Instrument shaft tension adjustment system and method

Abstract

Systems, devices, and methods for assessing and / or removing slack in an elongate shaft of a medical instrument are described herein. For example, an instrument feeder device can be configured to engage an elongate shaft to facilitate axial movement of the elongate shaft. An amount of slack between the instrument feeder device and an instrument handle of the medical instrument can be determined. Further, slack in the elongate shaft can be removed by moving the instrument handle away from the instrument feeder device and / or controlling the instrument feeder device to insert the elongate shaft.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims priority to U.S. Provisional Patent Application No. 63 / 150,533, titled "INSTRUMENT SHAFT TENSIONING SYSTEM AND METHOD," filed on February 17, 2021, and U.S. Provisional Patent Application No. 63 / 150,527, titled "ENGAGEMENT CONTROL OF INSTRUMENT FEEDER DEVICES," filed on February 17, 2021, the disclosures of which are hereby incorporated by reference in their entirety.

[0002] (Field of the Invention) This disclosure relates to the fields of medical treatment and medical devices.

Background Art

[0003] Various medical procedures involve the use of one or more medical devices to access a target anatomical site within a patient. In some instances, inappropriate use of a particular device when accessing the site in relation to the procedure can potentially have an adverse effect on the patient's health, the integrity of the medical device(s), and / or the effectiveness of the procedure.

Summary of the Invention

Means for Solving the Problems

[0004] In some implementations, this disclosure relates to a system comprising a first robotic arm configured to couple to an elongate shaft of a medical instrument, a second robotic arm configured to couple to an instrument base of the medical instrument, and a control circuit. The first robotic arm includes a drive output configured to control the axial movement of the elongate shaft. The control circuit is configured to operate at least one of the drive output or the second robotic arm and, based at least in part on the operation, determine an amount of slack in the elongate shaft between the first robotic arm and the second robotic arm.

[0005] In some embodiments, the control circuit is further configured to determine at least one of a first force associated with a drive output unit or a second force associated with a second robot arm, and to determine that at least one of the first force or the second force is greater than a threshold. The amount of slack in the elongated shaft can be determined at least in part on the determination that at least one of the first force or the second force is greater than a threshold. The amount of slack in the elongated shaft may be less than a predetermined amount.

[0006] In some embodiments, the control circuit is configured to actuate a second robotic arm. The actuatement of the second robotic arm can be directed away from the first robotic arm.

[0007] In some embodiments, the control circuit is configured to operate the drive output unit while allowing the second robot arm to operate below a threshold amount.

[0008] In some embodiments, the control circuit is further configured to receive an input signal indicating the insertion of an elongated shaft. The control circuit may be configured to activate a drive output unit in response to the reception of the input signal. The activation of the drive output unit can actuate the insertion of the elongated shaft.

[0009] In some embodiments, the first robot arm is configured to be coupled to an instrument feeder device. The instrument feeder device may be configured to implement an engaged state in which the instrument feeder device is engaged with an elongated shaft, and an unengaged state in which the instrument feeder device is disengaged from the elongated shaft.

[0010] In some embodiments, the control circuit may be further configured to determine whether to transition the instrument feeder device from an engaged state to a disengaged state. The control circuit may be configured to actuate a second robotic arm in response to the decision to transition the instrument feeder device from an engaged state to a disengaged state. The actuatement of the second robotic arm may cause the second robotic arm to move away from the first robotic arm.

[0011] In some embodiments, the control circuit is further configured to determine that the amount of slack in the elongated shaft is less than a predetermined amount, and to act in cooperation with the drive output unit and the second robot arm to move the elongated shaft in the axial direction, at least in part based on the determination that the amount of slack in the elongated shaft is less than a predetermined amount.

[0012] In some embodiments, the first robot arm is configured to be coupled to an instrument feeder device. The control circuit may be further configured to cause the instrument feeder device to apply force to an elongated shaft to prevent axial movement of a portion of the elongated shaft positioned within the instrument feeder device. The control circuit may be configured to actuate a second robot arm. The actuatement of the second robot arm can be directed away from the first robot arm.

[0013] In some implementations, the present disclosure relates to a method comprising a control circuit acting on at least one of a drive output unit of a first robotic arm or a second robotic arm. The first robot is coupled to an elongated shaft of a medical device, and the second robotic arm is coupled to the base of the medical device. The drive output unit is configured to control the axial motion of the elongated shaft. The method further includes, at least in part, the control circuit determining the amount of slack in the elongated shaft between the first robotic arm and the second robotic arm based on the actuation.

[0014] In some embodiments, the method further includes determining at least one of a first force applied by a drive output unit or a second force applied by a second robot arm. Determining the amount of slack in the elongated shaft can be based on at least one of the first force or the second force.

[0015] In some embodiments, activation includes moving the second robot arm away from the first robot arm. Furthermore, in some embodiments, activation includes activating the drive output unit while preventing the second robot arm from moving beyond a threshold amount.

[0016] In some embodiments, the method further includes receiving an input signal indicating the insertion of an elongated shaft. Activation may include activating a drive output unit in response to the reception of the input signal. Activation of the drive output unit can cause the insertion of the elongated shaft.

[0017] In some embodiments, the method further includes deciding to transition an instrument feeder device configured to engage with an elongated shaft from an engaged state to a disengaged state. Actuating may include acting a second robot arm away from the first robot arm in response to the decision to transition the instrument feeder device from an engaged state to a disengaged state.

[0018] In some embodiments, the method further includes determining that the amount of slack in the elongated shaft is less than a predetermined amount, and, at least in part based on determining that the amount of slack in the elongated shaft is less than a predetermined amount, causing the drive output unit and the second robot arm to cooperate in moving the elongated shaft in the axial direction.

[0019] In some embodiments, the method further includes applying force to an elongated shaft to prevent it from retracting away from the patient. Actuating may include moving a second robotic arm away from the first robotic arm.

[0020] In some implementations, the present disclosure relates to a system comprising an instrument feeder device configured to move an elongated shaft of a medical instrument in the axial direction, and a control circuit. The medical instrument includes an instrument handle. The control circuit is configured to determine the amount of slack in the elongated shaft between the instrument handle and the instrument feeder device, and to control the instrument feeder device at least in part on the amount of slack in the elongated shaft.

[0021] In some embodiments, the control circuit is further configured to determine at least one of a first force applied by a drive output unit to control the instrument feeder device, or a second force applied by a second robotic arm. The amount of slack in the elongated shaft can be determined based on at least one of the first or second force.

[0022] In some embodiments, the control circuit is configured to control the instrument feeder device by causing the instrument feeder device to perform at least one of the following actions: move the elongated shaft axially, disengage from the elongated shaft, or maintain engagement with the elongated shaft.

[0023] In some embodiments, the control circuit is configured to determine the amount of slack in the elongated shaft based on at least one of a first force applied to an instrument feeder device, a second force applied by a robotic arm coupled to an instrument handle, shape sensing data indicating the shape of the elongated shaft, or position sensor data indicating the position of at least a portion of the elongated shaft.

[0024] In some embodiments, the control circuit is further configured to operate the second robotic arm in a direction away from the first robotic arm. The second robotic arm may be coupled to the instrument handle. The amount of slack can be determined based at least in part on the operation of the second robotic arm.

[0025] In some embodiments, the control circuit is configured to operate the second robotic arm without controlling the instrument feeder device.

[0026] In some embodiments, the control circuit is further configured to determine that at least one of the second robotic arm has been operated beyond a threshold amount or has been operated to a workspace boundary, and to generate a signal indicating that at least one of the second robotic arm has been operated beyond a threshold amount or has been operated to a workspace boundary.

[0027] In some embodiments, the control circuit is further configured to determine that the amount of slack in the elongate shaft is less than a predetermined amount, and based at least in part on the determination that the amount of slack in the elongate shaft is less than a predetermined amount, to disengage the instrument feeder device from the elongate shaft.

