface includes determining an optimality score based on the pose of the robotic arm, actuating the positioning indicator to indicate manual repositioning of the base in response to an optimality score that does not meet an optimality criterion, and stopping the actuation of the positioning indicator in response to an optimality score that meets the optimality criterion.

[0030] In some implementations, the processor actuates a braking mechanism to inhibit movement of the base away from an optimal base location envelope. In some implementations, actuating the robotic arm to maintain the position (and / or orientation) of the distal portion during manual repositioning of the base includes actuating the powered joints of the robotic arm, separately or simultaneously from selectively actuating a release mechanism for a passive joint of the robotic arm.

[0031] In some implementations, actuating a positioning indicator to indicate manual repositioning of the base includes any one or more of selectively activating a plurality of indicator lights, projecting light toward the floor surface indicating a repositioning direction for manual repositioning of the base, providing a tactile indication that inhibits movement of the robotic arm and indicates manual repositioning of the base, and actuating a positioning indicator indicating whether the base is inside or outside an optimal base location envelope.

[0032] In some implementations, determining a target base pose of the base includes receiving a signal indicative of a manual demonstration of a desired range of motion of the robotic arm and using the signal to determine the target base pose. In some implementations, determining a target base pose of the base includes determining the target base pose based on at least one of the location of an obstacle and the pose of a second robotic arm.

[0033] In some implementations, the operating method further includes the steps of: having a processor determine a second target base posture of the base; activating a positioning indicator to instruct a second manual repositioning of the base relative to the floor; and activating a robotic arm to maintain the position (and / or orientation) of the distal portion of the base relative to a second reference during the second manual repositioning of the base relative to the floor.

[0034] In some implementations, the operating method further includes the steps of activating a positioning indicator to instruct manual repositioning of a movable table supporting a workpiece for a robot arm, and activating the robot arm to maintain the position (and / or orientation) of the distal portion of the workpiece while the movable table is being manually repositioned.

[0035] The aforementioned advantages may include, but are not limited to, those described below and elsewhere in this specification. Positioning indicators in the surgical system can assist the operator in manually repositioning the base to a position (and / or orientation) that improves the performance of the remotely controlled arm during surgery. Positioning indicators can instruct manual repositioning of the base so that the surgical tool is positioned (and / or oriented) to easily access portions of the workspace around the patient during surgery. During manual repositioning, positioning indicators can command the operator to move the base toward a position (and / or orientation) that allows the joints of the remotely controlled arm to be moved through a range of motion suitable for performing surgery.

[0036] Positioning indicator systems can also facilitate the manual repositioning process by reducing the amount of time required to complete manual repositioning. Without the guidance provided by the positioning indicator system, the operator may reposition the base in a direction away from the optimal base location envelope, potentially causing delays due to suboptimal positioning (and / or orientation). By suppressing movement in these directions, the positioning indicator system can reduce the amount of time spent manually repositioning the base to the preferred position (and / or orientation).

[0037] The guidance provided by the positioning indicator system during manual repositioning simplifies the base repositioning step because it is performed while the position (and / or orientation) of the distal portion of the arm is maintained. For example, the distal portion can be positioned so that a surgical tool can be manually positioned or placed at the patient's access port. The subsequent steps of manual base repositioning can be separated from the distal portion positioning step because manual base repositioning can occur while the position (and / or orientation) of the remotely controllable arm is controlled so as to maintain the position (and / or orientation) of the distal portion. Thus, the base can be manually repositioned without requiring the operator to manually reposition the distal portion in response to base movement.

[0038] The specific examples presented in this disclosure often discuss maintaining the position of the distal portion of a controllable arm (or the position of an item supported by a controllable arm, such as a cannula or tool), but these techniques can be used to maintain the position and / or orientation of the distal portion of a controllable arm (or an item supported by a controllable arm).

[0039] Furthermore, although the examples described are surgical, the techniques disclosed are also applicable to non-surgical uses. For example, they may be used in conjunction with general or industrial robotic actions, such as when manipulating workpieces. These techniques may also be used with medical robotic actions for diagnosis and non-surgical treatment, and these may be improved upon.

[0040] Furthermore, while the specific examples presented in this disclosure often discuss remotely operated robotic systems and remotely controllable arms, the techniques disclosed are also applicable, in part or in whole, to robotic systems that are directly moved manually by an operator. For example, these techniques can be applied to robotic systems designed to help stabilize a tool held by a robotic arm while the tool is being manipulated by an operator. As another example, any of the controllable arms discussed herein may be configured to allow direct manipulation and may be configured to accept operator commands through inputs applied directly to the manipulator's links or joints.

[0041] Details of one or more embodiments of the subject matter described herein are shown in the accompanying drawings and the following description. Other potential configurations, embodiments, and advantages will become apparent from this description, drawings, and claims. [Brief explanation of the drawing]

[0042] [Figure 1] This is a top view of the surgical system within the surgical environment. [Figure 2A] A perspective view of a surgical manipulator assembly equipped with indicator lights. [Figure 2B] Figure 2A is a perspective view of the surgical manipulator assembly with the first indicator light activated. [Figure 2C] Figure 2A is a perspective view of the surgical manipulator assembly with the second indicator light activated. [Figure 3]Figure 1 is a block diagram of a control system for a robotic system, such as a surgical system. [Figure 4] This is a flowchart of the process for instructing manual positioning of the base. [Figure 5] This figure depicts the inputs and outputs for the processor executing the process shown in Figure 4. [Figure 6A] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6B] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6C] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6D] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6E] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6F] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6G] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6H] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6I] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6J] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6K] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6L] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6M]This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6N] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6O] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 6P] This is a top view illustrating the operation of positioning a surgical manipulator assembly adjacent to the operating table. [Figure 7] A perspective view of an example of a manipulator assembly base with indicator lights. [Figure 8A] An exemplary perspective view of a robotic table system. [Figure 8B] This is a perspective view of another exemplary controllable arm. [Figure 8C] Figure 8B is a perspective view of an indicator system for a controllable arm. [Figure 9A] This is a bottom view of a controllable arm having a range of joint states with respect to a given end effector position. [Figure 9B] This is a side view of a controllable arm having a range of joint states with respect to a given end effector position. [Figure 9C] This is a rear view of a controllable arm having a range of joint states with respect to a given end effector position. [Figure 9D] Figures 9A to 9C are schematic diagrams illustrating the degrees of freedom of a controllable arm. [Figure 10] This is a schematic diagram illustrating the degrees of freedom of another exemplary controllable arm. [Modes for carrying out the invention]

[0043] Equivalent reference numbers and symbols in various drawings indicate equivalent elements.

[0044] Starting with a surgical example, one or more operators (e.g., one or more of a surgeon, surgical assistant, nurse, technician, and other healthcare worker) can operate the surgical system 100 depicted in Figure 1 to perform surgery on a patient 102 in a surgical environment 10. The operator can interact with the surgical system 100 to operate a surgical manipulator assembly 104, which includes a remotely controlled arm 106, to perform surgery. When the remotely controlled arm 106 is operated, surgical instruments attached to the remotely controlled arm 106 can perform surgery on the patient 102. The surgical manipulator assembly 104 includes a base 108 supported above the floor surface 20 of the surgical environment 10. The base 108 supports the remotely controlled arm 106 above the floor surface 20 so that the remotely controlled arm 106 moves around the surgical environment 10 above the floor surface 20 relative to the base 108 during a surgical operation in which the remotely controlled arm 106 is operated to perform surgery. As described in more detail herein, during various stages of the surgical procedure, the operator may manually reposition the base 108 within the surgical environment 10.

[0045] "Reposition" is used herein in conjunction with "base" to indicate a change in the position, orientation, or both of the base.

[0046] During manual repositioning of the base 108 by one or more operators, the distal portion of the remotely controlled arm (or an item supported by the remotely controlled arm, such as a cannula or surgical instrument attached to and extending distally to the remotely controlled arm 106) can be maintained in a desired position and / or orientation within the surgical environment 10. The processor can control the remotely controlled arm 106 to maintain the desired position and / or orientation of the distal portion of the remotely controlled arm (or an item supported by the remotely controlled arm, such as a cannula or surgical instrument). For example, the desired position and / or orientation may be relative to a frame of reference and may be maintained statically with respect to that frame. An exemplary frame of reference includes coordinate frames fixed to the tissue or anatomical structure of a particular patient, a surface supporting the patient, a floor, the surgical environment, etc.

[0047] "and / or" is used herein to indicate one or both of two stated possibilities. For example, "position and / or orientation" is used to indicate position, orientation, or a combination of both position and orientation parameters.

[0048] A position is maintained when it is kept within a permissible range of positional change. For example, in some implementations, the permissible range of positional change is zero, and maintaining a position includes keeping the position completely immutable. In some implementations, the permissible range of positional change is non-zero and is based on the limits of the system design. The position is maintained as close to immutable as possible, taking into account mechanical, electrical, and calculated tolerances and errors. In some implementations, the permissible range of positional change is non-zero and includes limits based on operating conditions. For example, in some cases, the permissible range of positional change is on the order of millimeters or centimeters and is set to avoid damage to the workpiece or human tissue. In some cases, the permissible range of positional change is larger. In some cases, the permissible range of positional change differs between different translational degrees of freedom.

[0049] Similarly, the orientation is maintained when it is kept within the permissible range of orientation change. In various implementations, the permissible range of orientation change may be zero, the smallest amount limited by system performance, less than one degree, less than several degrees, or more than several degrees, or equivalent, based on performance requirements such as avoiding damage to the workpiece or human tissue. In some cases, the permissible range of orientation change differs between different rotational degrees of freedom.

[0050] In some implementations, the distal portion of the arm that is maintained in position and / or orientation may include part or all of the distal link of the arm. For example, the maintained distal portion may include the distal end of the distal link, a portion of the distal link configured to be adjacent to an access port during operation, or a portion of the distal link that connects to a device attached to the arm, such as a tool or cannula.

[0051] Similarly, a tool or cannula that is maintained in position and / or orientation may include part or all of the tool or cannula. For example, a tool or cannula can be considered maintained in position and / or orientation when the position and / or orientation of a particular part of the tool or cannula is maintained. In some cases, a tool or cannula is maintained in position and / or orientation by maintaining the position and / or orientation of the distal end of the tool or cannula, or by maintaining the position and / or orientation of the part of the tool or cannula adjacent to the access port, if the part of the tool or cannula coincides with a remote center of rotation such as the tool or cannula.

[0052] In some implementations, the desired position may be relative to a reference point within the surgical environment 10. For example, the desired position of the distal portion of the remotely controlled arm (or the item supported by the remotely controlled arm) may correspond to the position in which a cannula, surgical instrument, or other surgical device is inserted into (or has already been inserted into) the patient's access port. An exemplary access port of patient 102 is the patient's minimally invasive orifice. If the reference point corresponds to the position of the patient's access port, then the control of the remotely controlled arm 106 during manual repositioning allows the remotely controlled arm 106 to remain docked to or otherwise in close proximity to the access port, even while the base 108 is being manually repositioned. In some cases, the operator positions the remotely controlled arm 106 to the desired position before the manual repositioning of the base 108 occurs. Alternatively, the operator positions the device to be attached to the remotely controlled arm 106 to the desired position before the manual repositioning of the base 108 occurs. Examples of devices that may be attached to the remotely controlled arm 106 include surgical tools or cannulas or other surgical devices. During repositioning of the base 108, the end effector remains in the desired position relative to the reference point.

[0053] The operator may move the base 108 toward the optimal base location envelope 110 during manual repositioning. The optimal base location envelope 110 corresponds, for example, to a range of three-dimensional positions for the base 108 within the surgical environment 10. When the base 108 is within the optimal base location envelope 110, the remotely controlled arm 106 can be positioned and directed so that the surgical tool attached to the remotely controlled arm 106 can easily access the area of ​​the patient 102's anatomical structure related to the surgical procedure to be performed or is being performed.

[0054] To direct the manual repositioning of the base 108 of the remotely controlled arm 106 toward the optimal base location envelope 110, one or more processors of the surgical system 100 can selectively activate a positioning indicator system. Selective activation of the positioning indicator system can indicate to the operator 112 performing the manual repositioning the base 108 in the direction in which it must be moved to reach the optimal base location envelope 110. For example, a visual indicator 115 can visually indicate the direction in which the base 104 of the surgical manipulator assembly 104 must be moved so that the base 108 is repositioned toward the optimal base location envelope 110. This technique guides the operator 112 to manually reposition the base 108 while controlling the remotely controlled arm 106 to maintain the orientation of the distal portion of the remotely controlled arm 106 (or the orientation of an item indicated by the remotely controlled arm 106, such as a cannula or surgical tool).

[0055] The orientation of the distal portion of a manipulator arm (or the item held by the manipulator arm) can include the position, orientation, or any combination of positional and orientational parameters of the distal portion (or item). Thus, while the specific examples presented herein often discuss maintaining the position of the distal portion of a controllable arm for the sake of brevity, the techniques described herein can be used in other embodiments as well. For example, they may be used to maintain the position, orientation, or combination of positional and orientational parameters of the distal portion of a controllable arm or of an item (such as a cannula or tool) supported by the controllable arm.

[0056] Position and / or orientation may be maintained against any appropriate reference. In some implementations, the reference is a reference point, such as a point corresponding to the location of the patient's access port into which the surgical instrument is inserted or to be inserted. In implementations where only position is maintained, a single point without orientation information may suffice. In some implementations, the reference includes one or more reference directions but does not include a reference location. For example, one or more reference directions may be based on the three-dimensional orientation of the distal portion immediately before the start of the repositioning process. In implementations where only orientations corresponding to a set of directions are maintained, a set of directions without a reference location may suffice. In some implementations, the reference includes both a reference location and one or more reference directions when position and one or more orientations are maintained. In some implementations, the reference includes a complete reference system sufficient to define location and orientation in three-dimensional space.

[0057] Therefore, the remotely controlled arm 106 is controlled to maintain one or more positional and / or orientation parameters of part or all of the distal portion of the remotely controlled arm 106 (or an item supported by the remotely controlled arm 106, such as a cannula or tool). For example, in some implementations, the remotely controlled arm 106 is controlled to maintain both the position and orientation of the end effector of the remotely controlled arm 106 or the tool supported by the remotely controlled arm 106. Thus, the positioning indicator system can enable the remotely controlled arm and associated surgical tools and other instruments or accessories to be optimally positioned and oriented for performing surgery on patient 102 when manual repositioning by one or more operators is completed.

[0058] (Example surgical system) Figure 1 shows an example of a surgical system 100 that includes a positioning indicator system for guiding the manual repositioning of the base 108 of a surgical manipulator assembly 104. The surgical manipulator assembly 104 includes a remotely controllable arm 106 extending from the base 108. The base 108 is movable relative to the floor surface 20 to allow an operator 112 to perform manual repositioning. In the example shown in Figure 1, the operator 112 (e.g., a surgical assistant) guides the base 108 to a predetermined position so that they can control the remotely controllable arm 106 of the surgical manipulator assembly 104 to perform surgery.

[0059] In some implementations, the surgical system 100 includes one or more of the following: a surgical console 114, an electronics cart 116, a tray 118, an accessories table 119, or an anesthesia cart 120. In the example shown in Figure 1, the patient to be treated 102 is positioned on the operating table 123. The surgeon 122 operates, for example, the surgical console 114 to control the remotely controllable arm 106 of the surgical manipulator assembly 104 during the surgery. An anesthesiologist or assistant 124 can administer anesthesia to the patient 102 from the anesthesia cart 120 during the surgery, and another assistant 126 can select surgical tools on the tray 118 to be mounted on the surgical manipulator assembly 104.

[0060] To perform surgery, the surgeon 122 can operate the remotely controlled arm 106 of the surgical manipulator assembly 104 by activating the console 114. The console 114 can be located within the surgical environment 10, or in some cases, in a remote location outside the surgical environment 10. The console 114 enables the surgical system 100 to be used for minimally invasive remote surgery. The surgeon 122, for example, operates the surgeon console 114 to control the remotely controlled arm 106 of the surgical manipulator assembly 104 and to operate the surgical tools attached to the remotely controlled arm 106.