[0028] In some embodiments, the control circuit causes the instrument feeder device to perform at least one of axially moving the elongate shaft in the insertion direction or moving the instrument handle in a direction away from the instrument feeder device, determines that the amount of slack in the elongate shaft is less than a predetermined amount, and based at least in part on the determination that the amount of slack in the elongate shaft is less than a predetermined amount, causes the instrument feeder device to perform at least one of axially moving the elongate shaft in the retraction direction or moving the instrument handle in a direction toward the instrument feeder device.

[0029] In some embodiments, the control circuit is further configured to cause the instrument feeder device to apply force to the elongated shaft to prevent axial movement of a portion of the elongated shaft positioned within the instrument feeder device, and to move the instrument handle in a direction away from the instrument feeder device. The amount of slack can be determined when moving the instrument handle.

[0030] In some implementations, the present disclosure relates to a system comprising an instrument feeder device and a control circuit. The instrument feeder device is configured to be coupled to a first robotic arm and to axially move an elongated shaft of a medical instrument. The medical instrument includes an instrument handle. The control circuit is configured to determine that there is substantially no slack between the elongated shaft and the instrument handle and the instrument feeder device, and to control the instrument feeder device based at least in part on there being substantially no slack between the elongated shaft and the instrument handle and the instrument feeder device.

[0031] In some embodiments, the control circuit is further configured to operate a second robotic arm in a direction away from the first robotic arm. The second robotic arm can be coupled to the instrument handle. The determination that there is substantially no slack in the elongated shaft can be based at least in part on the operation of the second robotic arm.

[0032] In some embodiments, the control circuit is further configured to operate a drive output portion of the first robotic arm to control the instrument feeder device while preventing movement of the instrument handle. The determination that there is substantially no slack in the elongated shaft can be based at least in part on the operation of the drive output portion.

[0033] In some embodiments, the control circuit is further configured to determine at least one of a first force applied by a drive output unit to control the instrument feeder device, or a second force applied by a second robotic arm coupled to the instrument handle. The determination that there is substantially no slack in the elongated shaft may be based on at least one of the first or second force.

[0034] In some embodiments, the control circuit is configured to control the instrument feeder device by causing the instrument feeder device to perform at least one of the following actions: move the elongated shaft axially in the insertion direction, or disengage from the elongated shaft.

[0035] In some embodiments, the control circuit is configured to determine that there is substantially no slack in the elongated shaft based on at least one of a first force applied to an instrument feeder device, a second force applied by a second robotic arm coupled to an instrument handle, shape sensing data indicating the shape of the elongated shaft, or position sensor data indicating the position of at least a portion of the elongated shaft.

[0036] In some embodiments, the control circuit is further configured to cause the instrument feeder device to apply force to an elongated shaft to prevent axial movement of a portion of the elongated shaft positioned within the instrument feeder device, and to actuate a second robotic arm away from the first robotic arm. The second robotic arm may be coupled to an instrument handle. The determination that there is substantially no slack in the elongated shaft can be based at least in part on the operation of the second robotic arm.

[0037] For the purpose of summarizing this disclosure, certain aspects, advantages, and features are described. It should be understood that not all such advantages can necessarily be realized by any particular embodiment. Therefore, the disclosed embodiments may realize or optimize one or more advantages or groups of advantages taught herein without necessarily realizing other advantages that may be taught or suggested herein. [Brief explanation of the drawing]

[0038] Various embodiments are shown in the accompanying drawings for illustrative purposes, but should not be construed as limiting the scope of this disclosure. In addition, various features of the different embodiments disclosed can be combined to form further embodiments that are part of this disclosure. Throughout the drawings, reference numbers may be reused to indicate correspondences between reference elements. [Figure 1] This document illustrates exemplary robotic medical systems, in one or more embodiments, that are deployed for diagnostic and / or therapeutic ureteroscopy procedures. [Figure 2] Figure 1 illustrates an exemplary robotic medical system, configured for diagnostic and / or therapeutic bronchoscopy procedures, according to one or more embodiments. [Figure 3] This paper illustrates a table-based robotic system configured to perform medical procedures, using one or more embodiments. [Figure 4] Examples of medical system components that may be implemented in any of the medical systems described herein, according to one or more embodiments, are illustrated below. [Figure 5] This document illustrates medical system components, including scope assemblies / systems and instrument feeder assemblies, which may be implemented in one or more embodiments of the medical systems described herein. [Figure 6A] Perspective views of exemplary instrument feeder devices according to one or more embodiments are illustrated. [Figure 6B]To illustrate various features of the instrument feeder device according to one or more embodiments, an instrument feeder device in which a portion of the housing has been removed is illustrated. [Figure 6C] An example is provided of an instrument feeder device in which a portion of the housing and / or holding mechanism(s) are removed, according to one or more embodiments. [Figure 6D] Perspective views illustrating exemplary actuator / roller assemblies that may be implemented in an instrument feeder device according to one or more embodiments are illustrated. [Figure 6E] To illustrate an exemplary gear assembly according to one or more embodiments, perspective views of a roller assembly with portions of the rollers and carrier plate removed are provided as illustrations. [Figure 6F] An example top view of an exemplary gear assembly according to one or more embodiments is illustrated. [Figure 6G] A bottom view of a roller assembly according to one or more embodiments is illustrated. [Figure 7] Exploded views illustrating exemplary instrument device manipulator assemblies associated with a robotic arm, according to one or more embodiments, are provided. [Figure 8-1] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are engaged and the cover is closed. [Figure 8-2] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are engaged and the cover is closed. [Figure 9-1] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are engaged with the instrument shaft and the cover is closed. [Figure 9-2] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are engaged with the instrument shaft and the cover is closed. [Figure 10-1] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are disengaged and the cover is closed. [Figure 10-2]One or more embodiments illustrate a state in which the rollers of an instrument feeder device are disengaged and the cover is closed. [Figure 11-1] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are disengaged and the cover is open. [Figure 11-2] One or more embodiments illustrate a state in which the rollers of an instrument feeder device are disengaged and the cover is open. [Figure 12] The following illustrates exemplary states of the engagement assembly when the instrument shaft is not disposed / loaded within the engagement assembly, according to one or more embodiments. [Figure 13] Exemplary states of engagement assemblies when the instrument shaft is disposed / loaded within the engagement assembly are illustrated according to one or more embodiments. [Figure 14] This illustrates an exemplary process for determining the state of the engagement assembly of an instrument feeder device, according to one or more embodiments. [Figure 15] This illustrates an exemplary process for determining whether the elongated shaft of a medical instrument is loaded / properly loaded into an instrument feeder device, according to one or more embodiments. [Figure 16-1] This document illustrates exemplary processes for determining and / or eliminating slack in the elongated shaft of a medical device, according to one or more embodiments. [Figure 16-2] This document illustrates exemplary processes for determining and / or eliminating slack in the elongated shaft of a medical device, according to one or more embodiments. [Figure 16-3] This document illustrates exemplary processes for determining and / or eliminating slack in the elongated shaft of a medical device, according to one or more embodiments. [Figure 17] This document illustrates exemplary processes for determining and / or eliminating slack in an elongated shaft of a medical instrument in the context of inserting an elongated shaft, according to one or more embodiments. [Figure 18-1]The following illustrates exemplary processes for determining and / or eliminating slack in the elongated shaft of a medical instrument, in connection with enabling an admittance control mode and / or rotating the elongated shaft, according to one or more embodiments. [Figure 18-2] The following illustrates exemplary processes for determining and / or eliminating slack in the elongated shaft of a medical instrument, in connection with enabling an admittance control mode and / or rotating the elongated shaft, according to one or more embodiments. [Modes for carrying out the invention]

[0039] While certain embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, and their modifications and equivalents. Therefore, the scope of this disclosure is not limited to any of the specific embodiments described below. For example, in any method or process disclosed herein, the actions or operations of the method or process may be performed in any preferred order and are not necessarily limited to any specific disclosed order. Various operations may be described sequentially as several distinct operations in a manner that may be helpful in understanding a particular embodiment, but the order of description should not be interpreted as meaning that these operations are sequential. In addition, structures, systems, and / or devices described herein may be embodied as integrated components or separate components. For the purpose of comparing various embodiments, certain aspects and advantages of these embodiments are described. Not all such aspects or advantages are necessarily realized by any particular embodiment. Therefore, for example, various embodiments can be implemented in a manner that realizes or optimizes one or more advantages or groups of advantages as taught herein, without necessarily realizing other embodiments or advantages that may also be taught or suggested herein.

[0040] Certain spatially relative terms, such as “outside,” “inside,” “upper,” “lower,” “below,” “downward,” “upper,” “vertical,” “horizontal,” “top,” “bottom,” and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure. However, these terms are used herein to simplify the description of the positional relationships between elements / structures, as illustrated in the drawings. It should be understood that spatially relative terms are intended to encompass different orientations of elements / structures in use or operation, in addition to the orientations shown in the drawings. For example, when an element / structure is described as being “above” another element / structure, it may mean that it is located below or beside such other element / structure with respect to the patient or an alternative orientation of the element / structure, and vice versa. It should be understood that spatially relative terms, including those listed above, can be understood in relation to each illustrated orientation in the referenced drawings.

[0041] For the convenience of devices, components, systems, features, and / or modules having similar characteristics in one or more respects, certain reference numerals are reused across different drawings in the set of drawings of this disclosure. However, with respect to any embodiment disclosed herein, the reuse of a common reference numeral in the drawings does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, those skilled in the art may be notified by the context to the extent that the use of a common reference numeral can imply similarity between the referenced subjects. The use of a particular reference numeral in the context of the description of a particular drawing can be understood as relating to an identified device, component, aspect, feature, module, or system in that particular drawing, and not necessarily relating to any device, component, aspect, feature, module, or system identified by the same reference numeral in another drawing. Furthermore, aspects of separate drawings identified by a common reference numeral can be interpreted as sharing characteristics or being completely independent of one another.

[0042] Certain aspects of this disclosure are described in detail herein in the context of renal, urinary, and / or nephrological procedures, such as the removal / treatment of kidney stones. However, such contexts are provided for convenience, and it should be understood that the concepts disclosed herein are applicable to any suitable medical procedure, such as bronchoscopy. Nevertheless, a description of the anatomical structure of the kidney / urinary tract and related medical issues and procedures is presented below to aid in explaining the concepts disclosed herein.

[0043] Kidney stones, also known as urolithiasis, are a medical condition involving the formation of solid fragments of a substance in the urinary tract, referred to as “kidney stones,” “urinary tract stones,” “kidney stones,” “urolithiasis,” or “urolithiasis.” Urinary tract stones may form and / or be found in the kidneys, ureters, and bladder (referred to as “bladder stones”). Such urinary tract stones may form as a result of the concentration of minerals in the urine, and when such stones grow large enough to obstruct the flow of urine through the ureters or urethra, they can cause significant abdominal pain. Urinary tract stones may form from calcium, magnesium, ammonia, uric acid, cystine, and / or other compounds, or combinations thereof.

[0044] Several approaches can be used to treat patients with kidney stones, including observation, medical treatment (such as elimination therapy), non-invasive treatment (such as extracorporeal shock wave lithotripsy, ESWL), and minimally invasive or surgical treatment (such as ureteroscopy and percutaneous nephrolithotomy, PCNL). In some approaches (e.g., ureteroscopy and PCNL), a physician accesses the stone, breaks it into smaller fragments or pieces, and uses a basket device and / or suction to remove the relatively small stone fragments / microparticles from the kidney.

[0045] In a ureteroscopy procedure, a physician may insert a ureteroscope through the urethra into the urinary tract to remove urinary tract stones from the bladder and ureters. Typically, the ureteroscope includes an imaging device at its distal end, configured to allow visualization of the urinary tract. The ureteroscope may also include a lithotomy device for capturing or crushing urinary tract stones. During a ureteroscopy procedure, one physician / technician may control the position of the ureteroscope, while another physician / technician may control the lithotomy device(s).

[0046] In PCNL procedures, which may be used to remove relatively large stones, a physician may insert a nephroscope through the skin (i.e., percutaneously) and through intervening tissue to provide access to the treatment site for fragmenting and / or removing the stone(s). During a PCNL procedure, fluid mechanics may be applied to clear dust, fragments, and / or thrombi from the treatment site and / or field of view. In some cases, a relatively straight and / or rigid nephroscope is used, and the physician positions the tip of the nephroscope in the appropriate location within the kidney (e.g., renal calyces) by pushing / leveraging the device against the patient's body. This movement can be harmful to the patient (e.g., causing tissue damage).

[0047] In some procedures described herein, robotic tools can be implemented to enable a physician to gain access to and / or treat a target anatomical site. For example, a medical system may be configured to engage with a medical instrument that includes an elongated shaft, such as a scope or another medical instrument. The medical system may be configured to control the medical instrument to perform a procedure such as removing kidney stones from a patient and / or treating a target site in other ways. The medical system may include one or more robotic arms configured to connect to the instrument base / handle of the medical instrument and / or to the elongated shaft of the medical instrument.

[0048] In some examples, medical systems implement instrument feeder devices to assist in performing a specific function. Instrument feeder devices can selectively engage with the elongated shaft of a medical instrument, control its movement, and / or support it in other ways. For example, an instrument feeder device can facilitate the axial movement of an elongated shaft (e.g., inserting / retracting the shaft), hold the shaft during rotation, or hold the shaft during manual movement by a robotic arm. For instance, an instrument feeder device may include one or more actuators configured to engage with the elongated shaft and move it axially during the driving of a medical instrument. Furthermore, an instrument feeder device may include a holding mechanism that still provides some degree of freedom of movement for the elongated shaft, such as rotating the elongated shaft within the device while holding it, or sliding the elongated shaft through the device. Often, instrument feeder devices can efficiently / rapidly control the movement of an elongated shaft, such as by inserting or retracting the shaft and / or providing buckling-resistant support for the elongated shaft.

[0049] Instrument feeder devices can generally be coupled to one robotic arm / component, and the instrument base of a medical instrument can generally be coupled to another robotic arm / component. In some examples, instrument feeder devices can be controlled in a manner that correlates with the movement of the instrument handle. For example, to insert a shaft, the instrument feeder device can cause axial movement of the shaft in the insertion direction, while the robotic arm coupled to the instrument handle moves toward the robotic arm coupled to the instrument feeder device in a manner that correlates with the velocity of the axial movement. Similarly, to retract a shaft, the instrument feeder device can cause axial movement of the elongated shaft in the retraction direction, while the robotic arm coupled to the instrument handle moves toward the robotic arm coupled to the instrument feeder device in a manner that correlates with the velocity of the axial movement.

[0050] This disclosure relates, in particular, to devices, systems, and methods for controlling an instrument feeder device to intelligently engage with and / or control a medical instrument. This can help a physician use an instrument feeder device and / or a medical instrument in different ways / scenarios. For example, a medical system may be configured to control an instrument feeder device to implement various configurations / states for using a medical instrument, such as loading a medical instrument into the instrument feeder device, controlling the movement of an elongated shaft of a medical instrument, or adjusting a device / component of the medical system. For example, a medical system may be able to open / disengage an instrument feeder device at an appropriate time so that a physician can load an elongated shaft into the instrument feeder device. Furthermore, a medical system may be able to engage an elongated shaft with an instrument feeder device at an appropriate time so that the medical system can drive / navigate the medical instrument, such as by inserting or retracting the elongated shaft. Furthermore, the medical system can disengage the instrument feeder device from the elongated shaft at the appropriate time and hold the elongated shaft in order to facilitate certain actions, such as rotating the elongated shaft or moving the robotic arm freely without resistance caused by the engagement between the elongated shaft and the instrument feeder device.