[0061] In some cases, the surgical console 114 includes a display that allows the surgeon 122 to view the surgical site through images acquired by an imaging device. The display is, for example, a stereoscopic display showing a stereoscopic image of the surgical site. While viewing the image of the surgical site, the surgeon 122 can perform surgical procedures on the patient 102 by operating a control input device on the surgical console 114, which then controls the movement of the remotely controllable arm 106 of the surgical manipulator assembly 104.

[0062] In some cases, the control input devices of the surgical console 114 include a manual input device that can be grasped by the surgeon 122. Operation of the manual input device moves, for example, a remotely controllable arm 106 on the surgical manipulator assembly 104 to the surgical manipulator assembly 104. The degrees of freedom of the remotely controllable arm 106 are sufficient, for example, to allow the surgeon 122 to perform surgery by operating the manual input device to translate and rotate the remotely controllable arm 106. The control input devices may optionally or additionally include a foot pedal equipped with one or both of a toe control device and a heel control device. The surgeon 122 can actuate the foot pedal to cause movement or activation of a device associated with the foot pedal. The surgeon 122 can press down on the foot pedal to cause activation of an end effector. The surgical console 114 may include a processor that generates signals in response to the mechanical movement of the control input devices of the surgical console 114. These signals can then cause corresponding movements of the remotely controllable arm 106 of the surgical manipulator assembly 104.

[0063] In some implementations, the electronics cart 116 is connected to an imaging device that generates images of the surgical site. The surgical manipulator assembly 104 includes, for example, an imaging device connected to the electronics cart 116. The imaging device may include an illumination device (e.g., a xenon lamp) that provides illumination to image the surgical site. The imaging device can acquire images and then transmit the images to the electronics cart 116 for processing. The electronics cart 116 can then transmit the images to the surgeon console 114 so that the processed images can be presented to the surgeon 122. The electronics cart 116 may include optional auxiliary surgical instruments such as electrosurgical units, insufflators, suction irrigation instruments, or third-party cautery equipment.

[0064] Figure 2A depicts an example of a surgical manipulator assembly 104. The remotely controllable arm 106 of the surgical manipulator assembly 104 extends from the base 108. The surgical manipulator assembly 104 includes an instrument holder 132 connected to the remotely controllable arm 106, on which a tool 134 is mounted. The base 108 is supported so as to be movable above the floor surface 20 of the surgical environment 10, allowing the operator to manually reposition the base 108 above the floor surface 20.

[0065] The surgical manipulator assembly 104 includes a setup assembly 109 that supports a base 108 above the floor surface 20. In some implementations, the setup assembly 109 is supported above the floor surface 20 to support the base 108 above the floor surface 20. In some cases, the setup assembly 109 is supported by the walls or ceiling of the surgical environment 10 to support the base 108 above the floor surface 20. In some cases, as described herein, the setup assembly 109 is supported by the operating table 123.

[0066] As shown in the example in Figure 2A, the setup assembly 109 is supported on the floor. The setup assembly 109 includes a setup arm 128 extending from a cart 111. The cart 111 is movable in all directions, for example, across the floor 20. The cart 111 includes wheels 136 that facilitate the rolling motion of the cart 111 across the floor 20. The wheels 136 allow the surgical manipulator assembly 104 to be transported from place to place, such as between or within an operating room, to position it near an operating table (for example, operating table 123 in Figure 1). In some implementations, the cart 11 includes a column 138 that extends vertically upward when the cart 111 is supported on the floor 20. If the cart 111 includes a column 138, the setup arm 128 is connected to the column 138 of the cart 111. In some cases, a braking mechanism 140 is connected to one or more of the wheels 136. In some cases, the operator manually manipulates the setup assembly 109 and / or the cart 111 to reposition the base 108.

[0067] In some examples, the setup arm 128 includes a first setup joint 142a (setup joint) that connects the setup arm 128 to the column 138. The setup arm 128 may include several links connected to each other by joints. In the example depicted in Figure 2A, the setup arm 128 includes a first setup link 144a, a second setup link 144b, and a third setup link 144c. The setup arm 128 further includes a second setup joint 142b and a third setup joint 142c. The first joint 142a connects the proximal end of the first setup link 144a to the column 138. The second setup joint 142b connects the distal end of the first setup link 144a to the proximal end of the second setup link 144b. The third setup joint 142c connects the distal end of the second setup link 144b to the proximal end of the third setup link 144c. The distal end of the third setup link 144c is connected to the base 108.

[0068] The first joint 142a may be a prismatic joint, allowing the setup arm 128, and therefore the remotely controlled arm 106, to be translated vertically above the floor 20 relative to the cart 111. If the cart 111 includes a column 138, the first joint 142a may connect the setup arm 128 to the column 138 so that the arm 128 can be translated vertically along the column 138. The second and third setup joints 142b and 142c may be revolute joints, allowing any two of the setup links 144a, 144b, and 144c, which are connected to each other by one of the joints 142b and 142c, to be rotated relative to each other with respect to the connecting joint.

[0069] The remotely controllable arm 106, connected to the distal end of the setup arm 128, includes a series of links and joints connected to the instrument holder 132. As depicted in Figure 2A, the remotely controllable arm 106 includes manipulator links 146a to 146f connected in series with each other. Manipulator joint 148a connects manipulator link 146a to a third setup link 144c. Manipulator joints 148b to 148f connect manipulator links 146a to 146f with each other so that they can move relative to each other. Manipulator joint 146g of the remotely controllable arm 106 provides movable support for the instrument holder 132.

[0070] In the example shown in Figure 2A, the manipulator joint 148a can also be a rotary joint that allows relative rotation between the remotely controlled arm 106 and the base 108. Each of the manipulator joints 148b to 148f can be a rotary joint that allows relative rotation between the manipulator links 146a to 146f. Similarly, the instrument holder 132 can be pivotally connected to the manipulator link 146f of the remotely controlled arm 106 so that the instrument holder 132 can be rotated relative to the remotely controlled arm 106. The manipulator joint 148g can be a rotary joint that allows the instrument holder 132 to rotate relative to the remotely controlled arm 106 by pivoting at the manipulator joint 148g. In some examples, joint 148g is a wrist joint that allows pivotal movement about two axes.

[0071] The instrument holder 132 is configured to hold a surgical tool 134. The instrument holder 132 is also optionally configured to hold a cannula 150, which is a tubular member inserted into the patient's access port 102. The cannula 150 and surgical tool 134 can be releasably connected to the instrument holder 132, respectively, so that different types of cannulas and surgical tools can be attached to the instrument holder 132.

[0072] The surgical tool 134 optionally includes a transmission assembly 154 positioned at the proximal end of the elongated shaft 152. The transmission assembly 154 can be activated to cause movement of an end effector 156 positioned at the distal end of the elongated shaft 152. The end effector 156 of the surgical instrument 134 can be controlled in a manner such as manipulating, treating, imaging, or performing other surgical procedures on the patient's 102 during surgery. The cannula 150 defines a lumen that receives the elongated shaft 152 of the surgical tool 134, allowing the elongated shaft 152 to be slidably positioned within its lumen. The elongated shaft 152 defines a longitudinal axis that coincides with the longitudinal axis of the cannula 150. The instrument holder 132 may include an instrument holder carriage 158 that can translate along the instrument holder frame 160, allowing the elongated shaft 152 of the surgical tool 134 to be translated along its longitudinal axis. The slender shaft 152 and the end effector 156 can be inserted into the lumen of the cannula 150 and the access port of the patient 102, and can be retracted from the lumen of the cannula 150 and the access port of the patient 102, so that the end effector 156 can perform surgery during the procedure.

[0073] The term "tool" encompasses both general or industrial robotic tools and specialized robotic medical devices (including robotic surgical instruments and robotic medical devices for diagnostic and non-surgical treatment). The tool / manipulator interface, for example, the instrument holder 132, can be a quick-disconnect tool holder or coupling, enabling rapid removal and replacement of tools with replacement tools. While the specific examples presented in this disclosure are often surgical, the techniques disclosed are also applicable to non-surgical applications. For example, these may be used in conjunction with general or industrial robot operations, such as those involving the manipulation of workpieces, and these operations may be improved. These techniques may also be used in conjunction with medical robot operations for diagnostic and non-surgical treatments, and these operations may be improved.

[0074] Furthermore, while the specific examples presented in this disclosure often discuss remotely operated robotic systems, the techniques disclosed are also applicable to robotic systems that are operated directly and manually by an operator, in part or in whole. For example, these techniques can be applied to robotic systems designed to help stabilize a tool held by a robotic arm while the tool is being manually manipulated by an operator. As another example, any of the controllable arms discussed herein, including arms 106, 804A, 804B, 804C, 904, and 1000, may be configured to allow direct operation and to accept operator instructions through inputs applied directly to the links or joints of the controllable arm.

[0075] The setup assembly 109, base 108, and remotely controlled arm 106 form a kinetic chain that controls a surgical tool 134, which is supported by the remotely controlled arm 106, for example, by an instrument holder 132 of the remotely controlled arm 106. For example, the proximal end of the setup assembly 109 is supported by the floor surface 20, the distal end of the setup assembly 109 is connected to the base 108, the base 108 is connected to the proximal end of the remotely controlled arm 106, and the distal portion 159 of the remotely controlled arm 106 is configured to hold a cannula 150. The setup assembly 109, base 108, and remotely controlled arm 106 are kinematically connected in series. As a result, movement of one or more joints of the surgical manipulator assembly 104, movement of the cart 111, or movement of both the surgical manipulator assembly 104 and the cart 111 can cause movement of the distal portion 159 (or the cannula 150 or tool 134, if present and held by the instrument holder 132) relative to the floor surface 20. When the surgical tool 134 is attached to the remotely controlled arm 106, a portion of the surgical tool 134 extends through the cannula 150. Thus, when the surgical tool 134 is attached to the remotely controlled arm 106, the setup assembly 109, base 108, remotely controlled arm 106, and surgical tool 134 are kinematically connected in series. As a result, movement of the joints of the surgical manipulator assembly 104 or the cart 111 can cause movement of the surgical tool 134 relative to the floor surface 20.

[0076] During surgery, the setup assembly 109 can be fixed above the floor 20, thereby allowing the base 108 to remain stationary within the surgical environment 10 above the floor 20. While the setup assembly 109 is fixed and the surgical tool is allowed to perform the surgery, the joints of the remotely controlled arm 106 can be manipulated. The surgical manipulator assembly 104 may include multiple degrees of freedom between the setup assembly 109 and the surgical tool 134 so that the surgical tool 134 can be positioned in a range of possible positions during surgery. The operation of the end effector 156 (such as opening and closing the jaws of a grasping device, energizing an electrosurgical paddle, or the same) may be separate from and additional to the degrees of freedom of the remotely controlled arm 106.

[0077] The joints of the remotely controlled arm 106 can have sufficient degrees of freedom to move the distal portion 159 closer to the patient's access port so that a cannula 150 and surgical tools 134 can be inserted through the patient's access port to perform surgery. The specific combinations of joints described with respect to Figure 2A are examples of possible combinations of joints and links and the degrees of freedom possible for the remotely controlled arm 106. Rotary joints, including joints 142b-142c and 148a-148g, each connect two links so that the links can rotate relative to each other about a joint axis defined by the rotary joint. Prismatic joints, including joint 142a and the joint between the instrument holder frame 160 and the instrument holder carriage 158, allow translation along a joint axis defined by the prism joint.

[0078] In some implementations, some of the joints 142a-142c and 148a-148g of the surgical manipulator assembly 104 are powered joints that can be controlled and actuated to cause relative movement of connecting links. The joints 142a-142c and 148a-148g can be controlled by the surgeon 122 using control inputs located in the surgeon console 114. After operating the control inputs in the surgeon console 114, the surgeon 122 can actuate one or more actuators associated with the joint, and then move two or more links connected by the joint outward. For example, joint 148g that movably supports the instrument holder 132 may be a powered joint that, when the powered joint is actuated, allows the surgeon 122 to move the end effector 156. In some implementations, the surgeon 122 or another operator manually interacts with the joints of the surgical manipulator assembly 104 to cause joint movement.

[0079] In some implementations, some of the joints 142a-142c and 148a-148g are passive joints that are not actively controlled by the processor or multiple processors of the surgical system 100 in response to operator input. Instead of being actively controlled, the joints 142a-142c and 148a-148g can move in response to the movement of actively controlled joints. In some examples, the passive joints of the surgical manipulator assembly 104 may be selectively releaseable. A passive joint may include a release mechanism that enables the movement of the passive joint when activated. For example, the release mechanism may include a releaseable clamp that, when activated, releases the passive joint and makes it movable. A passive joint may include a braking mechanism that enables the movement of the joint after it has been released or inhibits the movement of the joint after it has been activated. In some implementations, the surgeon 122 or other operator manually interacts with the joints of the surgical manipulator assembly 104 to cause the movement of the joints.

[0080] The remotely controlled arm 106 may have more degrees of freedom than necessary to position the distal portion 159, the cannula 150, or the surgical tool 134 in a given position, for example, it may have extra degrees of freedom. The manipulator linkage (manipulator link mechanism) may have sufficient degrees of freedom to occupy a range of joint states for a given end-effector state. Such a structure may include a linkage with redundant degrees of freedom. For example, in some embodiments, the remotely controlled arm 106, the setup arm 128, or the remotely controlled arm 106 and setup arm 128 as a whole may include multiple joints that provide sufficient degrees of freedom to enable a range of joint states for (1) the posture of the base 108 and (2) the end-effector state of the distal portion of the remotely controlled arm 106 or the surgical tool 134.

[0081] In this specification, “linkage” is used to describe a structure comprising a single link, at least one link, or multiple links, as applicable depending on the context. In some implementations, the action of one joint may be directly replaced by the similar action of different joints along the kinetic chain. These structures are referred to in some cases as having surplus, extra, or redundant degrees of freedom. These terms can, for example, encompass a kinetic chain in which an intermediate link can move without changing the orientation of the end effector.

[0082] In this regard, at this position on the distal portion 159 (or surgical tool 134, if present), each joint of the remotely controlled arm 106 can occupy or be driven between a range of joint states, and each link of the remotely controlled arm 106 can occupy or be driven between a range of alternative linkage positions. At this position on the distal portion 159 (or surgical tool 134, if present), each joint of the remotely controlled arm 106 can have a range of joint velocity vectors or speeds. The range of available joint states, the range of alternative linkage positions, and the range of joint velocity vectors or speeds can be determined by the number and type of degrees of freedom.

[0083] The term "state" of a joint can refer to the control variables associated with the joint. For example, the state of a rotary joint that allows relative rotation between links may include the angular velocity of the joint and / or the angle determined by the joint within its range of motion. The state of a prism joint may refer to the axial velocity and / or axial position of the joint.

[0084] The movement of the remotely controllable arm 106 may be controlled such that the distal portion 159 is constrained to the access port (or, if present, the surgical tool 134 is constrained to a desired movement through the access port). Such movements may include, for example, axial insertion of the elongated shaft 152 through the access port, rotation of the elongated shaft 152 about its longitudinal axis, and pivoting motion of the elongated shaft 152 about a pivot point adjacent to the access port.

[0085] In some examples, these movements may be suppressed through the use of robotic data processing and control techniques for the joints of the remotely controlled arm 106. The joints 148a-148g of the remotely controlled arm 106 can be controlled to maintain the position and / or orientation of the distal portion 159 (or cannula 150 or surgical tool 134, if present). The position and / or orientation may be maintained relative to any appropriate reference, exemplary references including a reference system fixed to the surgical environment, the floor, the anatomical configuration of the patient 102, etc. The reference may be defined as a reference point 162 in the surgical environment 10. In some examples, only one of the joints of the remotely controlled arm 106 is controlled to maintain the position and / or orientation of the distal portion 159 (or cannula 150 or surgical tool 134, if present) relative to the reference. In some examples, multiple joints of the remotely controlled arm 106 are controlled to maintain the position and / or orientation. The reference may be a reference point 162 in the surgical environment 10. If the orientation of the distal portion 159 (or the cannula 150 or surgical tool 134, if present) is also maintained, the reference may include a reference system with the origin at the reference point.