[0051] Furthermore, this disclosure relates to devices, systems, and methods for determining the state of an instrument feeder device and / or a medical instrument relative to the instrument feeder device. For example, a robotic arm may include a drive output unit configured to be coupled to an instrument feeder device and provide output to control engagement with an elongated shaft of a medical instrument. The medical system may determine the engagement state between the instrument feeder device and the elongated shaft and / or the state of the medical instrument based on and / or by means of the force applied by the drive output unit, the position of the drive output unit, sensors on the instrument feeder device, etc. The state of the instrument feeder device / medical instrument may indicate whether the medical instrument is loaded into the instrument feeder device / properly loaded, whether the instrument feeder device is engaged with the medical instrument, whether the instrument feeder device is configured to hold the medical instrument and allow degrees of freedom of movement of the medical instrument, etc. This may enable the medical system to verify / determine that the instrument feeder device is operating in the appropriate configuration / state and / or that the medical instrument is loaded at the appropriate time / properly loaded. For example, if the medical system determines that a medical device is properly loaded into the instrument feeder device, it can proceed with driving / navigating the medical device. Furthermore, if the medical system determines that the medical device is not loaded or not properly loaded (e.g., not positioned within the appropriate location for facilitating shaft drive), it can provide a notification / signal to inform the user / component of such a condition and / or wait to drive the medical device until the medical device is properly loaded.

[0052] Accordingly, in embodiments, the medical system described herein may be configured to control an instrument feeder device to intelligently engage with and / or control a medical instrument. For example, the medical system may position the instrument feeder device in the appropriate state at the appropriate time and / or verify the state of the instrument feeder device / medical instrument. This can help physicians use the instrument feeder device and / or medical instrument in different ways / scenarios by enabling smooth workflow transitions such as loading / unloading medical instruments, inserting / retracting medical instruments, adjusting the position of a robotic arm or another component of the medical system, and rotating medical instruments. In embodiments, the instrument feeder device may be controlled without user confirmation regarding the state of the instrument feeder device / medical instrument. Furthermore, by controlling and / or verifying the status of the instrument feeder device / medical instrument, the medical system can avoid / solve problems associated with improper loading of medical instruments (e.g., avoiding the holding mechanism / cover pinching the elongated shaft (which could damage the elongated shaft), or avoiding driving the elongated shaft when it is improperly loaded (which could also damage the elongated shaft)).

[0053] Furthermore, this disclosure relates to devices, systems, and methods for evaluating and / or eliminating slack in the elongated shafts of medical instruments. For example, as described above, instrument feeder devices can be implemented to control the elongated shafts of medical instruments. Instrument feeder devices can generally be coupled to one robotic arm / component, and the instrument base of the medical instrument can generally be coupled to another robotic arm / component. In some cases, the elongated shaft may contain slack between the instrument base and the instrument feeder device, and this slack may result from loading the medical instrument, backlash / play in one or more components such as the instrument feeder device / robot arm / handle, a mismatch between the actual backlash and the backlash due to the software configuration, or slippage of the instrument feeder device on the elongated shaft. Such slack can cause undesirable problems. For example, if there is slack in the elongated shaft when the shaft is inserted, the curvature of the slack may increase as the instrument handle moves closer to the instrument feeder device, which could potentially damage the elongated shaft and / or cause other problems. Furthermore, if there is slack in the elongated shaft when the instrument feeder device disengages it (for example, to allow manual movement of the robotic arm to initiate rotation of the elongated shaft, and / or for other reasons), the elongated shaft may move in the insertion direction as the energy within the shaft is released. This can be harmful to the patient (for example, due to the tip of the elongated shaft contacting the tissue with relatively strong force). To prevent such problems, the medical system can determine whether there is slack in the elongated shaft between the instrument handle and the instrument feeder device, and, if there is slack in the elongated shaft, it can be removed / reduced.

[0054] A medical system can determine the amount of slack in an elongated shaft in various ways. For example, a medical system can determine the amount of arm force applied by a robotic arm coupled to the instrument base of a medical instrument, and / or the amount of force applied by a drive output unit(s) of the robotic arm coupled to an instrument feeder device. The drive output unit(s) can be configured to control the axial motion of the elongated shaft. The amounts of force from the arm and / or the drive output unit(s) can be used to determine whether there is slack or tension in the elongated shaft. Additionally or alternatively, a medical system can determine the amount of slack in an elongated shaft based on shape-sensing data indicating the shape of the elongated shaft, position sensor data indicating the position of at least a portion of the elongated shaft, and / or other data.

[0055] In some embodiments, a medical system can eliminate / reduce slack in an elongated shaft. For example, a medical system can move a robotic arm coupled to an instrument handle away from a robotic arm coupled to an instrument feeder device. This can be done without actively acting the elongated shaft using the instrument feeder device. Alternatively or additionally, a medical system can move the elongated shaft in an insertion direction away from the instrument handle using the instrument feeder device. This can be done without actively acting the robotic arm coupled to the instrument handle. In some examples, a medical system can identify and / or eliminate slack in an elongated shaft before performing a particular function, such as before disengaging the instrument feeder device from the elongated shaft, before rotating the elongated shaft, as part of inserting the elongated shaft, and / or as part of other situations.

[0056] Accordingly, in embodiments, the medical system described herein can be configured to intelligently assess and / or remove slack in a medical instrument. This prevents the elongated shaft from unintentionally moving in the insertion direction, which could harm the patient (e.g., when the instrument feeder device is disengaged from the shaft). Furthermore, by assessing and / or removing slack in the elongated shaft, damage to the medical instrument can be avoided (e.g., by excessively bending the elongated shaft when excessive slack is introduced between the instrument handle and the instrument feeder device). Furthermore, interruptions during the procedure can be avoided (e.g., by avoiding the user having to check for slack in the medical instrument and reload the medical instrument). For example, the medical system can automatically assess and / or remove slack in the elongated shaft at a specific point in time before, during, or after a procedure. In some cases, the technology can take into account unknown causes that introduce slack into the elongated shaft.

[0057] While various techniques are described in the context of implementing two robotic arms to connect to medical devices, these techniques can be implemented using multiple components contained within a single robotic arm. For example, a robotic arm may include a first coupling element / robot component for connecting to an instrument feeder device and a second coupling element / robot component for connecting to an instrument handle, and the feeder device and handle can move relative to each other, such as along a rail or other feature.

[0058] Furthermore, while some techniques are described in the context of robot-assisted medical procedures, these techniques may be applicable to other types of medical procedures, such as those that do not implement robotic tools, or those that implement robotic tools for relatively few movements (e.g., below a threshold number). For example, these techniques may be applicable to procedures that implement manually operated medical instruments, such as manual catheters and / or scopes, which are fully controlled by a physician.

[0059] Certain aspects of this disclosure are described herein in the context of kidney, urinary tract, and / or kidney procedures, such as kidney stone removal / treatment procedures. However, such context is provided for convenience, and it should be understood that the concepts disclosed herein are applicable to any suitable medical procedure. For example, the following descriptions are also applicable to other surgical / medical procedures or medical treatments relating to the removal of objects from a patient, including any objects that can be removed from the treatment site or the patient's body cavities (e.g., esophagus, ureters, intestines, eyeballs, etc.) via percutaneous and / or endoscopic access, such as gallstone removal, lung (lung / transthoracic) tumor biopsy, and cataract removal. However, as stated above, a description of the anatomical structure of the kidney / urinary tract and related medical issues and procedures is provided below to aid in the explanation of the concepts disclosed herein.

[0060] Figure 1 illustrates an exemplary robotic medical system 100, configured for diagnostic and / or therapeutic ureteroscopy procedures, according to one or more embodiments. The medical system 100 includes a robotic system 110 configured to engage with and / or control one or more medical instruments / devices to perform a procedure on a patient 120. In the example of Figure 1, the robotic system 110 is coupled to a scope 130 and an electromagnetic (EM) field generator 140. However, the robotic system 110 can be coupled to any type of device / instrument. The medical system 100 also includes a control system 150 configured to interface with the robotic system 110 and / or a physician 160, to provide information about the procedure, and / or to perform various other actions. For example, the control system 150 may include a display 152 configured to present certain information, and / or an input / output (I / O) device 154 (in this example, a controller) configured to receive input from the physician 160, such as for controlling the robotic system 110. The medical system 100 may include a table 170 (e.g., a bed) for holding the patient 120. Various actions are described herein as being performed by a physician 160. These actions may be performed directly by the physician 160, a user under the direction of the physician 160, another user (e.g., a technician), a combination of these, and / or any other user. The devices / components of the medical system 100 may be arranged in various ways depending on the type of procedure, the stage of the procedure, the user's preferences, etc.

[0061] The control system 150 can generally work in cooperation with the robot system 110 to perform medical procedures. For example, the control system 150 can communicate with the robot system 110 via wireless or wired connection to control instruments / devices connected to the robot system 110 and receive images(s) acquired by the medical instruments. For example, the control system 150 can receive image data from the scope 130 (e.g., an imaging device associated with the scope 130) and display that image data (and / or a display generated therefrom) via a display(s) 152 to assist the physician 160 in navigating the scope 130 and / or other instruments within the patient 120. The physician 160 can provide input via an I / O device 154 or another I / O device, and the control system 150 can send control signals to the robot system 110 to control the movement of the scope 130 connected to the robot system 110. The scope 130 (and / or other medical instruments) can be configured to move in various ways, such as articulating, rotating, etc.

[0062] In some embodiments, the control system 150 may provide power to the robot system 110 via one or more electrical connections, and provide optics to the robot system 110 via one or more optical fibers or other components. In embodiments, the control system 150 may communicate with a medical device to receive sensor data (via the robot system 110 and / or directly from the medical device). The sensor data may indicate or can be used to determine the position and / or orientation of the medical device. Furthermore, in embodiments, the control system 150 may communicate with a table 170 to orient the table 170 or otherwise control the table 170. Furthermore, in embodiments, the control system 150 may communicate with an EM field generator 140 to control the generation of an EM field around the patient 120.

[0063] The robotic system 110 may include one or more robotic arms 112 configured to engage with and / or control medical instruments / devices. Each robotic arm 112 may include multiple arm segments coupled to a joint, thereby providing multiple degrees of motion. The distal end of a robotic arm 112 (e.g., an end effector) may be configured to couple to an instrument / device. In the example in Figure 1, robotic arm 112(A) is coupled to an EM field generator 140. A second robotic arm 112(B) is coupled to an instrument feeder device 180 that can facilitate robotic control / advancement of the scope 130. Furthermore, a third robotic arm 112(C) is coupled to a handle 132 of the scope 130, which may be configured to facilitate the advancement and / or movement of medical instruments that can be deployed through the scope 130, such as instruments deployed through the working channels of the scope 130. In this example, the second robotic arm 112(B) and / or the third robotic arm 112(C) can control the movement of the scope 130 (e.g., joint movement, rotation, etc.). In Figure 1, three robotic arms are connected to a specific instrument / device, but the robotic system 110 can include any number of robotic arms configured to connect to any type of medical instrument / device.

[0064] The robot system 110 can be communicatively coupled to any component of the medical system 100. For example, the robot system 110 can be communicatively coupled to a control system 150 to receive control signals from the control system 150 and perform actions such as controlling a robotic arm 112 in a specific manner or operating instruments / devices. Furthermore, the robot system 110 can be configured to receive images (also referred to as image data) showing the internal anatomical structure of a patient 120 from a scope 130 and / or transmit those images to the control system 150, which can then display those images on a display 152. In addition, the robot system 110 can be coupled to components of the medical system 100, such as a control system 150, and / or to a fluid management system, in a manner that allows it to receive fluids, optics, power, etc., from those components.

[0065] Medical instruments can include various types of instruments such as scopes (sometimes referred to as “endoscopes”), catheters, needles, guidewires, lithotomizers, basket retrieval devices, forceps, vacuums, needles, surgical scalpels, imaging probes, imaging devices, grippers, scissors, holding devices, needle holders, micro-dissection instruments, staple applicators, tackers, suction / irrigation tools, and clip applicators. Medical instruments can include direct access instruments, percutaneous access instruments, and / or other types of instruments. In some embodiments, medical instruments are maneuverable devices, while in other embodiments, medical instruments are non-maneuverable devices. In some embodiments, surgical tools refer to devices such as needles, surgical scalpels, and guidewires that are configured to puncture or be inserted through human anatomical structures. However, surgical tools can refer to other types of medical instruments.

[0066] The terms “scope” or “endoscope” can refer to any type of elongated medical instrument having image generation, visualization, and / or acquisition functions (or configured to provide such functions using an imaging device deployed through a working channel) and configured to be introduced into any type of organ, body cavity, lumen, chamber, and / or body space of the body. For example, a scope or endoscope such as Scope 130 could refer to a ureteroscope (e.g., for accessing the urinary tract), laparoscope, nephroscope (e.g., for accessing the kidneys), bronchoscope (e.g., for accessing the airways such as the bronchi), colonoscope (e.g., for accessing the colon), arthroscope (e.g., for accessing joints), cystoscope (e.g., for accessing the bladder), borescope, etc. In some examples, a scope / endoscope may include a rigid or flexible tube and / or be sized to pass through an outer sheath, catheter, introducer, or other tubular device, or may be used without such device. In some embodiments, the scope includes one or more working channels that allow further tools / medical instruments, such as lithotomizers, basket devices, forceps, laser devices, and imaging devices, to be introduced into the treatment site.

[0067] The terms “direct penetration” or “direct access” can refer to any penetration of an instrument through a natural or artificial orifice within a patient’s body. For example, since Scope 130 penetrates into the patient’s urinary tract via the urethra, Scope 130 may be referred to as a direct access instrument.

[0068] The terms “percutaneous penetration” or “percutaneous access” can refer to the penetration of an instrument through the patient’s skin and any other body layer necessary to reach a target anatomical location associated with the procedure (e.g., the renal calyx netula of the kidney), such as by puncture and / or small incision. Thus, percutaneous access instruments can refer to medical instruments, devices, or assemblies configured to puncture or be inserted through the skin and / or other tissues / anatomical structures, such as needles, surgical scalpels, guidewires, sheaths, shafts, scopes, and catheters. However, it should be understood that percutaneous access instruments can refer to other types of medical instruments in the context of this disclosure. In some embodiments, percutaneous access instruments refer to instruments / devices that are inserted or implemented by a device that facilitates puncture and / or small incision through the patient’s skin. For example, a catheter may be referred to as a percutaneous access instrument when it is inserted through a sheath / shaft inserted into the patient’s skin.

[0069] In some embodiments, the medical device includes a sensor (also referred to as a position sensor) configured to generate sensor data. In embodiments, the sensor data may indicate the position and / or orientation of the medical device and / or can be used to determine the position and / or orientation of the medical device. For example, the sensor data may indicate the position and / or orientation of a scope, which may indicate the rotation of the distal end of the scope. The position and orientation of the medical device may be referred to as the posture of the medical device. The sensor may be positioned at the distal end of the medical device and / or any other location. In some embodiments, the sensor may provide sensor data to a control system 150, a robotic system 110, and / or another system / device to perform one or more positioning techniques for determining / tracking the position and / or orientation of the medical device.

[0070] In some implementations, the sensor may include an electromagnetic (EM) sensor with a coil of conductive material. Here, an EM field generator can provide an EM field that is detected by the EM sensor on a medical device. The magnetic field can induce a small current in the coil of the EM sensor, and by analyzing this small current, the distance and / or angle / orientation between the EM sensor and the EM field generator can be determined. Furthermore, the sensor may include other types of sensors such as cameras, distance sensors (e.g., depth sensors), radar devices, shape-sensing fibers, accelerometers, gyroscopes, satellite-based positioning sensors (e.g., Global Positioning System, GPS), and radio frequency transceivers.