[0086] The reference point 162 can correspond to a remote movement center that constrains the movement of the remotely controlled arm 106 (and thus any item supported by the remotely controlled arm 106, such as the distal portion 159 or the surgical tool 134). Specifically, the reference point 162 may be a pivot point around which a portion of the remotely controlled arm 106 rotates. In some cases, the reference point 162 may coincide with the access port of the patient 102 so that when the remotely controlled arm 106 or the surgical tool 134 is moved, the area in which the surgical tool 134 enters the patient's anatomical structure through the access port is subjected to little to no movement relative to the reference point 162, thereby reducing the stress on the patient's anatomical structure at the reference point 162. When the joints 148a-148g are moved, the joints 148a-148g can be controlled so that any point along the surgical tool 134 or the associated cannula 150 is rotated relative to the reference point 162. The joints 148a–148g may have sufficient available degrees of freedom so that when the joints of the first set are moved, the joints of the second set are moved in accordance with that so that the position and / or orientation of the distal portion 159 (or an item supported by a remotely controlled arm 106, such as a cannula 150 or surgical tool 134) can be maintained. In some implementations, the joints 148a–148g, or a subset of the joints 148a–148g, have multiple settings for maintaining a specific position and / or orientation of the distal portion 159 (or an item supported by a remotely controlled arm 106, such as a cannula 150 or surgical tool 134).

[0087] In this regard, the joints 148a-148g can be moved toward an optimal position within the surgical environment 10 without causing movement of the distal portion 159 (or an item supported by a remotely controllable arm 106, such as a cannula 150 or surgical tool 134). Another example of a software-constrained remote motion center of a robotic arm and manipulator is described in U.S. Patent No. 8,004,229 (hereinafter referred to as "Patent No. 229"), published on 23 August 2011, which is incorporated by reference in full.

[0088] See also Figure 3, the surgical system 100 may include a control system 300 that can control the operation of the instruments of the surgical system 100. The control system 300 can control the instruments to instruct manual repositioning of the surgical manipulator assembly 104. The control system 300 may also control the joint of the remotely controllable arm 106 of the surgical manipulator assembly 104, for example, to maintain the position and / or orientation of the distal portion 159 (or an item supported by the remotely controllable arm 106, such as a cannula 150 or surgical tool 134) during manual repositioning. The control system 300 includes a processor 302, the surgical manipulator assembly 104, and a positioning indicator system 304. The control system 300 may optionally also include a surgeon console 114, an electronics cart 116, and a sensor system 306.

[0089] Processor 302 can be one of several processors. Each of the surgical console 114, surgical manipulator assembly 104, electronics cart 116, and positioning indicator system 304 of the control system 300 may include an independent processor for controlling its operation. Wired or wireless connections can enable communication between the surgical manipulator assembly 104, electronics cart 116, surgical console 114, and positioning indicator system 304. The connection may be, for example, an optical fiber communication link between the surgical console 114, electronics cart 116, and surgical manipulator assembly 104. In some examples, the control system 300 may include a single processor that functions as a central electronic data processing unit capable of performing some or all of the data processing used to operate the surgical system 100.

[0090] The surgical system 100 may include the sensor section of the sensor system 306 to detect the treatment parameters and status of the instruments within the surgical system. The surgical manipulator assembly 104 may include, for example, attitude sensors 308 positioned at joints 142b-142c and 148a-148g to detect the relative orientation of the links along the surgical manipulator assembly 104. The attitude sensors 308 may include pressure sensors, torque sensors, force sensors, position sensors, velocity sensors, accelerometers, rotary encoders, linear encoders, and other appropriate combinations of sensors that determine the position and orientation of the links and joints within the surgical manipulator assembly 104.

[0091] The posture sensor 308 can generate signals indicating the relative position, relative orientation, or both relative position and relative orientation of the setup assembly 109, the base 108, the remotely controlled arm 106, and one or more joints 142a-142c and 148a-148g. These posture sensors 308 can optionally detect the posture of the remotely controlled arm 106 relative to the posture of the base 108, the posture of one link relative to other links, the posture of the surgical tool 134, or the posture of other elements of the surgical manipulator assembly 104. These postures may refer to any appropriate criteria. Exemplary criteria include the surgical environment 10, the floor, the patient 102, and the base 108. For a given joint equipped with a posture sensor, the posture sensor can detect the joint state of the joint. The sensor can detect the position and velocity of the joint within a range of available joint states and joint velocities for a given position of the distal portion 159 (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134). The sensor can also detect the relative link posture of the links connected at a given joint. This sensor can thereby detect the posture of the links within a range of available link states for a given posture of the distal portion 159 (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134).

[0092] The posture sensor 308 optionally includes a sensor that can detect the posture of the base 108 within the surgical environment 10. The sensor can generate a signal that can be used by the processor 302 to calculate the posture of the base 108 based on the movement of the setup assembly 109, which supports the base 108 and allows the base 108 to move around the surgical environment. The setup assembly 109 is, for example, the wheels 136 of a cart 111, which are supported within the surgical environment above the floor surface 20. The wheels 136 may be operable with a rotary encoder that can be used to track the horizontal position and orientation of the cart 111 on the floor surface 20 of the surgical environment 10. The horizontal position and orientation of the base 108 can then be determined from the horizontal position and orientation of the cart 111. The cart 111 of the setup assembly 109 optionally includes an optical sensor that can track the movement of the cart 111 along the floor surface 20, e.g., position, velocity, orientation, and / or acceleration. The optical sensor is, for example, similar to those used in an optical mouse. The optical sensor captures an image of the floor surface 20 as the cart 111 moves along it. The image of the floor surface 20 changes as the cart 111 moves. The processor 302 can use the captured image to determine the position and orientation of the cart 111.

[0093] In some cases, the powered joint of the remotely controlled arm 106 can be manually repositioned by an operator. In some cases, the powered joint is manually positionable by an operator. A sensor associated with the powered joint can detect an external force that causes articulation of the powered joint. In response to the detection of an external force, the processor 302 of the control system 300 can actuate an actuator associated with the powered joint so that the powered joint moves in the direction of the external force. The processor 302 may cancel out external forces below an appropriate threshold for the sensor, but may treat external joints exceeding the threshold as input to the remotely controlled arm 106.

[0094] In some examples, the processor 302 can determine the position of the distal portion 159 (or an item supported by the remotely controlled arm 106, such as a cannula 150 or surgical tool 134) by directly sensing the movement of the remotely controlled arm 106 or surgical tool 134. In some examples, the processor 302 can calculate the motion using forward kinematics. Using actual joint motion information from the posture sensor 308, for example, data indicating the joint state of the joints of the controllable arm 106, the processor 302 can determine the posture of the distal portion 159 (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool). Joint torque, force, velocity, orientation, and / or position may optionally be transmitted to the processor 302 so that the processor 302 can determine the movement of the distal portion 159 (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134). Using forward kinematics, the processor 302 can use information from the posture sensor 308 to calculate the posture of the distal portion 159 (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134) relative to the base 108. In some examples, if the remote motor center and reference point 162 correspond to the position along the cannula 150 or surgical tool 134, particularly the position along the cannula 150 or surgical tool 134 to which such an component is inserted into the patient's access port, the processor 302 can determine the location of the remote motor center and reference point 162 based on information from the posture sensor 308.

[0095] The sensor system 306 optionally includes a patient motion sensor 310 that measures the movement of the patient 102 relative to the distal portion 159 (or an item supported by a remotely controllable arm, such as a cannula 150 or a surgical tool 134). The patient motion sensor 310 may include a sensor positioned close to the distal portion 159 that detects when the patient 102's body moves relative to the sensor. The sensor is, for example, an emitter-receiver sensor that detects the distance to a nearby object. The sensor may be an optical time-of-flight sensor that emits infrared light and receives reflected infrared light to determine the distance to the patient 102. The relative change in distance over time can indicate patient motion.

[0096] The sensor system 306 optionally includes a tool sensor 312, which is positioned to generate a sensor signal indicating the force applied to the patient by the surgical tool 134 or cannula 150, or vice versa. The tool sensor 312 can be positioned on the surgical tool 134 or cannula 150 to directly measure the applied force. In some examples, the tool sensor 312 is positioned on a joint, for example, joint 148g, to measure torque. The processor 302 can then calculate the applied force based on the torque at joint 148g.

[0097] In some implementations, the sensor system 306 may include an obstacle detection sensor 314. The obstacle detection sensor 314 may be positioned at one or more locations within the surgical system 10 to detect an imminent collision or contact with a nearby obstacle within the surgical environment 10. The surgical manipulator assembly 104 and / or remotely controlled arm 106 may include an obstacle detection sensor 314 that detects when a portion of the surgical manipulator assembly 104 and / or remotely controlled arm 106 is in contact with or nearly in contact with a nearby obstacle. Obstacles may include other equipment in the surgical system 100, such as the operating table 123, the electronics cart 116, and the surgeon's console 114. Obstacles may also include operators within the surgical environment 10, such as the surgeon 122, the operator 122, and the assistants 124, 126. The obstacle detection sensor 314 may include a contact sensor, a proximity sensor, an optical time-of-flight sensor, and other sensors suitable for detecting contact with or distance from an obstacle. The obstacle detection sensor 314 may include, for example, a tape switch, a flexible sensing array, individual force-sensing resistors or arrays of force-sensing resistors, or a passive capacitive sensing system. The signal from the obstacle detection sensor 314 can be monitored by the processor 302 of the control system 300, and in some cases the processor 302 may issue a warning after determining that contact or collision may be imminent.

[0098] The control system 300 includes a positioning indicator system 304 that instructs manual repositioning of the base 108 of the remotely controllable arm 106. The processor 302 controls the positioning indicator system 304 to provide the operator with human-perceptible instructions to move the base 108 toward the optimal base location envelope 110. The indications include, for example, one or more of tactile, audible, or visual indications. The operator can directly manipulate the base 108. As described with respect to Figure 1, the positioning indicator system 304 may provide the operator 112 with a visual indication 115 to instruct the operator to move the base 108 toward the optimal base location envelope 110.

[0099] In the example shown in Figures 2B and 2C, the positioning indicator system 304 includes indicator lights 200a and 200b (collectively referred to as indicator lights 200) that provide a visual indication to the operator 112. Each of the indicator lights 200 is positioned to indicate a different repositioning direction for the base 108 when the light is activated. In this regard, when a given indicator light is activated (activated), the indicator light generates a visual indication of a given repositioning direction, instructing the operator 112 to move the base 108 in the given repositioning direction. Selective activation of the indicator lights 200 can induce manual repositioning of the surgical manipulator assembly 104 to move the base 108 toward the optimal base location envelope 110 for the base 108 of the surgical manipulator assembly 104. For example, when operator 112 moves base 108, if operator 112 directly manipulates base 108, the indicator light 200 can be selectively activated to guide the operator to move base 108 toward the optimal base location envelope 110.

[0100] The indicator lights 200 may optionally be positioned on the base 108 of the surgical manipulator assembly 104. The indicator lights 200 may include, for example, four or more indicator lights. One of the indicator lights 200 can be illuminated to indicate to the operator that the surgical manipulator assembly 104 should be moved in the direction indicated by the indicator light. A combination of the indicator lights 200 can be illuminated to indicate to the operator that the surgical manipulator assembly 104 should be moved in a direction between the directions indicated by the indicator lights 200 when individually illuminated.

[0101] As shown in Figure 2B, when indicator light 200a is activated, it projects light toward the floor surface 20 of the surgical environment 10. The light is projected in a first direction, thereby indicating to operator 112 that the base 108 of assembly 104 must be moved in the first direction 202 so that it can be repositioned toward the surgical manipulator optimal base location envelope 110. As depicted in Figure 2C, when indicator light 200b is activated, it projects light toward the floor surface 20. The light is projected in a second direction 204, thereby indicating to operator 112 that the base 108 of surgical manipulator assembly 104 must be moved in the second direction 204 so that it can be repositioned toward the optimal base location envelope 110.

[0102] In some examples, the operator can move other parts of the surgical manipulator assembly 104 to move the base 108 toward the optimal base location envelope 110. For example, the operator can move parts of the setup assembly 109 to move the base 108 toward the optimal base location envelope 110. In this regard, in some implementations, the positioning indicator system 304 can direct the manual repositioning of links, joints, or other elements of the setup assembly 109 toward the optimal location, or it can direct the repositioning of these elements so that the base 108 is moved toward the optimal base location envelope 110. For example, the positioning indicator system 304 may include indicator lights that direct the manual repositioning of the cart 111 on the floor surface 20. Alternatively or additionally, the positioning indicator system 304 may include indicator lights that direct the manual repositioning of links or joints of the setup arm 128.

[0103] (Example of system operation) As described herein, the control system 300 for the surgical system 100 can guide the operator 112 when the operator 112 manually repositions the base 108. For example, before surgery is performed, the operator 112 can manually reposition the base 108 by manually moving the base 108 toward an optimal base position envelope 110 near or adjacent to the operating table 123. The processor 302 controls the positioning indicator system 304 to instruct the operator 112 when the operator 112 is performing manual repositioning.

[0104] During the manual repositioning portion, the processor 302 controls the remotely controlled arm 106 of the surgical manipulator assembly 104 and instructs manual repositioning to maintain the position and / or orientation of the distal portion 159 (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134). The position and / or orientation may be maintained relative to a reference point, such as a reference point 162. Maintaining the position and / or orientation relative to a reference point 162 allows the operator to position the distal portion 159 (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134) at or near the patient's access port, and then manually reposition the base 108 of the surgical manipulator assembly 104 without needing to consider the position of the distal portion 159 (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134). The operator 112 can move the base 108 during manual repositioning without shifting the position of the distal portion 159 (or an item supported by a remotely controlled arm, such as a cannula 150 or surgical tool 134). In this regard, the steps of positioning the distal portion 159 (or an item supported by a remotely controlled arm, such as a cannula 150 or surgical tool 134) and positioning the base 108 can be separated steps so that they can be performed sequentially without the result of one step affecting the result of the other.

[0105] Exemplary processes and actions for instructing manual repositioning while maintaining the position and / or orientation of the distal portion 159 (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134) are described herein. Figure 4 illustrates a flowchart of process 400 performed by processor 302 to instruct manual repositioning of base 108, for example. Figure 5 schematically shows the inputs and outputs used by processor 302 to instruct manual repositioning of base 108. Although process 400 is described in relation to surgical system 100 of Figure 1, process 400 is applicable to other implementations of the surgical system described herein.

[0106] At the start of process 400, the processor 302 receives input from the surgical system 100 (operation 402). As shown in Figure 5, the processor 302 may receive input 500 from the surgical system 100 (operation 402), and the processor 302 processes it to determine output 502, which controls the positioning indicator system 304 to instruct manual repositioning of the base 108. Input 500 may include user inputs identified by the operator as well as sensor signals generated by sensors of the sensor system 306. Input 500 may include, for example, procedure data 504, instrument data 506, posture data 508, operator data 509, obstacle data 510, patient data 512, and port data 514. Data 504, 506, 508-510, 512, and 514 represent some examples of data available to the processor 302 to control the positioning indicator system 304 to instruct manual repositioning. Other types and types of data may be appropriately used by the processor 302 to control the positioning indicator system 304.

[0107] The procedure data 504 includes data indicating a specific surgical procedure to be performed on patient 102. The procedure data 504 may also point to an area around patient 102 that should be accessible to surgical tools 134 during surgery due to specific requirements of the surgical workspace, for example, a specific surgical procedure to be performed on the patient. The surgical procedure may require a certain range of workspace.

[0108] In some cases, a specific range of movement for the surgical tool 134 can be specified to represent the extent of the workspace. In some cases, the boundaries of the workspace can be drawn to represent the extent of the workspace. In some implementations, the operator can input data indicating the extent of the workspace. The operator can input data before performing the procedure and before performing manual repositioning of the base 108.