[0071] In some embodiments, the medical system 100 may also include an imaging device (not shown in Figure 1) which is integrated into a C-arm and / or can be configured to take images during a procedure, such as in the case of a fluoroscopy-type procedure. The imaging device may be configured to acquire / generate one or more images of the patient 120 during the procedure, such as one or more X-ray or CT images. In embodiments, images from the imaging device can be provided in real time to allow the physician 160 to visualize anatomical structures and / or medical instruments within the patient 120 to assist in performing the procedure. The imaging device may be used to perform fluoroscopy or another type of imaging technique (e.g., with a contrast agent within the patient 120).

[0072] Furthermore, in some embodiments, the medical system 100 may also include a fluid management system (sometimes referred to as the “suction system” or “irrigation system”) configured to control / provide aspiration and / or irrigation to a target site via a catheter, a scope 130, instruments / devices associated with the catheter / scope (e.g., one or more access sheaths), and / or other instruments / devices. The fluid management system may be configured to hold one or more fluid bags / containers and / or control the fluid flow to and from them. In embodiments, the fluid management system may include certain electronic components such as a display, a flow control mechanism, and / or a control circuit. The fluid management system may include a standalone tower / cart. The fluid management system may include a pump capable of drawing aspirated fluid into a collection container / cartridge via a suction channel / tube coupled to the catheter / scope.

[0073] Various components of the medical system 100 can be connected to communicate with one another via a network that may include wireless and / or wired networks. Exemplary networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), body area networks (BANs), cellular networks, and the Internet. Furthermore, in some embodiments, components of the medical system 100 are connected via one or more support cables, pipes, etc., for purposes such as data communication, fluid / gas exchange, and power exchange.

[0074] In some examples, the medical system 100 is implemented to perform medical procedures related to the anatomical structure of the kidney, such as treating kidney stones. For example, robot-assisted percutaneous procedures can be performed, and robotic tools (e.g., one or more components of the medical system 100) can enable a physician / urologist to perform endoscopic (e.g., ureteroscopy) targeted access as well as percutaneous access / treatment. However, this disclosure is not limited to kidney stone removal and / or robot-assisted procedures. In some implementations, robotic medical solutions can provide relatively high precision, superior control, and / or superior visual-hand coordination for certain instruments compared to strictly manual procedures. For example, robot-assisted percutaneous access to the kidney by some procedures can enable a urologist to perform both direct intrusion endoscopic kidney access and percutaneous kidney access. While some embodiments of this disclosure are presented in the context of catheters, nephroscopes, ureteroscopes, and / or the anatomical structure of the human kidney, it should be understood that the principles disclosed herein can be implemented in any type of endoscopic / percutaneous procedure or another type of procedure.

[0075] In one exemplary and non-limiting procedure, the medical system 100 can be used to examine a kidney 190 and / or remove a kidney stone 191. During setup for the procedure, the physician 160 can position the robotic arm 112 of the robotic system 110 into a desired configuration and / or attach appropriate medical instruments. For example, the physician 160 can position the first robotic arm 112(A) near the treatment site and attach an EM field generator 140, which can help track the location of the scope 130 and / or other instruments / devices during the procedure. Furthermore, the physician 160 can position the second robotic arm 112(B) between the legs of the patient 120 and attach an instrument feeder device 180 that can facilitate robotic control / advancement of the scope 130. In some examples, the physician 160 can insert a sheath / access instrument 134 into the urethra 192 of the patient 120, through the bladder 193 and / or over the ureter 194. Physician 160 can connect the sheath / access instrument 134 to the instrument feeder device 180. The sheath / access instrument 134 may include a tubular device configured to receive the scope 130, thereby assisting in the insertion of the scope 130 into the anatomical structure of the patient 120. However, in some embodiments, the sheath / access instrument 134 is not used (for example, the scope 130 is inserted directly into the urethra 192). The physician 160 can then insert the scope 130 into the sheath / access instrument 134 manually, robotically, or a combination thereof. The physician 160 may attach the handle 132 of the scope 130 to a third robotic arm 112(C), which may be configured to facilitate the movement of the handle 132, the operation of a basket device / laser device / another medical instrument deployed through the scope 130, and / or other functions.

[0076] The physician 160 can interact with the control system 150 to cause the robotic system 110 to advance and / or navigate the scope 130 into the kidney 190. For example, the physician 160 can use the controller 154 or another I / O device to navigate the scope 130 to locate the kidney stone 191. The control system 150 can provide information about the scope 130 via the display 152 to assist the physician 160 in navigating the scope 130, such as viewing an image representation (e.g., real-time images acquired by the scope 130). In some embodiments, the control system 150 can use localization techniques to determine the position and / or orientation of the scope 130, which can then be viewed by the physician 160 through the display 152. Furthermore, to assist the physician 160 in controlling the scope 130, other types of information, such as X-ray images or other images of the patient's 120 internal anatomical structures, can also be presented via the display(s) 152.

[0077] Once the scope 130 reaches the site of the kidney stone 191 (e.g., within the renal calyces of the kidney 190), the scope 130 can be used to designate / tag a target site for the catheter to percutaneously access the kidney 190. To minimize damage to the kidney 190 and / or surrounding anatomical structures, the physician 160 may designate the papilla as a target site for percutaneous penetration into the kidney 190. However, other target sites can be designated or determined. In some embodiments of designating the papilla, the physician 160 may navigate the scope 130 to make contact with the papilla, and the control system 150 may use localization techniques to determine the location of the scope 130 (e.g., the location of the distal end of the scope 130), and the control system 150 may associate the location of the scope 130 with the target site. Furthermore, in some embodiments, the physician 160 may navigate the scope 130 to be within a certain distance of the papilla (e.g., placed in front of the papilla) and provide input indicating that the target site is within the field of view of the scope 130. The control system 150 can perform image analysis and / or other localization techniques to determine the location of the target location. Furthermore, in some embodiments, the scope 130 can deliver reference points to mark the nipple as the target location.

[0078] Once a target site is specified, the catheter or other device can be inserted into the patient 120 through a percutaneous access pathway to reach the target site (e.g., by aligning with the scope 130). For example, the EM field generator 140 can be removed and the catheter (not shown) can be connected to a first robotic arm 112(A). The physician 160 can interact with the control system 150 to cause the robotic system 110 to advance and / or navigate the catheter. Alternatively or additionally, the catheter can be manually inserted and / or controlled, such as when the catheter is implemented as a manually controllable catheter. The control system 150 can provide information about the catheter via a display(s) 152 to assist the physician 160 in navigating the catheter. For example, the display(s) 152 can provide image data from the viewpoint of the scope 130, and the image data may show the catheter (e.g., when it is within the field of view of the imaging device of the scope 130). In some embodiments, a needle or another medical device is inserted into the patient 120 to create a percutaneous access route for the catheter to enter. Furthermore, in some embodiments, a percutaneous access device / assembly (e.g., one or more sheaths and / or shafts) is inserted into the route created by the needle or other device to provide an access route for the catheter to reach a target site. Here, the catheter can be inserted into the percutaneous access device. The percutaneous access device can provide irrigation to a target anatomical structure, while the catheter can provide aspiration (e.g., through the lumen within the catheter).

[0079] Once the scope 130 and / or catheter are positioned at the target site, the physician 160 can use the scope 130 to fragment the kidney stone 191 and / or use the catheter to remove the fragments of the kidney stone 191 from the patient 120. For example, the scope 130 may deploy a tool (e.g., a laser, cutting instrument, etc.) through the working channel to fragment the kidney stone 191 into fragments, and the catheter may aspirate the fragments from the kidney 190 through a percutaneous access pathway. The catheter may provide suction to maintain / hold the kidney stone 191 at the distal end of the catheter and / or in a relatively fixed position while the scope 130 fragments the kidney stone 191 using a tool (e.g., a laser), as shown in Figure 1. A fluid management system may provide irrigation to the target site via a percutaneous access device / assembly associated with the catheter and / or provide suction to the target site via the catheter (e.g., the lumen within the catheter 140).