[0109] Before manually repositioning the base 108, the operator can demonstrate the scope of the workspace by moving the surgical tool 134 within an area representing the workspace required or otherwise desired for the surgical tool 134 during surgery. For example, the operator can demonstrate the desired workspace by moving the surgical manipulator assembly 104 (with or without the tool), or demonstrate the desired workspace by moving a substitute for the surgical tool 134. Examples of substitutes include a device representing an average surgical tool that may be used during the procedure, a device that replicates the proximal portion of the surgical tool 134 (replicate) but does not replicate the entire shaft and end effector, and a device that projects a visual representation of the location associated with the distal end of the surgical tool that may be used during surgery. Information about the desired range of motion of the remotely controllable arm 106 or the surgical tool 134 can be derived at least in part from such demonstrations. The posture sensor 308 of the sensor system 306 can, for example, generate a signal indicating manual demonstration by the operator 112 in a desired workspace and can provide information about the desired range of motion of the remotely controllable arm 106. A sensor on the surgical manipulator assembly 104 (e.g., the posture sensor 308) can detect the physical movement of the surgical manipulator assembly 104 and / or the surgical tool 134 and can generate a signal indicating the posture of the surgical manipulator assembly 104 and / or the surgical tool 134. When the surgical manipulator assembly 104 and / or the surgical tool 134 is moved, the processor 302 receives procedure data 504 containing these sensor signals and can then process these sensor signals to determine the range of workspace to be demonstrated by the operator.

[0110] The instrument data 506 includes data indicating the specifications of the instrument used during surgery. The instrument data 506 may include data specifying the range of motion of each joint of the surgical manipulator assembly 104. The range of motion may be structural or mechanical limits.

[0111] For a given joint, the range of motion of the joint can refer to the amount of motion possible between the two links connected by the joint. In the case of a rotary joint, the instrument data 506 may specify a value for a range of motion between 90 and 180 degrees (for example, the range of motion of the joint is 90, 135, or 180 degrees). In the case of a prism joint, the instrument data 506 may specify a value for momentum between 10 and 30 centimeters (for example, the momentum of the joint is 10, 20, or 30 centimeters). Other ranges of motion beyond those specified herein may be appropriate depending on the configuration of the remotely controllable arm 106 and the setup assembly 109. The ranges of motion shown in the instrument data 506 may include the ranges of motion for passive joints, active joints, or both.

[0112] The equipment data 506 can further describe the structure of the remotely controllable arm 106 and the setup assembly 109. For example, the equipment data 506 can identify the number of joints, the type of each joint, the length of the links of the remotely controllable arm, and other parameters relating to the structure of the remotely controllable arm 106.

[0113] The device data 506 may also include information about the type of surgical tool 134 attached to the remotely controllable arm 106. The type of surgical tool 134 may affect, for example, the working space and the amount of torque required to perform the movement. The type of surgical tool 134 can be manually entered by the operator. In some examples, the surgical tool 134 may include a detectable tag indicating the type of surgical tool 134.

[0114] The equipment data 506 may also include information about the operating table, such as the manufacturer and model, size and dimensions, range of motion if the operating table top plate is movable relative to the operating table base, dimensions of the operating table rails, and, if removable operating table segments exist, their mounting location and dimensions.

[0115] The posture data 508 includes data indicating the posture of joints, links, surgical tools, and other components of the surgical manipulator assembly 104. The posture data 508 includes the initial posture of each joint and / or link of the remotely controlled arm 106, the initial posture of each joint and / or link of the setup assembly 109, the initial posture of the distal portion and / or surgical tool 134, and the initial posture of the base 108. If the base 108 is moved during manual repositioning, the posture sensor 308 can generate a signal in response to the movement of the base 108. Based on the signal from the posture sensor 308, the processor 302 can control the remotely controlled arm 106 to maintain the position of the distal portion (or an item supported by the remotely controlled arm, such as the cannula 150 or surgical tool 134). The position and / or orientation may be maintained relative to a reference. Exemplary references include the surgical environment 10, the anatomical structure of the patient 102, a reference point such as reference point 162, and a reference system arising from reference point 162.

[0116] Operator data 509 includes data about the surgical team performing the surgical procedure, for example, the operators. Operator data 509 includes information about their capabilities, preferences regarding the layout of surgical instruments, level of experience, level of skill, and other operator-specific attributes. In some examples, an operator profile is created for each operator prior to the surgical procedure. Surgical team profiles are created for specific surgical teams, either alternatively or additionally.

[0117] Obstacle data 510 includes data indicating the orientation or position of the patient 102 and obstacles within the surgical environment 10 relative to the surgical manipulator assembly 104. In some examples, obstacle data 510 may include a map of the surgical environment 10 input by the operator. The map may include the locations of potential obstacles within the surgical environment 10, such as other equipment in the surgical system 100. Obstacle data 510 may optionally or additionally include data from obstacle detection sensors 314. As the remotely operated arm 106, setup assembly 109, and base 108 are moved within the surgical environment 10, obstacle detection sensors 314 may generate signals indicating the position, orientation, or orientation of obstacles within the surgical environment 10.

[0118] Patient data 512 includes data that indicates patient-specific characteristics. Patient data 512 may include data indicating the patient's constitution and the patient's geometric shape. In some examples, the operator inputs the patient's constitution and the patient's geometric shape. In some cases, an imaging device can determine the patient's constitution and the patient's geometric shape by generating images that can be analyzed by the processor 302. The imaging device may be inserted into the patient 102 before manual repositioning of the base 108 is performed. The endoscope can generate images that can be used to estimate the patient's constitution and the patient's geometric shape. In some examples, patient data 512 may also include data indicating the posture of the patient 102 relative to the remotely controlled arm 106 and / or the posture of the operating table 123 relative to the remotely controlled arm 106. Patient data 512 may include preoperative images such as X-ray images, X-ray computed tomography images, magnetic resonance imaging scans, and equivalents. In some cases, patient data 512 includes intraoperative images or surface scans.

[0119] Port data 514 includes data describing the characteristics of the patient's access port. Port data 514 can indicate the position and orientation of the access port. The processor 302 can use port data 514 to determine a reference point 162 during manual repositioning of the base 108. In some implementations, port data 514 is based on the position of the controllable arm 106, such as when a cannula is docked, when the operator indicates readiness for repositioning the base, or when a surgical tool is attached. In some implementations, a component such as a cannula 150 or surgical tool 134 is inserted through the patient's access port, and the processor 302 can determine the position and orientation of the access port based on signals from sensors on the remotely controllable arm 106.

[0120] In some cases, port data 514 can be input by an operator. If the surgical tool 134 is not inserted into the access port before manual repositioning of base 108 occurs, the processor 302 can select a reference point 162 based on the input port data 514. The reference point 162 is selected so that the surgical tool 134 can be positioned and oriented so that it can be easily inserted into the access port after manual repositioning is complete. Specifically, the surgical tool 134 may be in a retracted position during manual repositioning, and then be translated axially to the insertion position so that the reference point 162 corresponds to the position of the access port.

[0121] After receiving the input (operation 402), the processor 302 may optionally generate one or more indices based on the input (operation 404). The processor 302 can compute functions, each representing one of the indices. For example, one or more indices can be selected according to the operator or default settings to be optimized by the processor 302. The processor 302 can then optimize the functions of the selected indices, as will be described in more detail in operation 406.

[0122] Each of the metrics generated in operation 404 can represent an optimization target for processor 302. The metrics can point to a value that should be optimized during manual repositioning of base 108. Each metric generated by processor 302 during operation 404 can be a value based on one or more of the inputs. The number of metrics generated may depend on the number of degrees of freedom, in particular the number of redundant degrees of freedom. In this regard, the metrics generated in operation 404 represent metrics for the current configuration of surgical manipulator assembly 104 during manual repositioning. The values ​​for the metrics may change as base 108 is manually repositioned and joints are moved during manual repositioning.

[0123] Based on the input and / or one or more indicators, the processor 302 determines an optimality score and optimal posture for the current posture of the base 108 (operation 406). The processor 302 can determine a range of optimal postures or optimal positions for the base 108 of the surgical manipulator assembly 104. The range of optimal postures or optimal positions can be represented as an optimal base location envelope 110. The optimal base location envelope 110 can correspond to a range of three-dimensional positions and orientations considered optimal for the base 108. In some implementations, the optimal base location envelope 110 corresponds to a range of optimal two-dimensional positions along a plane parallel to the floor. In some examples, the optimal base location envelope 110 includes multiple optimal positions having the highest optimality score. The processor 302 can calculate the optimal position, optimal posture, and / or optimal base location envelope 110 based on the input 500. In operation 404, the processor 302 can generate functions on the values ​​of the indicators and use those functions to execute an optimization strategy that optimizes each of the indicators. The optimization strategy includes, for example, a gradient descent-based optimization strategy, a least-squares-based optimization strategy, or other appropriate strategies. The processor 302 can compute a solution for a function, the solution representing the optimal attitude range or optimal base attitude for a base using a given optimization strategy. The optimization strategy enables the processor 302 to compute an optimality score that represents the optimality of the current attitude of base 108. In some examples, the optimality score represents the proximity of the current attitude of base 108 to the optimal base attitude or optimal base location envelope 110.

[0124] In some examples, processor 302 selects a single metric as a primary goal and then computes a solution using an optimization strategy that optimizes the metric. When this solution is computed, processor 302 is under-constrained, and the solution provided by processor 302 may represent a subset of the states available for the remotely controlled arm 106. To identify specific instructions to be sent to the joints of the remotely controlled arm 106 when the primary solution is under-constrained, processor 302 may include a module that acts as a subspace filter, selecting a desired state for the remotely controlled arm 106 from a subset of states. The subspace filter may also select a set of instructions for the joints of the remotely controlled arm 106, moving the joints so that the remotely controlled arm 106 is placed in a desired state. Advantageously, the selected instructions can be used to serve a second goal, for example, to optimize a second metric. In some examples, multiple metrics are selected, and a weight is assigned to each of the selected metrics. This weight indicates the priority of that metric over other selected metrics. For example, the operator may determine that the type of procedure and the patient's characteristics have a higher priority for optimization than the operator's preference. An example of optimizing multiple objectives is described in Patent No. 229, which is incorporated herein by reference in its entirety.

[0125] Each indicator may have a range of values ​​considered optimal. When the indicators are within the optimal range, the remotely controlled arm 106 and surgical tool 134 are in a state beneficial to the operation of the surgical manipulator assembly 104 compared to the state of the remotely controlled arm 106 and surgical tool 134 when the indicators are outside the optimal range. The optimal range for an indicator can correspond to any value of the indicator above a threshold. The threshold can be programmed as a default value, a percentage of the maximum or minimum value of the indicator, or can be entered by the operator.

[0126] Various metrics are described herein. These metrics may be functions of one or more of the inputs 500. The exemplary use of the data combinations 504, 506, 508, 510, 512, and 514 described herein for calculating the metrics is not intended to be limiting. For a given implementation of process 400, processor 302 may generate one or more of the indices. In some implementations, processor 302 does not generate any indices, but rather instructs manual repositioning by directly comparing one or more of the inputs 500 to calculate an optimality score.

[0127] The processor 302 optionally generates and optimizes a range of motion index based on the range of motion available for each joint. The range of motion index may be calculated, for example, based on equipment data 506 and posture data 508. For example, for a rotary joint that can rotate in two directions about a given axis, the processor 302 can determine the available momentum in each of the two directions. The processor 302 can determine a target range of joint states for each joint of the remotely controlled arm 106. In some cases, it may be beneficial for the joint to be positioned so that it can move substantially equally in both directions, while in some cases, it may be desirable to maximize the available momentum in a single direction. Thus, the target range of joint states may be a subset of the range of available joint states for a given joint. The processor 302 can calculate the range of motion index by considering the range of motion requirements for each joint of the remotely controlled arm 106.

[0128] The range of motion index may, alternatively or additionally, take into account the range of motion of the surgical tool 134. Specifically, the processor 302 may calculate the range of motion index based on whether the surgical tool 134 has a sufficient range of motion to reach the relevant part of the anatomical structure for a particular surgical procedure. In this regard, the processor 302 may use the procedure data 504 when calculating the range of motion index.

[0129] As the remotely controlled arm 106 moves during manual repositioning to maintain the position and / or orientation of its distal portion (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134), the posture sensor 308 generates signals in response to the movement of the joints and / or links of the remotely controlled arm 106, thereby updating the posture data 508. After receiving these signals, the processor 302 can update its determination of the range of motion index based on the new posture of each joint and / or link among the joints and / or links of the remotely controlled arm 106.

[0130] The processor 302 optionally or additionally calculates a smoothness index. The smoothness index indicates the motion performance of the surgical tool 134 and, in some cases, the motion performance of some or all of the joints of the remotely controlled arm 106. The processor 302 can estimate motion performance by determining the possible resolution of motion of the surgical tool 134 for the current posture of the remotely controlled arm 106 and the surgical tool 134. For example, for a particular joint, the actuation of the joint by an increment (e.g., a given applied voltage or current) may result in momentum of the surgical tool 134 that depends on the posture of each joint of the remotely controlled arm 106 and the posture of the surgical tool 134. In some implementations, the smoothness index is calculated based on the spatial resolution achievable as a function of posture and joint sensor position resolution. The smoothness index can describe the magnitude of motion caused by the applied increment (e.g., incremental voltage or current). In this regard, smaller movements of the surgical tool 134 from a given added increment can result in improved motor performance and greater smoothness of movement of the surgical tool 134. The processor 302 can calculate a smoothness index based, for example, on instrument data 506 and posture data 508.

[0131] The processor 302 optionally calculates a torque index for the surgical tool 134. The torque index can indicate the torque that the remotely controlled arm 106 can apply to the surgical tool 134. In some implementations, the surgical procedure may require that the remotely controlled arm 106 be able to operate the surgical tool 134 with the minimum torque required to perform the procedure. In these cases, it may be beneficial to maximize the torque achievable by the surgical tool 134. However, the achievable torque may depend on the position and orientation of the joint relative to the surgical tool 134. The processor 302 can calculate the torque index based, for example, on procedure data 504, instrument data 506, and posture data 508.

[0132] In some implementations, instead of or in addition to the torque index, a force index is calculated that indicates the force that the remotely controlled arm 106 can apply to the surgical tool 134. Furthermore, the torque index and / or force index may describe the forces and torques on the joints of the surgical manipulator assembly 104 so that the forces and / or torques on specific joints can be minimized during the movement of the remotely controlled arm 106 in the workspace.

[0133] The processor 302 can calculate a workspace index representing the portion of the workspace accessible by the surgical tool 134 for the current state of the remotely controllable arm 106. The processor 302 can calculate the workspace index based, for example, on the workspace shown in the procedure data 504, which is demonstrated by the operator. The processor 302 can control the positioning indicator system to instruct manual repositioning of the base 108 to optimize the workspace index. The processor 302 can control the positioning indicator system based on the data used to calculate the workspace index and signals from the attitude sensor 308 indicating manual demonstration.

[0134] The processor 302 can calculate the portion of the workspace accessible by the surgical tool 134 based on the instrument data 506 and posture data 508, by determining the range of motion of the surgical tool 134 based on the range of motion of the joints of the remotely controllable arm 106. In some implementations, the processor 302 can use patient data 512 to consider the patient's geometric shape and physical characteristics when determining spatial indicators. In some examples, the processor 302 can cause the calculation of spatial indicators to be based in part on port data 514, in particular on the location and orientation of the patient's access ports. In some examples, the patient data 512 includes physiological images of the patient, which can be used to estimate the required instrument workspace boundaries when used in combination with procedure data 504.

[0135] The processor 302 calculates a singularity index that indicates, in some cases, the possibility that the joints of the remotely controlled arm 106 may be operated to a state corresponding to a kinematic singularity. For example, for the remotely controlled arm 106, a kinematic singularity occurs when the remotely controlled arm 106 loses the ability to move in one or more directions or to apply force. The processor 302 can determine potential kinematic singularities based on the instrument data 506. For example, the kinematic singularity for a joint may depend on the current configuration of the remotely controlled arm 106.