[0080] While various examples are described in the context of providing irrigation / suction via catheters and / or percutaneous access devices / assemblies, the irrigation fluid and / or suction may, in some cases, be delivered to the treatment site (e.g., kidney) through another device such as Scope 130. Furthermore, irrigation and suction may or may not be delivered through the same instrument(s). If one or more of the instruments provide irrigation and / or suction functions, one or more of the other instruments may be used for other functions, such as crushing the object to be removed.

[0081] Furthermore, although various exemplary procedures are described in the context of implementing robot-controlled catheters, the procedures can also be performed using manually controllable catheters. For example, the catheter may include a manually controllable handle configured to be held / operated by physician 160. Physician 160 can navigate the catheter by moving the handle and / or operating a manual actuator, thereby resulting in articular movement of the distal portion of the catheter.

[0082] Medical system 100 (and / or other medical systems described herein) can provide a variety of benefits, such as providing guidance to assist physicians in performing procedures (e.g., instrument tracking, instrument navigation, instrument calibration), enabling physicians to perform procedures from ergonomic positions without requiring skilled arm movements and / or positions, enabling one physician to perform procedures using one or more medical instruments, avoiding radiation exposure (e.g., associated with fluoroscopy techniques), enabling procedures to be performed in a single surgical setting, and providing continuous aspiration / irrigation for more efficient removal of objects (e.g., removal of kidney stones). For example, medical system 100 can provide guidance information to assist physicians in using various medical instruments to access target anatomical structures while minimizing bleeding and / or damage to those structures (e.g., determinant organs, blood vessels, etc.). Furthermore, medical system 100 can provide non-radiation-based navigation and / or localization techniques to reduce physician and patient radiation exposure and / or reduce the amount of equipment in the operating room. Furthermore, the medical system 100 can provide distributed functions between at least the control system 150 and the robotic system 110, thereby enabling them to be independently mobile. Such distribution of functions and / or mobility can allow the control system 150 and / or the robotic system 110 to be positioned in locations that are optimal for specific medical procedures, thereby maximizing the work area around the patient and / or providing an optimized location for the physician to perform the procedure.

[0083] While various technologies / systems are described as being implemented as robot-assisted procedures (e.g., procedures using medical system 100 in at least part), these technologies / systems may also be implemented in other procedures, such as fully robotic medical procedures or human-only procedures (e.g., without a robotic system). For example, medical system 100 may be used to perform a procedure without a physician holding / manipulating medical instruments and without a physician controlling the movement of the robotic system / arm (e.g., a fully robotic procedure that relies on relatively little input to direct the procedure). That is, each medical instrument used during the procedure can be held / controlled by a component of medical system 100, such as the robotic arm 112 of robotic system 110.

[0084] Figure 2 illustrates an exemplary robotic medical system 100 configured for diagnostic and / or therapeutic bronchoscopy procedures in one or more embodiments. During a bronchoscopy, the arm(s) 112 of the robotic system 110 may be configured to deliver medical instruments, such as a maneuverable endoscope 210 (also referred to as “bronchoscope 210”), which may be a procedure-specific bronchoscope for bronchoscopy, to a natural opening access point (i.e., the mouth of the patient 120 positioned on the table 170 in this example) for delivering diagnostic and / or therapeutic tools. As shown, the robotic system 110 may be positioned close to the upper torso of the patient to provide access to the access point. Similarly, the robotic arm 112 may be actuated to position the bronchoscope 210 relative to the access point. The configuration of Figure 2 can also be used when performing gastrointestinal (GI) procedures using a gastroscopy, which is an endoscope specifically designed for GI procedures.

[0085] Once the robotic system 110 is properly positioned, the robotic arm 112 can insert the maneuverable endoscope 210 into the patient robotically, manually, or a combination of both. The maneuverable endoscope 210 may include at least two nested parts, such as an inner leader section and an outer sheath section, each section being coupled to a separate instrument drive from a set of instrument drive units, and / or each instrument drive unit being coupled to the distal end of its respective robotic arm 112. This linear arrangement of instrument drive units creates a “virtual rail” 220 that can be repositioned in space by manipulating one or more robotic arms 112 to different angles and / or positions. The virtual rails / paths described herein are generally shown in the figures using dashed lines that do not indicate any physical structure of the system. Translation of one or more instrument drive units along the virtual rail 220 can move the endoscope 210 forward or backward from the patient 120.

[0086] The endoscope 210 may be directed downstream of the patient's trachea and lungs after insertion using precise commands from the robotic system 110 until it reaches the target surgical site. The use of a separate instrument drive unit can allow independent driving of separate parts of the endoscope / assembly 210. For example, the endoscope 210 may be directed to deliver a biopsy needle to a target such as a lesion or nodule in the patient's lung. The needle may be deployed downstream of the working channel along the length of the endoscope 210 to obtain a tissue sample for analysis by a pathologist. Depending on the pathological results, further biopsies may deploy additional tools downstream of the working channel of the endoscope 210. For example, if a nodule is identified as malignant, the endoscope 210 may deliver a tool endoscopically to excise the potentially cancerous tissue. In some cases, diagnostic and therapeutic treatments can be performed in separate procedures. In these situations, the endoscope 210 may also be used to deliver a criterion to "mark" the location of the target nodule. In other cases, diagnostic and therapeutic treatments can be performed during the same procedure.

[0087] In the arrangement of system 100 in Figure 2, the patient introduction device 230 is attached to the patient 120 via a port (not shown, e.g., a surgical tube). The patient introduction device 230 may be fixed to the table 170 (e.g., via a patient introduction device holder configured to support the introduction device 230 and fix the position of the patient introduction device 230 to the table 170 or other structure). In some embodiments, the patient introduction device 230 may include a proximal end, a distal end, and an introduction tube between them. The proximal end of the patient introduction device 230 may provide an opening that can be configured to receive an instrument 210 (e.g., a bronchoscope), and the distal end of the patient introduction device 230 may provide a second opening that can be configured to guide the instrument 210 to the patient access port. A curved tubular component of the introduction device 230 connects its proximal and distal ends and can guide the instrument 210 through the introduction device 230.

[0088] The curvature of the introduction device 230 may allow the robotic system 110 to operate the instrument 210 from a position not directly axially aligned with the patient access port, thereby enabling greater flexibility in the placement of the robotic system 110 within the room. Furthermore, the curvature of the introduction device 230 may allow the robotic arm 112 of the robotic system 110 to be positioned substantially horizontally with the patient introduction device 230, thereby facilitating manual movement of the robotic arm(s) 112 as needed.

[0089] In some embodiments, one or more of the instrument feeder devices described herein can be implemented in a bronchoscopy procedure, such as the one illustrated in Figure 2. For example, the instrument feeder device can be implemented in cooperation with an endoscope 210 and can at least partially control the movement of the endoscope 210.

[0090] Figure 3 illustrates a table-based robotic system 300 configured to perform medical procedures in one or more embodiments. Here, one or more robotic components of the robotic medical system 100 can be incorporated into the table 302, thereby reducing the amount of capital equipment in the operating room and / or allowing more access to the patient 120 compared to a cart-based robotic system. For example, system 300 may include one or more components of the control system 150 and / or the robotic system 110.

[0091] As shown in the figures, the table 302 may include / incorporate one or more robotic arms 304 configured to engage with and / or control medical instruments / devices. Each robotic arm 304 may include multiple arm segments coupled to a joint, thereby providing multiple degrees of motion. The distal end of a robotic arm 304 (i.e., an end effector) may be configured to couple to an instrument / device, which may include any of the medical instruments / devices described herein, such as catheters, needles, or scopes. For example, robotic arm 304(B) may couple to an instrument feeder device 180 as shown in Figure 3, and / or robotic arm 304(C) may couple to a handle 132 of a scope 130. Each robotic arm 304 may be similar to or different from the robotic arm 112 of system 100 in Figures 1 and 2. Furthermore, each end effector may be similar to or different from the end effector of robotic system 110.