[0136] The processor 302 optionally estimates an obstacle index based on posture data 508 and obstacle data 510. The obstacle index represents the likelihood that the remotely controlled arm 106 may collide with a nearby obstacle. In this regard, using the obstacle data 510, the current posture of the remotely controlled arm 106, and the procedure data 504, the processor 302 can calculate the obstacle index to determine whether the remotely controlled arm 106 may collide with a nearby obstacle, provided that the surgical tool 134 should be able to access the working space range identified in the procedure data 504.

[0137] The processor 302 may, alternatively or additionally, calculate a patient force index indicating the amount of force applied to the patient. For example, the patient force index may be calculated based on posture data 508, patient data 512, and port data 514, and may indicate the amount of torque or force that may be applied to the wall of patient 102 around the vicinity of the access port. The processor 302 may use the patient force index to determine whether the remotely controlled arm 106 or base 108 is being moved in a manner that may apply a force to the tissue of patient 102 that exceeds a desired amount.

[0138] In some implementations, the processor 302 optionally calculates a dexterity index representing the dexterity of the surgical tool 134 in a given posture. The dexterity index may be an aggregate index that describes one or more of the following: a smoothness index, a torque index, a workspace index, and a singularity avoidance index. In some implementations, the dexterity index is calculated based on the manipulability index and / or Jacobian condition number for the joints of the surgical manipulator assembly 104.

[0139] In some implementations, the optimization strategy for surgical procedures is based on data from previous surgical procedures. This data includes, for example, inputs collected during previous surgical procedures, metrics determined during previous surgical procedures, and / or scores determined during previous surgical procedures. In some cases, the optimization strategy is determined using machine learning techniques, such as artificial neural networks.

[0140] After the processor 302 determines the optimal base pose and optimality score for the current pose (operation 406), the processor 302 compares the optimality score to a threshold optimality score (operation 407). Whether the optimality score is greater than (operation 408) or less than (operation 412) the threshold optimality score, the processor 302 can generate and deliver output 502. As shown in Figure 5, output 502 can be sent to the surgical manipulator assembly 104 to control the operation of the surgical manipulator assembly 104.

[0141] If the optimality score is greater than the threshold optimality score (e.g., operation 408), the processor 302 optionally outputs a signal to activate an indicator that indicates the completion of manual repositioning (operation 410). If base 108 includes indicator lights 200, the signal indicating the completion of manual repositioning may be the illumination of each indicator light 200 in a specific pattern or sequence. For example, the processor 302 may control the positioning indicator system 304 so that all of the indicator lights 200 are illuminated. In some examples, the processor 302 controls a speaker to provide an audible signal indicating the completion of manual repositioning. In some implementations, the optimality score is maximized in operation 408. Alternatively or additionally, when the optimality score is maximized, optimization results in minimizing a score such as the error score.

[0142] In some examples, the positioning indicator system 304 is controlled to guide the movement of the base 108 so that the base 108 is within a position range that exceeds a threshold optimality score. For example, if the optimization process does not account for certain conditions important to the operator, such as heuristics regarding surgical procedures that are not considered during process 400, the positioning indicator system 304 provides a position range that gives the operator flexibility when repositioning the base. The operator can select a position that may not have the highest optimality score but may satisfy other conditions that process 400 does not consider when controlling the positioning indicator system 304.

[0143] If the optimality score is less than the threshold optimality score (operation 412), the processor 302 outputs a manual repositioning signal to instruct manual repositioning (operation 414). The processor 302 may transmit the repositioning signal to the positioning indicator system 304. In some examples, as shown in Figure 5, the processor 302 transmits a signal to a surgical manipulator assembly 104 which includes indicator lights 200 that form part of the positioning indicator system 304. The repositioning signal illuminates the indicator lights 200, thereby indicating the repositioning direction in which the operator should move the base 108 of the surgical manipulator assembly 104 to reposition the base 108 toward the optimal base orientation or toward the optimal base location envelope 110.

[0144] The processor 302 then transmits a drive signal to maintain the position and / or orientation of the distal portion (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134) relative to a reference such as a reference point 162 (operation 416). The processor 302 generates the drive signal based on signals from the sensors. For example, posture data 508 may indicate, for example, that the base 108 is being moved in the repositioning direction at a detected velocity and acceleration. The processor 302 can then generate a drive signal to move the joint in response to the movement of the base 108 so that the position and / or orientation of the distal portion (or an item supported by a remotely controllable arm, such as a cannula 150 or surgical tool 134) is maintained. The position and / or orientation may be maintained relative to a reference such as a reference point 162.

[0145] In some examples, while outputting a repositioning signal (operation 414) or transmitting a drive signal (operation 416), the processor 302 may activate a brake at the joint of the remotely controllable arm 106 to activate a braking mechanism to stop the movement of the base 108, and / or activate a braking mechanism associated with the wheels 136 on the cart 111 to stop the movement of the cart 111. The processor 302 may control the brake or braking mechanism based on a change in the value of the patient force index. For example, based on the patient force index, the processor 302 may determine that a force exceeding a desired amount is being applied to the tissue of the patient 102. In this regard, the operator 112 may reposition the base away from the optimal base position envelope 110, and the processor 302 may attempt to suppress this movement. In some implementations, the processor 302 is unable to drive the remotely controlled arm 106 to maintain the remote portion (or an item supported by the remotely controlled arm 106, such as a cannula 150 or surgical tool 134) in its desired position and / or orientation relative to a reference, such as a reference system with its origin at reference point 162. This may be due, for example, to joint limits, singularities, excessive vibration, or excessive velocity / acceleration of the base's motion.

[0146] Using posture data 508, the processor 302 can determine or estimate the remote center of motion for the remotely controlled arm (often the same as the remote center of motion for a cannula 150 or surgical tool 134 connected to the remotely controlled arm), and can control the operation of the powered joint of the remotely controlled arm 106 to maintain the remote center of motion. Optionally, the processor 302 uses reverse motion to determine how the joint should be driven to maintain the position and / or orientation of the distal portion (or item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134). The actuator of the powered joint can be selectively driven to maintain the position and / or orientation of the distal portion (or item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134) and / or position the powered joint in a more optimal position. In some cases, the processor 302 controls the actuator of the powered joint to suppress movement of the powered joint that may result from the movement of the base 108. In some examples, the processor 302 controls the actuator of the powered joint to cause the powered joint to move toward a more optimal position. An example of such a method is described in Patent No. 229, which is incorporated herein by reference.

[0147] As described herein, the movement of the remotely controlled arm 106 and / or surgical tool 134 can be constrained so that the surgical tool 134 rotates about a pivot point defined by a reference point 162. In estimating these pivot points, the processor 302 can selectively implement different modes characterized by the compliance or stiffness of the remotely controlled arm 106. After the estimated pivot points have been calculated, the processor 302 can implement different modes across a range of compliance or stiffness about the pivot points or remote center of motion. The range can be, for example, between a compliant pivot point resulting in a passive pivot point and a rigid pivot point resulting in a fixed pivot point.

[0148] In the case of a fixed pivot point, the estimated pivot point can be compared to a desired pivot point to generate an error output that can be used to drive the pivot point of a remotely controlled arm (e.g., the distal portion of a remotely controlled arm) to the desired location. In the case of a passive pivot point, the desired pivot location may not be the primary or highest priority objective. The estimated pivot point can still be used for error detection. A change in the estimated pivot point location may give the processor 302 an opportunity to take corrective action by indicating that the patient 102 has been moved or that the sensor is malfunctioning.

[0149] The processor 302 optionally allows the compliance or stiffness of the remotely controlled arm 106 to be varied over the entire range. For example, joint 148g may be an instrument holder wrist joint (wrist joint) that allows pivoting motion about two axes. When joint 148g is controlled to be at the compliant end of the range, the processor 302 can move the proximal end of the surgical tool 134 in space while the actuator of joint 148g applies little to no torque. In this regard, the surgical tool 134 acts as if it were connected to the remotely controlled arm 106 by a pair of passive joints. In this mode, the interaction between the patient tissue along the access port and the elongated shaft 152 causes pivoting motion of the distal portion (or an item supported by the remotely controlled arm, such as a cannula 150 or surgical tool 134) about the pivot point.

[0150] When joint 148g is controlled to be at the rigid end of the range, processor 302 may determine the location of the access port from port data 514 and use the location of the access port as input indicating a reference point 162 on which the distal portion (or an item supported by a remotely controlled arm, such as a cannula 150 or surgical tool 134) should rotate. In some cases, processor 302 may calculate the location of the access port based on posture data 508 and treat the location of the access port as the reference point 162. Next, processor 302 may drive actuators associated with each joint of the remotely controlled arm 106 positioned proximal to the pivot point such that any lateral force on the elongated shaft 152 at the calculated pivot point results in a reaction force that maintains the elongated shaft 152 through the pivot point. Thus, processor 302 may control the joints of the remotely controlled arm 106 so that the remotely controlled arm 106 behaves in a manner similar to a mechanically constrained remote central linkage. Implementation may range from providing a calculated motion for a pivot point corresponding to an access site to moving the remote center of motion within an acceptable range as tissue along the access port moves without applying excessive lateral force to the tissue. Patent No. 299, incorporated herein by reference in its entirety, describes other examples of calculating the remote center of motion and pivot point.

[0151] After the processor 302 outputs a repositioning signal (operation 414) and transmits a drive signal (operation 416), the processor 302 may repeat operations 402, 404, 406, 407, 412, 414, and 416 until the processor 302 determines that the base attitude optimality score has exceeded the threshold optimality score. At that point, the processor 302 may then perform operations 408 and 410 to indicate the completion of manual repositioning.

[0152] In some implementations, manual repositioning of the base 108 is terminated before the optimality score exceeds the threshold optimality score, rather than repeating operations 402, 404, 406, 407, 412, 414, and 416 until the processor 302 determines that the optimality score of the base posture exceeds the threshold optimality score. For example, the operator can provide user input to disable process 400, causing the processor 302 to stop repeating operations that induce manual repositioning. Alternatively, the processor 302 can automatically stop inducing manual repositioning of the base 108 in response to the fulfillment of a predetermined condition. The predetermined condition may indicate to the processor 302 that the base 108 cannot be repositioned within the optimal base location envelope 110. For example, if the optimality score does not exceed the threshold optimality score after a predetermined amount of time, e.g., 5 to 15 minutes, has elapsed since process 400 started, the processor 302 disables process 400. In a further example, the processor 302 tracks numerous instances in which the base 108 is moved away from the optimal base location envelope 110, and disables process 400 when the number of instances exceeds a predetermined amount, for example, 10 to 20 instances. In a further example, the processor 302 determines, based on obstacle data 510, that there is no movement path for the base 108 to the optimal base location envelope 110 due to an obstacle between the base 108's current location and the optimal base location envelope. If manual repositioning of the base 108 is stopped before the optimality score exceeds a threshold optimality score, the processor 302 may issue a warning (alert) indicating that the base 108 is in a suboptimal position, for example, outside the optimal base location envelope 110.

[0153] Figures 6A to 6P illustrate a series of operations 600A to 600P for manually repositioning the base 108 of a surgical manipulator assembly 104 adjacent to the operating table 123 supporting patient 102, so that a surgical tool (not shown) attached to a remotely controllable arm 106 can reach the workspace 602 around patient 102. Each of operations 600A to 600P may include sub-operations performed by operator 112, a processor (e.g., processor 302 of control system 300), or both. In some implementations, some or all of operations 600A to 600P are performed by multiple operators.

[0154] In Figure 6A, the surgical manipulator assembly 104 is positioned within the surgical environment 10. The remotely controlled arm 106 can be in a retracted configuration. The remotely controlled arm 106 can be deployed by controlling it with the processor during operations 600A, 600B, and 600C. The processor can control the joint of the remotely controlled arm 106 so that the remotely controlled arm 106 extends further from the base, as shown in operations 600B and 600C of Figures 6B and 6C, respectively. The processor can actuate the joint so that the distal portion (or an item supported by the remotely controlled arm 106, such as a surgical tool or cannula 150 located on the distal link of the remotely controlled arm 106) is moved in the deployment direction 603. In some examples, instead of the processor controlling the joint to move the remotely controlled arm 106, the operator manually moves the remotely controlled arm 106 to the deployed position shown in Figure 6C. Once the remotely controlled arm 106 is deployed, the operator 112 can cover the remotely controlled arm 106 with a sterile drape (not shown).

[0155] In each of Figures 6D to 6F, operator 112 manually positions the base so that the surgical manipulator assembly 104 is positioned adjacent to the workspace 602. In some examples, between operations 600D and 600F, the processor can control a positioning indicator system (e.g., positioning indicator system 304) to provide a repositioning direction 606 in which operator 112 should push the base 108. The indicator can be a visual display projected onto the floor. In some examples, the processor can calculate an optimal base location or optimal base location envelope 110, and then control the positioning indicator system to indicate a repositioning direction 606 instructing operator 112 to move the base 108 toward the optimal base location envelope 110. In some implementations, the inertia of the remotely controlled arm 106 and the base 108 may cause the remotely controlled arm 106 to move relative to the base 108 while operator 112 moves the base 108 toward the optimal base location envelope 110. While operator 112 moves base 108, the processor can control the joints of the remotely controlled arm 106 so that the remotely controlled arm 106 remains in the deployed position. In this regard, the joints may be driven in the deployment direction 603 shown in Figures 6D to 6F, respectively, during operations 600D to 600F.

[0156] In operation 600G, shown in Figure 6G, the base 108 is positioned adjacent to the operating table 123 and the patient 102. Next, in operations 600H, 600I, and 600J, shown in Figures 6H, 6I, and 6J respectively, the remotely controlled arm 106 is positioned so that the surgical tool is within the workspace 602 when the surgical tool is attached to the remotely controlled arm 106. The processor can control the deployment of the remotely controlled arm 106, for example, by acting on the joints of the remotely controlled arm 106, or the operator 112 can manually deploy the remotely controlled arm 106.

[0157] When the remotely controlled arm 106 is deployed, in some implementations, the operator 112 can demonstrate the extent of the workspace 602. The operator 112 can, for example, manually manipulate an instrument holder or another part of the remotely controlled arm 106 so that a portion of the remotely controlled arm 106 (or the surgical tool, if the surgical tool is attached to the remotely controlled arm 106) is moved across the boundary of the workspace 602. The processor can then receive sensor signals from the posture sensors on the remotely controlled arm 106 and use those signals to estimate the extent of the workspace 602. Other methods for demonstrating the workspace 602 are described herein.

[0158] In operation 600J, a reference point is identified. In this example, the reference point is reference point 162. In some examples, in operation 600J, a surgical tool is inserted into the access port of patient 102, and a reference point is established corresponding to the location of the access port. Operator 112 can insert the surgical tool into the access port by clutching various joints of the remotely operated arm 106 and manipulating the distal link or other parts of the remotely operated arm 106. An example of clutching is described in detail in Patent No. 223, which is incorporated herein by reference.

[0159] In some implementations, the processor is provided with a reference point location in a manner other than physically positioning the surgical tool through the access port. The processor can determine a reference point 162 so that the surgical tool can be inserted into the access port after manual repositioning of the base 108 is complete. The reference point 162 can be a point on a component that is in physical contact with the remotely controlled arm 106, or a point in space not mechanically connected to the remotely controlled arm 106, or a part of a component not mechanically connected to the remotely controlled arm 106. For example, if the instrument holder 132 is connected to the cannula 150 and the cannula 150 is inserted into the patient, the reference point 162 may point to a point along the cannula 150, such as where the cannula 150 makes contact with the patient's body wall. If the instrument holder 132 is detached from the cannula 150, the reference point 162 may point to a point associated with a location in the surgical environment 10 that is not mechanically connected to the remotely controlled arm 106, where the cannula would be located if the cannula were fitted. Reference point 162 may be indicated in other ways in various implementations. In some implementations, the operator operates an input device to indicate that the remotely controlled arm 106 is close to the patient's access port, that the remotely controlled arm 106 is docked to a cannula already inserted into the patient's access port, that the cannula held by the remotely controlled arm 106 is inserted into the patient, and that image acquisition and recognition are being performed to identify the patient's incision or guide marks placed on the patient to indicate (multiple) reference points and / or (multiple) directions.

[0160] In operation 600J, the processor can determine the optimal base location envelope 110 based on the input it receives, as will be described in more detail with respect to Figures 4 and 5. Then, in each of operations 600K to 600M, as shown in Figures 6K to 6M, the processor guides the manual repositioning device for the base 108. The processor controls the positioning indicator system to indicate a repositioning direction 606 for the base 108. The repositioning direction 606 indicates the direction in which the operator 112 should reposition the base 108 so that the base 108 is moved toward the optimal base location envelope 110. The operator 112 manually repositions the base 108 according to the repositioning direction 606 provided by the positioning indicator system. While operator 112 manually repositions the base 108, as described with respect to Figures 4 and 5, operator 112 can detect the movement of the base 108 and control the operation of the joints of the remotely operated arm 106 so that the position and / or orientation of the distal portion (or item supported by the remotely operated arm 106, such as a cannula 150 or surgical tool) is maintained relative to a reference (e.g., reference point 162) during manual repositioning. Thus, the processor can move one or more portions of the remotely operated arm 106 (e.g., the distal end of the remotely operated arm 106 or (more than) other portions) relative to the base 108 in the deployment direction 603 while manual repositioning is occurring.

[0161] The processor can control the positioning indicator system to indicate both rotation and translation of the base 108 during manual repositioning. As shown in Figure 6K3, the processor can control the positioning indicator system to indicate a repositioning direction 606 in which operator 112 translates the base 108 in the repositioning direction 606. As shown in Figures 6L and 6M, the processor can also control the positioning indicator system to indicate a repositioning direction 606 in which operator 112 rotates the base 108 in the repositioning direction 606.

[0162] In Figure 6N, operator 112 successfully manually repositioned the base 108 so that it was within the optimal base location envelope 110. In some implementations, in operation 600N, the processor controls the surgical manipulator assembly 104 to provide a success indicator 608. The success indicator 608 indicates that the manual repositioning of the base 108 is complete. In some implementations, the success indicator 608 is a specific sequence or pattern provided by the positioning indicator system. In some implementations, the success indicator 608 includes audible confirmation, tactile confirmation, or other signals indicating success to the operator. In some examples, the positioning indicator system also provides a display to the operator when the base 108 is outside the optimal base location envelope 110.

[0163] After the repositioning of the base 108 is successfully completed, the surgical procedure can be initiated. The surgical tools can be inserted into the patient's 102 access port. The surgeon can remotely control the surgical tools and perform the surgery by remotely controlling the remotely controllable arm 106 of the surgical manipulator assembly 104.

[0164] In some implementations, performing a second manual repositioning may be beneficial in repositioning the base 108 to a more optimal position. The operator 112 may request the processor to instruct a second manual repositioning. In some examples, the processor detects that a second manual repositioning would be beneficial and then warns the operator 112 to perform the second manual repositioning. For example, during a procedure after the initial manual repositioning is completed, an obstacle may be positioned adjacent to the surgical manipulator assembly 104. The initial manual repositioning performed by the operator 112 may not be sufficient to avoid the obstacle. As shown in Figure 6O, the optimal base location envelope is the initial optimal base location envelope 110, which does not take into account obstacles 612, e.g., accessory cart, patient, and / or operator. In Figure 6O, the obstacle 612 is far enough away from the surgical manipulator assembly 104 that a collision between the remotely controllable arm 106 and the obstacle 612 is unlikely. However, as shown in Figure 6P, the obstacle 612 is moved to a position adjacent to the surgical manipulator assembly 104, thus increasing the likelihood of a collision.

[0165] In some implementations, a second manual repositioning occurs because the surgical tool 134 must be moved to the patient's new port location during the surgical procedure. The initial port location may require a different base location than the base location required for the new port location. In this regard, the new port location may result in a new reference point 162, and consequently, a new optimal base location envelope for the second manual repositioning. As a result, the processor instructs a second manual repositioning so that the operator is guided to move the base 108 toward the new optimal base location envelope.

[0166] In some implementations, the processor instructs a second manual repositioning. The processor initiates the second manual repositioning process, for example, when an arm or surgical tool is moved to the edge of the workspace boundary and the operator wishes to move the arm or surgical tool beyond the workspace boundary. In such cases, the processor may trigger a second manual repositioning that takes into account a new workspace boundary defined, for example, by the operator using the manual demonstration process described herein. In some cases, the processor initiates the second manual repositioning process due to the movement of an obstacle, for example, the movement of the operator or device within the surgical environment 10.

[0167] As described with respect to Figures 3 to 5, the surgical manipulator assembly 104 includes an obstacle detection sensor that can be used to detect obstacles near the remotely controlled arm 106 of the surgical manipulator assembly 104. After detecting an obstacle, the processor may determine that the remotely controlled arm 106 must be repositioned away from the obstacle 112 because the likelihood of a collision is sufficiently high. While it may be possible to actuate the joints without moving the base to avoid a collision between the remotely controlled arm 106 and the obstacle 612, in some examples, it may be beneficial to instruct a second manual repositioning of the base 108 to achieve other objectives, as described with respect to Figures 4 and 5. For example, a second manual repositioning may beneficially improve the range of motion of the joints of the remotely controlled arm 106 in light of a new obstacle 612 that may obstruct the range of motion of some of the joints. As shown in Figure 6P, the processor may calculate a new optimal base position envelope 110 that takes the new obstacle into account. The processor controls the positioning indicator system to indicate a repositioning direction 606 for a second manual repositioning. The operator 112 can then perform a second manual repositioning according to the repositioning direction 606, so as to reduce the risk of collision with the obstacle 612 by moving the base 108 and the remotely controlled arm 106 away from the obstacle 612.

[0168] (Alternative to additional implementation) The above-mentioned system may optionally include one or more of the following configurations in addition to or instead of the configurations discussed above.

[0169] Although arm 106 is described as remotely controllable, in some implementations, arm 106 is controlled by an operator in the same room as arm 106. For example, if arm 106 is used during a surgical procedure, the operator can control arm 106 from beside the patient's bedside.

[0170] Although described as including cart 11, some setup assemblies 109 correspond to a platform mounted on a gantry above floor 20 and attached to the wall or ceiling of the surgical environment 10. The operator 112 moves the platform along the gantry to perform manual repositioning. The gantry may include a braking mechanism, for example, connected to a rail that mounts the base 108 to the gantry. A positioning indicator system may include a braking mechanism associated with the rail.

[0171] The surgical system 100 represents an example of a surgical system that may include methods, systems, and devices capable of inducing manual repositioning. The surgical system 100 and methods described herein can be modified to include alternative or additional configurations. Some configurations of the surgical system 100 may be omitted. In some cases, these modifications may additionally alter the operation of the surgical system 100, for example, operations 402, 404, 406-408, 410, 412, 414, and 416 and operations 600A-600P.

[0172] In some implementations, the joints and setup joints of the setup assembly 109 and / or the remotely controlled arm 106 may include combinations of rotary and prism joints different from those described with respect to Figure 2A. Each joint may provide translational degrees of freedom, rotational degrees of freedom, or a combination thereof. A joint may include multiple rotational degrees of freedom, e.g., rotation about multiple independent axes. A joint may include multiple translational degrees of freedom, e.g., translation along multiple independent axes. For example, setup joints 142b-142c and 148a-148g are described as rotary joints, but in some examples, one or more of these joints 142b-142c, 148a-148g may allow translational degrees of freedom, thus allowing relative translation between the remotely controlled arm 106 and the link of the setup arm 128. Joint 142a is described as a prism joint, but may be a rotary joint that allows the remotely controlled arm 106 to pivot relative to the base 108. In some cases, joints may allow both relative rotation and translation between links. The remotely controlled arm 106 may include fewer or additional links and joints, depending on the degrees of freedom desired for a given application.

[0173] The types of joints for the remotely controlled arm 106 and the setup arm 128 may differ in different implementations. In some examples, the remotely controlled arm 106 includes only powered joints, while the setup arm 128 includes only passive joints. In some implementations, the surgical manipulator assembly 104 does not include both the remotely controlled arm 106 and the setup arm 128. For example, the remotely controlled arm 106 may include a single powered joint connecting the remotely controlled arm 106 to the cart 111 or the setup assembly 109. The processor 302 may selectively activate a single powered joint during manual repositioning to drive the powered joint. The movement of the powered joint may maintain the position and / or orientation of the distal portion (or an item supported by the remotely controlled arm 106, such as a cannula 150 or surgical tool 134) during manual repositioning. In some implementations, the remotely controlled arm 106 and the setup arm 128 may together include two or more powered joints. During manual repositioning, the processor 302 can selectively activate each of the powered joints to maintain the position and / or orientation of the distal portion (or an item supported by a remotely controllable arm 106, such as a cannula 150 or surgical tool 134) relative to a reference, for example, a reference point 162.

[0174] In some cases, the remotely controlled arm 106 and setup arm 128 include a selectively releaseable passive joint. The selectively releaseable passive joint may include, for example, a braking mechanism to maintain the position of the passive joint. In this regard, the remotely controlled arm 106 may include a powered joint and a selectively releaseable passive joint. During manual repositioning of the base 108, the processor 302 may selectively activate the powered joint and selectively release the passive joint, using a reaction force to move the passive joint while maintaining the position and / or orientation of the distal portion (or item supported by the remotely controlled arm 106, such as a cannula 150 or surgical tool 134).

[0175] The surgical system 100 depicted in Figure 1 shows a single surgical manipulator assembly 104, but in some examples, the surgical manipulator assembly 104 may be one of several surgical manipulator assemblies, each of which includes a remotely controllable arm. Each of the remotely controllable arms may include a surgical tool and can be used to instruct manual repositioning of the base of each surgical manipulator assembly using the method described herein. Furthermore, each of the remotely controllable arms may include a corresponding reference point that functions as a remote center of motion. Manual repositioning of each base can occur while a powered joint for the surgical manipulator assembly is activated to maintain the position of each distal portion of the surgical manipulator assembly (or items supported by the surgical manipulator assembly, such as cannulas, surgical tools, other instruments, or accessories). In some cases, the processor may use obstacle detection sensors to detect other surgical manipulator assemblies and may consider the other surgical manipulator assemblies as obstacles in the surgical environment. In this regard, the obstacle data used by the processor to instruct manual repositioning of the base may include the positions of the other surgical manipulator assemblies. In some implementations, while the base for the first arm is being manually repositioned, the powered joint of the second arm is driven to avoid collisions between the first arm and the second arm when the first arm is being manually repositioned.

[0176] In some examples, rather than a surgical manipulator assembly 104 having a single arm 106, the surgical manipulator assembly includes multiple arms, each arm having a surgical tool. Each surgical tool can be inserted into a separate access port. During manual repositioning of the base 108, the processor can control the joints of each of the multiple arms to maintain the position and / or orientation of the distal portion of each arm (or cannula or item supported by each arm, such as a cannula) relative to its respective access port. Each arm extends from a single base 108. To instruct manual repositioning, the processor can consider the optimal position for each arm and instruct manual repositioning of the base to improve the optimality for each arm. In some implementations, it may not be possible to maximize the optimality score for position and orientation for each arm. In such cases, the optimization strategy may include a net optimality score that explains the optimality score for each arm. As part of the optimality strategy, the optimality score for a particular arm may be weighted more heavily than that of other arms. In this regard, optimizing the net optimality score results in a position and orientation for a particular arm that is closer to the optimal position and orientation for that particular arm, given the data associated with the surgical procedure to be performed.

[0177] Although the positioning indicator system 304 is described as having an indicator light 200 on column 138, in some embodiments the configuration of the positioning indicator system may differ in position, mechanism, and other embodiments. For example, in some embodiments the positioning indicator system 304 includes, instead of a light, a mechanical dial that visually indicates the direction in which the base 108 of the surgical manipulator assembly 104 should be repositioned.

[0178] The indicator light 200 can project light onto the floor surface of the surgical environment, but in some cases, the indicator light can project light onto a portion of the base 108. In some cases, the indicator light can be positioned on a portion of the base and directly illuminate to indicate the direction for manual repositioning. For example, as shown in Figure 7, the indicator light 700 can be positioned along the proximal portion 702 of the base 704.

[0179] Although the positioning indicator system 304 is described as part of the surgical manipulator assembly 104, in some examples it may be a system independent of the surgical manipulator assembly 104. The positioning indicator system 304 may be a separate visual or auditory indicator system from the surgical manipulator assembly 104. The positioning indicator system may be part of an audio system configured to emit an audible signal that can be heard in the surgical environment. The audible signal may indicate the direction in which the base should be moved. In some examples the positioning indicator system is a visual indicator system that illuminates the floor to indicate the direction in which the base should be moved, such as a ceiling-mounted projector, floor light, and equivalent.

[0180] The positioning indicator system 304 is described as providing an indication of a desired repositioning direction in which the base 108 should be moved to reach an optimal base position and / or orientation; however, in some implementations, the positioning indicator system 304 is operated in different ways to guide manual repositioning of the base 108. For example, the positioning indicator system 304 may provide an indication of the estimated distance between the optimal location of the base 108 and the current location of the base 108. If the positioning indicator system 304 includes an indicator light (e.g., one of the indicator lights 200), the intensity, wavelength, or color of the illumination emitted by the indicator light may change in response to a change in the estimated distance. If the positioning indicator system 304 includes a speaker or other audible display device, the intensity, pitch, frequency, volume, or linguistic indication of the audible display provided by the speaker may change in response to a change in the estimated distance. For example, the intensity, pitch, frequency, or volume of the audible display may increase in response to a decrease in the estimated distance, and the intensity, pitch, frequency, or volume may decrease in response to an increase in the estimated distance. Alternatively, the audible linguistic indication linguistically expresses that as the estimated distance increases, base 108 is being moved away from the optimal base location, or as the estimated distance decreases, base 108 is being moved towards the optimal base location.

[0181] In some implementations, rather than providing a display of a single parameter such as the repositioning direction, the positioning indicator system 304 provides a display of multiple parameters relating to the location of the base 108 during manual repositioning. For example, the display may indicate one or more parameters including one or more of the following: the repositioning direction of the base 108, the relative distance between the current location of the base 108 and the optimal location of the base 108, the relative angle between the current orientation of the base and the optimal angle of the base, the relative distance between the base 108 and the expected location of the obstacle, the relative distance between the base 108 and the limit of the base 108's range of motion, the successful positioning of the base 108 relative to a location within the optimal base location envelope, or the fact that the base 108 is outside the optimal base location envelope. In some cases, a single indicator device of the positioning indicator system 304 is operable to provide a display of multiple parameters. For example, a single indicator light (e.g., one of the indicator lights 200) may be operable to provide a display of the relative distance between the base 108 and the optimal location of the base 108, as well as a display of the repositioning direction of the base 108. The illumination of the indicator light can indicate the repositioning direction of the base 108, and the intensity of the illumination of the indicator light can indicate the relative distance between the current location of the base 108 and the optimal location of the base 108.

[0182] Each indication provided by the positioning indicator system 304 can be provided through one or more modalities. For example, when a single indication is provided, that indication can be provided through multiple modalities, for example, through two or more of audible, visual, or tactile indications. When multiple indications showing different parameters are provided, each indication can be provided through the same modality or through different modalities. For example, one indication can be provided by a visual indicator device and another by an audible indicator device. Alternatively, multiple indications can be provided by a visual indicator device and another by a tactile indicator device.

[0183] In some examples, the positioning indicator system includes a display that graphically depicts the current location of the base 108 and one or more preferred locations of the base 108. The graphic display can depict these locations in a plan view and can depict other obstacles in the surgical environment 10 to provide operator context when repositioning the base 108. The operator successfully moves the base 108 to the optimal base location envelope 110 when the visual display of the current location of the base 108 coincides with the visual display of one or more preferred locations of the base 108.

[0184] In some examples, the positioning indicator system can illuminate an area of ​​the floor corresponding to the optimal base location envelope, indicating the direction in which the base should be moved. The positioning indicator system can project the desired location onto the floor, allowing the user to manually push the base toward the desired location. If the projector is mounted on a remotely controlled arm 106 or base 108, the projector's position can be updated as the remotely controlled arm 106 or base 108 moves during repositioning. In this regard, the projection of the desired location remains in the desired location even when the remotely controlled arm 106 and base 108 are repositioned.

[0185] The positioning indicator system 304 may, alternatively or additionally, include tactile indication of the repositioning direction. For example, if the cart 111 includes wheels 136 and the wheels 136 include a braking mechanism, the processor 302 can control the braking mechanism as part of the positioning indicator system 304. The processor 302 can activate the braking mechanism if the operator 112 attempts to move the base 108 away from the optimal base location envelope 110, and can deactivate (start / stop) the braking mechanism if the operator 112 moves the base 108 toward the optimal base location envelope 110. Thus, the resistance provided by the activation of the braking mechanism can induce manual repositioning of the base 108 by providing tactile indication to the operator 112.

[0186] As described herein, the joints can be actuated so that they are positioned near the center of their range of motion. In some cases, where the processor 302 cannot control the joints so that each joint of the joint is actuated so that it is near the center of its range of motion during manual repositioning, the positioning indicator system can provide some indication that one or more joints are near the periphery of their range of motion. For example, the processor 302 may not be able to reposition a joint away from the periphery of its range of motion without regard to the objective of maintaining the position and / or orientation of the distal portion of the arm (or an item supported by the arm, such as a cannula or surgical tool 134). To restrain the movement of a joint beyond the range of joint states, the processor 302 can activate the positioning indicator system 304 to indicate that the base 108 should not be moved in a certain direction, because movement of the base 108 in that direction would move the joint beyond the range of joint states available for the joint. In some examples, the processor 302 can activate a braking mechanism of the base 108 to prevent further movement of the base 108 that could move the joint beyond the range of joint states.

[0187] In some implementations, the positioning indicator system controls the powered joint of the remotely controlled arm 106 so that the powered joint of the remotely controlled arm 106 can only move in the direction that moves the base 108 toward the optimal base location envelope 110. The operator 112 then pushes the base 108 or the joint so that the base 108 is moved toward the optimal base location envelope 110. The resistance to movement of the powered joint in the direction that moves the base 108 toward the optimal base location envelope 110 serves as a tactile indicator that guides the operator 112 to manually reposition the base toward the optimal base location envelope 110.

[0188] As described herein, the processor 302 may use an indicator to generate a signal to actuate the joint while manual repositioning of the base 108 occurs. In some implementations, in addition to controlling the joint to maintain the position and / or orientation of the distal portion of the arm (or an item supported by the arm, such as a cannula or surgical tool 134), the processor 302 may control the joint based on an indicator. For example, certain configurations of the joint of the remotely controllable arm 106 may be challenging during surgery. After determining that the joint is in one of these challenging configurations, the processor 302 may actuate the joint to avoid this configuration while maintaining the position and / or orientation of the distal portion of the arm (or an item supported by the arm, such as a cannula or surgical tool 134). For example, in response to physiological movements of patient 102, such as the patient's breathing or similar actions, in response to repositioning of patient 102, such as by reorienting the operating table, or similarly, the rotary joint of the remotely controlled arm 106 may be driven from a downwardly oriented apex configuration to an upwardly oriented apex configuration to reduce collisions with adjacent arms, equipment, or personnel, and to increase the range of motion of the distal portion of the remotely controlled arm 106 (or items supported by the remotely controlled arm 106, such as a cannula or surgical tool 134).

[0189] In some cases, manual repositioning of base 108 occurs before the surgery is performed. However, manual repositioning of base 108 may also occur during the surgery. Operator 112 may manually reposition base 108 multiple times during the procedure.

[0190] Figures 6O and 6P show that a second manual repositioning may occur due to a new obstacle 612 entering the vicinity of the base 108 of the surgical manipulator assembly 104, but other or additional parameters may vary that may cause the processor 302 to determine that a second manual repositioning may be beneficial in some implementations. In some implementations, different surgical tools may result in different workspace requirements. As a result, if one surgical tool is “switched” with another surgical tool during surgery (e.g., a surgical tool removed from the arm and a different surgical tool attached to the arm), the processor 302 can detect that the surgical tool has been switched and calculate a new optimal base location envelope. If, after the surgical tool has been switched, the base is not within the new optimal base location envelope for the different surgical tool to which it is currently attached, the processor 302 may instruct a second manual repositioning in light of the different surgical tool.

[0191] In some cases, the remotely controlled arm 106 may be subjected to surgical external forces that shift the base 108 from its position. The posture sensor 308 can detect joint movements of joints 142a-142c and 148a-148g caused by the external force, or it can detect movement of the base 108 caused by the external force. Due to the movement of components of the surgical manipulator assembly 104, the processor 302 may determine that the base 108 may need to undergo a second manual repositioning so that it can be repositioned within the optimal base position envelope 110.

[0192] In some cases, the surgical tool 134 may be moved from one access port to another during surgery. When the surgical tool 134 is moved to a new access port, the processor 302 may instruct a second manual repositioning of the base 108. Since the new access port may be located in a different area of ​​the patient 102, the range of workspace required for the surgical tool to perform the surgical procedure may also change. Therefore, after positioning the surgical tool 134 at the new access port, the operator 112 may demonstrate the new range of workspace. Using these changes in both the access port location (e.g., port data 514) and the range of workspace (e.g., procedure data 504), the processor 302 may calculate new values ​​for the current posture index of the remotely controlled arm 106 and, in light of these new index values, may instruct a second manual repositioning.

[0193] Although demonstration of the workspace is described herein as including the physical movement of the surgical tool 134 through the workspace, in some examples the operator 112 can demonstrate the workspace without physically moving the surgical tool 134. For example, the operator 112 may graphically display the extent of the workspace on a display. The operator can determine the extent of the workspace using a computing device having a touchscreen display. By manipulating the touchscreen display, the operator can depict the extent of the workspace. The computing device can send an input indicating the extent of the workspace to the processor 302. In some examples the operator can use a physical tool that can be detected by a sensor on the surgical manipulator assembly 104. The physical tool may be a hand device or pointing device that can define the boundaries of the workspace. The sensor may, for example, optically detect the position of the physical tool and then generate a signal for the processor 302, which then determines the extent of the workspace based on the sensor signal.

[0194] While the processor 302 is described as inducing manual repositioning of the base 108, in some examples the processor 302 may inducing manual repositioning of other parts of the surgical system 100. In some examples the processor 302 may inducing manual repositioning of the cart 111 toward the optimal cart location envelope. Other parts of the surgical system 100 may add additional degrees of freedom that can be used to optimize a larger number of goals or indicators. For example, if the operating table 123 is movable across the floor surface 20, the positioning indicator system 304 may include positioning indicators that indicate the direction in which the operating table 123 should be moved to achieve one or more goals of the optimization strategy. The positioning indicator system 304 may include positioning indicators for the base 108 of the surgical manipulator assembly 104 and positioning indicators for the operating table 123. The base 108 may include a braking mechanism that is activated when the operating table 123 is being manually repositioned. The operating table 123 may include a braking mechanism that is activated when the base 108 is being manually repositioned. In addition, during manual repositioning of the operating table 123, at least one of the powered joints of the remotely controllable arm 106 can be activated to maintain the position and / or orientation of the distal portion of the arm (or an item supported by the arm 134, such as a cannula or surgical tool 134). The position and / or orientation may be maintained relative to a suitable reference point, such as a reference point 162.

[0195] In some examples, if the remotely controlled arm 106 includes passive joints, each of the passive joints may include a positioning indicator. The processor 302 can control the manual repositioning of each of the passive joints. A braking mechanism may prevent movement of the base 108 during manual repositioning of the passive joints. If other passive joints are present, each of the other passive joints may also include a braking mechanism to prevent movement of the other passive joints during manual repositioning of the passive joint. The processor can control the active joints of the remotely controlled arm 106 to maintain the position and / or orientation of the distal portion of the arm (or an item supported by the arm, such as a cannula or surgical tool 134) relative to a reference point such as a reference point 162 during manual repositioning of the passive joints.

[0196] While the remotely controlled arm 106 is described as being attached to the cart 111, in some embodiments the remotely controlled arm may be attached to a stationary or movable table. Referring to the example depicted in Figure 8A, the wheeled robotic table system 800A includes a table base 802A. The remotely controlled arm 804A includes an arm base 806A that is movablely attached to the table base 802A. For example, the arm base 806A is attached to the table base 802A by a prism joint 808A that allows the arm base 806A to translate along the table base 802A. In some embodiments the arm base 806A is attached to the table base 802A by a rotary joint that allows the arm base 806A to rotate around the table base 802A. In other examples, various remotely controlled arms (e.g., arm 804A) are designed to be attached to different parts of the table system (e.g., table system 800A). Exemplary mounting components include the base of the table system, the surface of the table system, and one or more rails adjacent to the table surface (if such rails exist). In some implementations, the arm base 806A may be detachably attached to the table base 802A and removed when not in use during surgery. In some implementations, the arm 804A is folded under the table surface when not in use during surgery.

[0197] In the example shown in Figure 8A, the table surface 810A is positioned on the table base 802A and is movable relative to the table base 802A. For example, the table surface 810A may be pivoted or rotated relative to the table base 802A. In other examples, the table surface 810A may be stationary relative to the table base 802A.

[0198] Before surgery is performed, the operator may manually reposition the table surface 810A relative to the table base 802A. The operator may also manually reposition the arm base 806A relative to the table base 802A. In this regard, the processor may instruct a first manual repositioning for the table surface 810A using a first indicator 814A, and a second manual repositioning for the arm base 806A using a second indicator 816A. The processor can determine the optimal combination of table surface location and optimal arm base location based on the indicators described herein. Between each of the two instances of manual repositioning, the processor may control the joint of arm 804A so that the position and / or orientation of the distal portion of arm 804A (or an item supported by the arm, such as a cannula or surgical tool 812A) is maintained relative to a reference (e.g., a reference system, one or more reference directions, a reference point, etc.).

[0199] The table system 800A shown in Figure 8A includes multiple wheels that allow the table system 800A to be repositioned relative to a separately movable surgical manipulator assembly (e.g., surgical manipulator assembly 104) or to be moved around the surgical area or from room to room.

[0200] Figure 8B is a perspective view of another exemplary controllable arm that may be mounted on a stationary or movable table. A wheeled table 850B includes a table base 802B. A table surface 810B is positioned on the table base 802B. The table surface 810B can be used to support a workpiece, such as a patient 820B, a corpse, a body part, or a non-human workpiece. In the example shown in Figure 8B, two remotely controllable arms 804B, 80C include arm bases 806B, 806C that may be detachably mounted at a number of different locations along a table rail 818B.

[0201] During operation, the controllable arms 804B, 804C are driven to move the tools 834B, 834C within the associated workspace. In some embodiments, the controllable arms 804B, 804C are remotely operated and include remotely operated powered joints that, when driven, reposition and reorient the tools 834B, 834C relative to the workspace. In some embodiments, the controllable arms 804B, 804C may also be directly actuated through inputs applied directly to the links or joints of the controllable arms 804B, 804C, similar to other remotely controllable arms described herein, thereby enabling direct operator operation of the controllable arms 804B, 804C.

[0202] Similar to the robotic table system 800A, before surgery is performed, the operator may manually reposition the table surface 810B relative to the table base 802B. The operator may also manually reposition the arm bases 806B, 806C relative to the table rail 818B, or move one or more of the arms 804B, 804C to other table rails (not shown) on the other side (both sides) of the table. In this regard, the processor may activate a positioning indicator system (similar to, for example, positioning indicator system 304) to instruct manual repositioning using indicators for the arms 804B, 804C. Referring to, for example, Figure 8C, the positioning indicator system may include first indicator lights 836B, 836C similar to the indicator light 200 described herein. The first indicator lights 836B, 836C are positioned on or near the passive joints 807B, 807C that connect the arm bases 806B, 806C to the table rail 818B. The first indicator lights 836B, 836C are activated to indicate the direction in which the passive joints 807B, 807C (and thereby the arm bases 806B, 806C) should be moved in order to optimize the position of the arm bases 806B, 806C relative to the tools 834B, 834C. In some implementations, the passive joints 807B, 807C correspond to the arm bases 806B, 806C, rather than including separate passive joints 807B, 807C from the arm bases 806B, 806C.

[0203] During manual repositioning of arm bases 806B, 806C, the arm bases 806B, 806C are moved together with passive joints 807B, 807C, and thus move along the table rail 818B. Since the movement of each passive joint 807B, 807C is limited to movement along the table rail 818B, the direction indicated by indicator lights 836B, 836C for each passive joint 807B, 807C can be selected from two directions: one toward one end of the table rail 818B or the other end of the table rail 818B. In such cases, during manual repositioning, the operator is guided to move the arm bases 806B, 806C and passive joints 807B, 807C along the table rail 818B relative to the table surface 810B according to the indication provided by the first indicator lights 836B, 836C. As described herein, the position and / or orientation of the distal portion of the tool 834B, 834C or arm 804B, 804C is maintained during manual repositioning. Alternatively or additionally, the positioning indicator system may include second indicator lights 838B, 838C that project light toward the table surface 810B or toward the workpiece (e.g., patient 820B) to further indicate the direction in which the arm base 806B, 806C should move.

[0204] In some implementations, the arm bases 806B, 806C are movable relative to the tools 834B, 834C in a manner other than sliding along the table rail 818B. Manual repositioning of the passive joints 807B, 807C using the arm bases 806B, 806C corresponds to a first manual repositioning, and in a second manual repositioning, the arm bases 806B, 806C are further repositioned relative to the passive joints 807B, 807C. For example, links 812B, 812C connected to the arm bases 806B, 806C can be movable relative to the passive joints 807B, 807C in insertion or roll motion, thereby causing relative translation or reorientation of the arm bases 806B, 806C and the tools 834B, 834C. The first indicator lights 836B, 836C or the second indicator lights 838B, 838C can be activated to provide an indication that guides a second manual repositioning of the arm bases 806B, 806C (and therefore, the links 812B, 812C). As described herein, the position and / or orientation of the distal portion of the tool 834B, 834C or the arm 804B, 804C is maintained during the second manual repositioning.

[0205] Obstacle data 510 is described as indicating the location of obstacles in the workspace. Obstacles are described as including equipment in the workspace, but other obstacles are also possible. In some implementations, obstacle data 510 includes data indicating obstacles, including any expected location of the operator in the surgical environment 10, an uneven floor surface, or other obstacles in the workspace that may obstruct the movement of the base 108 or the remotely controlled arm 106. In some implementations, returning to Figure 8B, obstacle data 510 includes data indicating the locations of both ends of the table rail 818B relative to the locations of the arm bases 806B, 806C. The processor instructs manual repositioning based on the locations of both ends of the table rail 818B to avoid instructing the operator to move the arm bases 806B, 806C beyond the permissible range of motion along the table rail 818B. The passive joints 807B and 807C are configured to lock onto the table rail 818B in order to support the arm bases 806B and 806C, and therefore the arms 804 and 804C, above the table surface 810B. Thus, both ends of the table rail 818B limit the range of motion of the passive joints 807B and 807C, and therefore the arm bases 806B and 806C. The processor can instruct the operator to manually reposition the arm bases 806B and 806C to prevent the operator from being led to move the passive joints 807B and 807C beyond their allowable range of motion.

[0206] Returning to the example shown in Figure 2 and related figures, the wheel 136 is a powered wheel that, in some implementations, can be controlled by the processor 302 to move the base 108 around on the floor surface 20. The wheel 136 may include a drive mechanism that allows the processor 302 to control the orientation of the wheel 136 to facilitate or suppress repositioning. For example, the processor 302 can control the orientation of the wheel 136 so that it rolls along the repositioning direction and not along the non-repositioning direction. Thus, since the processor 302 can control the wheel 136, movement of the base 108 in directions other than the repositioning direction is suppressed.

[0207] The wheel 136 may include an actuator so that during manual repositioning, the processor 302 can activate an actuator that drives the powered wheel to assist the operator 112 in moving the base 108. In some embodiments, the wheel 136 may include a steering system so that when the operator pushes the base 108, the processor 302 can orient the wheel so that it preferentially moves the cart 111 toward an optimal repositioning region. Referring to Figure 2, in some embodiments, the surgical manipulator assembly 104 may include a handle 161 that the operator 112 can push or pull to move the base 108. The handle 161 may include a sensor that detects the displacement of the handle 161. In response to the displacement of the handle 161 resulting from the operator 112 pushing or pulling the handle 161, the processor 302 can activate an actuator that drives the powered wheel to assist the operator during manual repositioning of the base 108. The operator moves the powered wheel in a certain direction by, for example, operating a drive button, joystick, deadman switch, or other appropriate user input device. According to the process described herein, the processor 302 can guide the operator 112 by controlling the positioning indicator system when the operator performs manual repositioning using the input device.

[0208] In some cases, the processor 302 can move the cart 131, and therefore the base, within the surgical environment 10 simply by activating the actuator of the wheel 136 to drive the cart 111 toward the optimal base location envelope 110. A positioning indicator system can visually display the optimal base location envelope 110 toward which the base 108 is moved. The operator can provide the processor with confirmation that the visually displayed optimal base location envelope is appropriate. Alternatively or additionally, one or more joints of the surgical manipulator assembly 104 are powered, and the processor controls the wheel and / or one or more joints to move the surgical manipulator assembly 104 and its components toward the optimal orientation. In some cases, the processor activates the actuator of the wheel 136 and / or the actuator of one or more joints in response to the operator manually operating a switch. Once the switch is activated, the processor stops the operation of the actuators, thereby stopping further automatic movement of the wheel and / or one or more joints.

[0209] In some implementations, the positioning indicator system may additionally indicate the path to which the base 108 should be moved. For example, if the base 108 is manually repositioned by the operator 112, the positioning indicator system can provide a visual representation of the path along the floor that moves the base 108 into the optimal base location envelope 110. If the wheel is powered, the positioning indicator system can provide a visual representation of the optimal base location envelope 110 along with the path to which the base 108 moves to reach the envelope. The operator 112 can then provide confirmation of this visual representation, allowing the processor to control the wheel so that it moves along the path to the optimal base location envelope.

[0210] As described herein, remotely controllable arms 106 and 804A, 804B, and 804C are examples of the types of robotic manipulator arm assemblies envisioned within the scope of this disclosure. Figures 9A–9C depict bottom, side, and rear views of other examples of robotic manipulator arm assemblies 904 (also referred to as manipulator arms 904 or, since they may be configured to be remotely controllable, also as remotely controllable arms 904). In some embodiments, the remotely controllable arms 904 are coupled to surgical tools 906 (also referred to as "surgical instruments 906") to influence the movement of the surgical instruments 906 relative to the base 902. Since a number of different surgical instruments with different end effectors may be sequentially attached to each remotely controllable arm 904 during a surgical procedure (typically with the help of a surgical assistant), it is preferable that the instrument holder 920 allows for the rapid removal and replacement of the attached surgical instruments 906.

[0211] An exemplary remotely controllable arm 904 is attached to the base 902 by a pivot mounting joint 922, which allows the remainder of the remotely controllable arm 904 to rotate about a first joint axis J1, the first joint 922 providing rotation about a vertical axis in an exemplary implementation. The base 902 and the first joint 922 generally include the proximal portion of the remotely controllable arm 904, and the manipulator extends distally from the base toward the instrument holder 920 and end effector 950.

[0212] Describing the individual links of the controllable arm 904 as illustrated in Figures 9A-9C, along with the axes of rotation of the joints connecting the links as illustrated in Figure 9D, the first link 924 extends distally from the base 902 and rotates at joint 922 about the first pivot joint axis J1. Many of the remainder of the joints can be identified by their associated axes of rotation in Figure 9D. For example, the distal end of the first link 924 is connected to the proximal end of the second link 926 at a joint providing a horizontal pivot axis J2. The proximal end of the third link 928 is connected to the distal end of the second link 926 at a roll joint, so the third link 928 rotates or rolls at joint J3 about an axis that generally extends (ideally aligned) along the axes of both the second and third links. Further distally, after the other pivot joint J4, the distal end of the fourth link 930 is connected to the instrument holder 920 by a pair of pivot joints J5, J6 that together define the instrument holder list 932. A translational or prism joint J7 of the remotely controllable arm 904 facilitates the axial movement of the instrument 906 and its elongated shaft 914 through the minimally invasive opening, and also facilitates the attachment of the instrument holder 920 to the cannula into which the instrument 906 is slidably inserted.

[0213] Distal to the instrument holder 920, the surgical instrument 906 may include additional degrees of freedom. The operation of the degrees of freedom of the surgical instrument 906 is often driven by a motor of a remotely controlled arm 904. In an alternative implementation, the surgical instrument 906 can be separated from the supporting manipulator arm structure by a quickly detachable instrument holder / instrument interface, so that one or more joints shown herein as being on the surgical instrument 906 are instead on the interface, or vice versa. In other words, the interface between the surgical instrument 906 and the remotely controlled arm 904 may be located more proximal or distal to the kinetic chain of the manipulator arm assembly 904 (which may include both the surgical instrument and the manipulator arm assembly 904). In an exemplary implementation, the surgical instrument 906 includes a rotational joint J8 proximal to a pivot point PP, which is typically located at the site of a minimally invasive opening. The distal list of the surgical instrument 906 allows for the pivotal movement of the end effector 950 about the instrument list joint axes J9, J10. The angle α between the end effector jaw elements may be controlled independently of the location and orientation of the end effector 950. In some implementations, a positioning indicator system emitting a signal, e.g., an audible signal, a tactile signal, a visual signal, or other appropriate user-perceptible signal, guides manual repositioning of the joints of the remotely controlled arm 904 and / or base 902. In some cases, the remotely controlled arm 904 includes multiple positioning indicator systems, each positioning indicator system associated with a specific joint of the remotely controlled arm 904 or base 902.

[0214] In another example, referring to Figure 10, a controllable arm 1000, which may be remotely controllable, includes a base 1002 connected to a joint system 1004. A link 1012 connects joint system 1004 to joint system 1014, and a link 1020 connects joint system 1014 to joint system 1022. In some implementations, a joint 1006 rotates a portion of the remotely controllable arm 1000 that is distal to the base 1002 in rotation relative to the base 1002, for example, about the y-axis. In some implementations, a joint 1028 translates an instrument holder 1030 relative to joint system 1022, for example, along the y-axis. Each joint and joint system is selectively operable to cause, for example, relative movement between portions of the remotely controllable arm 1000, e.g., translation and / or rotation between portions of the remotely controllable arm 1000.

[0215] The joint system 1004 is operable to cause relative rotation between link 1012 and the joint system 1004. The joint system 1004 includes, for example, a first rotatable joint 1008 and a second rotatable joint 1010. When the first joint 1008 is driven, it causes relative rotation between the first joint 1008 and the second joint 1010, for example, about the x-axis. When the second joint 1010 is driven, it causes relative rotation between link 1012 and the second joint 1010, for example, about the z-axis. The joint system 1014 is operable to cause relative rotation between link 1020 and the joint system 1014. The joint system 1014 includes, for example, a first joint 1016 and a second joint 1018. The first joint 1016, when driven, causes a relative rotation between the first joint 1016 and the second joint 1018, for example, about the x-axis. The second joint 1018, when driven, causes a relative rotation between the second joint 1018 and the link 1020. The joint system 1022 is operable to cause a relative rotation between the instrument holder 1030 and the joint system 1022. The joint system 1022 includes, for example, a first joint 1024 and a second joint 1026. The first joint 1024, when driven, causes a relative rotation between the first joint 1024 and the second joint 1026, for example, about the x-axis. The second joint 1026, when driven, causes a relative rotation between the second joint 1026 and the instrument holder 1030, for example, about the y-axis.

[0216] In some implementations, a positioning indicator system emitting signals, such as audible, tactile, visual, or other appropriate user-perceptible signals, guides the manual repositioning of the base, joint system, and / or joints of the remotely controlled arm 1000. In some cases, the remotely controlled arm 1000 includes multiple positioning indicator systems, each positioning indicator system associated with a specific joint, joint system, or base of the remotely controlled arm 1000.

[0217] Remotely controllable arms 106, 804A, 804B, 804C, 904, and 1000 are examples of remotely controllable arms. In some embodiments, the remotely controllable arm includes combinations of joints in the examples of remotely controllable arms described herein. In this regard, in some embodiments, the remotely controllable arm includes combinations of prism joints, rotary joints, and joint systems other than those shown for remotely controllable arms 106, 804A, 804B, 804C, 904, and 1000.

[0218] The surgical systems described herein (e.g., surgical system 100) and the robotic components of the surgical system (e.g., remotely controllable arm 106, surgical manipulator assembly 104) can be controlled at least in part by using one or more computer programs (computer program products), for example, one or more data processing devices, e.g., programmable processors, computers, multiple computers, and / or programmable logic components, which are tangibly embodied in one or more information carriers, such as one or more non-temporary machine-readable media, for execution or control thereof.

[0219] Computer programs can be written in any form of programming language, including compiled languages ​​or interpreted languages, and computer programs can be deployed in any form, including standalone programs, or modules, components, subroutines, or other units suitable for use in a computing environment.

[0220] The operations associated with the control of the surgical system described herein can be performed by one or more programmable processors that execute one or more computer programs that perform the functions described herein. Control of all or part of the surgical system described herein can be performed using special-purpose logic circuits, such as FPGAs (field-programmable gate arrays) and / or ASICs (application-specific integrated circuits).

[0221] Processors suitable for executing computer programs include, as an example, both general-purpose and special-purpose microprocessors, and any one or more processors in any type of digital computer. Generally, a processor receives instructions and data from read-only storage, random-access storage, or both. The elements of a computer include one or more processors that execute instructions, and one or more storage devices that store instructions and data. Generally, a computer includes receiving data from one or more machine-readable storage media, such as a large-capacity PCB for storing data, e.g., magnetic disks, magneto-optical disks, or optical disks, transmitting data to them, receiving data from them and transmitting data to them, or being operationally linked to receiving data from them, transmitting data to them, receiving data from them and transmitting data to them. Machine-readable storage media suitable for embodying computer program instructions and data include, as an example, semiconductor storage devices, e.g., EPROM, EEPROM, and flash storage devices, magnetic disks, e.g., internal hard disks or removable disks, magneto-optical disks, and all forms of non-volatile storage, including CD-ROM and DVD-ROM disks.

[0222] Different implementation elements described herein may be combined to form other embodiments not specifically described above. Elements may be removed from the structures described herein without adversely affecting their operation. Furthermore, various separate elements may be incorporated into one or more individual elements to perform the functions described herein.

Claims

1. Bass and, A robotic arm extending from the base and configured to support and move a tool, comprising one or more actuators operable to move the robotic arm relative to the base, Positioning indicator, A processor that is communicatively coupled to the positioning indicator and the robot arm, It is a robotic system, The aforementioned processor, The system receives input data, which describes at least the characteristics of an access port into which the tool can be inserted, and further indicates information about the procedure to be performed on a subject using the robotic system. Using the information regarding the characteristics of the access port and the treatment, the desired position or orientation of the base is determined. The positioning indicator is activated to direct the manual repositioning of the base to the desired position or orientation of the base, and After the base has reached the desired position or orientation, one or more actuators are activated to move the robot arm relative to the base in response to operator input to move the robot arm to perform the action. It is configured in such a way. Robot system.

2. The base is connected to a table in which the subject is positioned during the procedure, or The base is connected to a cart configured to roll on the floor. The robot system according to claim 1.

3. The robotic system according to claim 1 or 2, wherein the information relating to the procedure includes the extent of the workspace for the procedure, and the extent of the workspace is the range of movement for the tool, defined by the boundary of the workspace or input by the operator.

4. The system further includes a sensor configured to sense the movement of the robot arm, Receiving the input data includes receiving signals from the sensor during a manual demonstration using the robot arm, the manual demonstration being performed to demonstrate the extent of the workspace for the procedure. The robot system according to claim 3.

5. The robot system according to any one of claims 1 to 4, wherein the characteristics of the access port include the location of the access port.

6. The access port is a first access port, the desired position or orientation of the base is a first desired position or orientation of the base, and the manual repositioning of the base is a first manual repositioning of the base. The aforementioned processor, Receiving second input data that indicates at least second characteristics of the second access port, Using the information regarding the second characteristic and the treatment, a second desired position or orientation of the base is determined, and The positioning indicator is activated to direct the second manual repositioning of the base toward the second desired position or orientation. It is further constructed in such a way. The robot system according to any one of claims 1 to 5.

7. The robotic arm includes a powered joint configured to move the tool when the tool is supported by the robotic arm, The aforementioned processor, When the tool is supported by the robot arm, the processor activates the powered joint while activating the positioning indicator to direct the manual repositioning. It is further constructed in such a way. The robot system according to any one of claims 1 to 6.

8. The aforementioned processor, Activating the powered joint in response to the movement of the base during the manual repositioning of the base, or To operate the powered joint to move the robot arm relative to the base in order to maintain the position of the distal portion of the robot arm relative to the access port during the manual repositioning. by The processor is configured to actuate the powered joint while activating the positioning indicator to direct the manual repositioning, The robot system according to claim 7.

9. A method for operating a robotic system including a robotic arm extending from a base, wherein the robotic arm is configured to support and move a tool. This method is The processor receives input data which includes port data indicating at least the characteristics of an access port into which the tool can be inserted, and further includes treatment data indicating information about a procedure to be performed on a subject using the robotic system. The processor determines a desired position or orientation of the base using the characteristics of the access port and the processing data, The processor activates a positioning indicator to direct the manual repositioning of the base of the robot system to the desired position or orientation of the base, The process includes, after the base has reached the desired position or orientation, the processor acting on one or more actuators of the robot arm to move the robot arm relative to the base in response to operator input to move the robot arm, method.

10. The aforementioned treatment data indicates the scope of the work space for the treatment. The port data includes the location of the access port. The method according to claim 9.

11. The robotic arm includes a powered joint configured to move the tool when the tool is supported by the robotic arm, This method is When the tool is supported by the robot arm, the processor further includes acting on the powered joint to move the robot arm relative to the base in order to maintain the position of the distal portion of the robot arm relative to the access port during manual repositioning, The method according to claim 9 or 10.

12. A non-temporary machine-readable medium containing multiple machine-readable instructions, When the plurality of machine-readable instructions are executed by one or more processors associated with a robot system, which includes a robotic arm extending from a base, the robotic arm being configured to support and move a tool, the plurality of machine-readable instructions are transmitted to the one or more processors in the following manner, i.e., Receiving input data, which describes at least the characteristics of the access port into which the tool can be inserted, and further indicates information about the procedure to be performed on the subject using the robotic system, Using the information regarding the characteristics of the access port and the treatment, the desired position or orientation of the base is determined. Activating a positioning indicator to direct the manual repositioning of the base of the robot system to the desired position or orientation of the base, After the base has reached the desired position or orientation, the robot arm is activated to move one or more actuators of the robot arm relative to the base in response to operator input to move the robot arm, in order to perform the action. The method is configured to be implemented. A non-temporary machine-readable medium.

13. The robotic arm includes a powered joint configured to move the tool when the tool is supported by the robotic arm, The method further includes, when the tool is supported by the robot arm, acting on the powered joint to move the robot arm relative to the base in order to maintain the position of the distal portion of the robot arm relative to the access port during the manual repositioning, The non-temporary machine-readable medium according to claim 12.

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