[0092] As illustrated, the robot-enabled table system 300 may include a column 310 coupled to one or more carriages 312 (e.g., a ring-shaped movable structure) from which one or more robotic arms 304 can emerge. The carriages 312 may provide different viewpoints, translating along a vertical column joint running over at least a portion of the length of the column 310, from which the robotic arms 304 can be positioned to reach the patient 120. In some embodiments, the carriages 312 may rotate around the column 310 using a mechanical motor positioned within the column 310, allowing the robotic arms 304 to access multiple sides of the table 302. The rotation and / or translation of the carriages 312 may enable the system 300 to position medical instruments such as endoscopes and / or catheters at different access points on the patient 120. By providing vertical adjustment, the robotic arms 304 may be configured to be compactly housed beneath the platform of the table system 300 and then raised during the procedure. The robotic arm 304 may be mounted on the carriage 312(or more) via one or more arm mounts 314, which may include a series of joints that can rotate individually and / or expand in a nesting manner, in order to provide additional configurability for the robotic arm 304. The column 310 structurally provides support for the table platform and a path for the vertical translation of the carriage(or more) 312. The column 310 may also transmit power and control signals to the carriage(or more) 312 and / or the robotic arm 304 mounted thereon.

[0093] In some embodiments, the table-based robotic system 300 may include, or be associated with, a control system similar to the control system 150 for interface with a physician and / or provide information regarding medical procedures. For example, the control system may include input components(s) that enable a physician to control one or more robotic arms 304 and / or medical instruments attached to one or more robotic arms 304. In some implementations, the input components(s) may enable a physician to provide inputs for controlling the medical instruments in a manner similar to how a physician physically holds / operates the medical instruments.

[0094] Figure 4 illustrates a medical system component that may be implemented in any of the medical systems shown in Figures 1 to 3 according to one or more embodiments of the present disclosure. While Figure 4 illustrates certain components, it should be understood that additional components not shown may be included in embodiments of the present disclosure. Furthermore, any of the illustrated components can be omitted, replaced, and / or integrated into other devices / systems such as Table 170, medical instruments, etc.

[0095] The control system 150 may include, separately / individually and / or in combination / collectively, one or more of the following components, devices, modules, and / or units (hereinafter referred to as “Components”), namely, a control circuit 401, one or more communication interfaces 402, one or more power supply units 403, one or more I / O components 404, one or more movable components 405 (e.g., casters or other types of wheels), and / or memory / data storage devices 406. In some embodiments, the control system 150 may include a housing / enclosure configured to house or include at least one or more of the components of the control system 150 and / or a dimensioned housing / enclosure. In this example, the control system 150 is illustrated as a cart-based system that is movable with one or more movable components 405. In some cases, after reaching a suitable position, one or more movable components 405 can be locked in place using wheel locks to hold the control system 150 in place. However, the control system 150 can be implemented as a fixed system and integrated with other systems / devices.

[0096] Various components of the control system 150 can be electrically and / or communicatively coupled using certain connection circuits / devices / features, which may or may not be part of the control circuit. For example, the coupling mechanism(s) may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuits of the control system 150. In some embodiments, two or more components of the control system 150 can be electrically and / or communicatively coupled to one another.

[0097] One or more communication interfaces 402 can be configured to communicate with one or more devices / sensors / systems. For example, one or more communication interfaces 402 can transmit / receive data wirelessly and / or via a wired method over a network. In some embodiments, one or more communication interfaces 402 can implement wireless technologies such as Bluetooth, Wi-Fi, and near-field communication (NFC).

[0098] One or more power supply units 403 can be configured to manage and / or provide power to the control system 150 (and / or optionally to the robot system 110). In some embodiments, one or more power supply units 403 include one or more batteries, such as lithium-ion batteries, lead-acid batteries, alkaline batteries, and / or other types of batteries. That is, one or more power supply units 403 can include one or more devices and / or circuits configured to provide power and / or power management functions. Furthermore, in some embodiments, one or more power supply units 403 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power supply.

[0099] One or more I / O components / devices 404 may include various components for receiving inputs and / or providing outputs, such as for interface connection with a user to assist in performing medical procedures. One or more I / O components 404 may be configured to receive touch, speech, gestures, or any other type of input. In an embodiment, one or more I / O components 404 may be used to provide inputs for controlling a device / system, such as controlling a robotic system 110, navigating a scope / catheter or other medical instrument attached to and / or deployed through a scope on the robotic system 110, controlling a table 170, or controlling a fluoroscopy device. For example, a physician (not shown) may provide inputs via an I / O component(s) 404, and in response, a control system 150 may send control signals to the robotic system 110 for operating a medical instrument. In an embodiment, the physician may use the same I / O device to control multiple medical instruments (e.g., switching control between instruments).

[0100] As shown in the figures, one or more I / O components 404 may include one or more displays 152 (sometimes referred to as "one or more display devices 152") configured to display data. One or more displays 152 may include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type(s) of technology. In some embodiments, one or more displays 152 may include one or more touchscreens configured to receive input and / or display data. Furthermore, one or more I / O components 404 may include one or more I / O devices / control units 407, which may include controllers 154 (e.g., handheld controllers, video game type controllers, finger-based control units that enable finger-like movements), touchpads, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual reality or augmented reality devices (e.g., head-mounted displays), foot panels (e.g., buttons under the user's feet), and the like. In addition, one or more I / O components 404 may include one or more speakers configured to output sound based on an audio signal, and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, one or more I / O components 404 include or are implemented as a console.

[0101] In some embodiments, one or more I / O components 404 can output information related to the procedure. For example, the control system 150 can receive real-time images acquired by the scope and display the real-time images and / or visual / image representations of the real-time images via a display(s) 152. The display(s) 152 can present an interface(s) that can include image data from the scope and / or other medical devices. Additionally or alternatively, the control system 150 can receive signals (e.g., analog signals, digital signals, electrical signals, acoustic / sound wave signals, pneumatic signals, tactile signals, hydraulic signals, etc.) from medical monitors and / or sensors associated with the patient, and the display(s) 152 can present information related to the patient's health or the environment. Such information may include, for example, information displayed via a medical monitor, such as heart rate (e.g., ECG, HRV), blood pressure / blood flow velocity, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, electroencephalogram (e.g., EEG), ambient temperature and / or local or core body temperature.

[0102] In some embodiments, the control system 150 can be coupled to the robot system 110, the table 170 or another table, and / or medical instruments through one or more cables or connectors (not shown). In some implementations, support functions from the control system 150 can be provided through a single cable, simplifying and tidying up the operating room. In other implementations, specific functions can be coupled in separate cables and connectors. For example, power can be provided through a single power cable, while support for control, optics, fluid mechanics, and / or navigation can be provided through separate cables.

[0103] The robotic system 110 generally includes an elongated support structure 410 (also referred to as the “column”), a robotic system base 411, and a console 412 at the top of the column 410. The column 410 may include one or more carriages 413 (also referred to as “arm supports 413”) for supporting the deployment of one or more robotic arms 112. The carriages 413 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arm 112 for positioning relative to a patient. The carriages 413 also include carriage joints 414 that allow the carriages 413 to translate vertically along the column 410. The carriage joints 414 may be connected to the column 410 through slots such as slots 415 located on both sides of the column 410 to guide the vertical translation of the carriages 413. Slot 415 may include vertical translation joints for positioning and / or holding the carriage 413 at various vertical heights relative to the base 411. As the carriage 413 is translated vertically, the robot system 110 can adjust the reach of the robot arm 112 to accommodate various table heights, patient sizes, physician preferences, etc. Similarly, individually configurable arm mounts on the carriage 413 allow the robot arm base 416 of the robot arm 112 to be angled in various configurations. Column 410 may contain devices such as gears and / or motors designed to use vertically aligned lead screws to mechanize the translation of the carriage 413 in response to control signals generated in response to user inputs, such as inputs from I / O devices.

[0104] The base 411 can balance the weight of the column 410, carriage 413, and / or robot arm 112 on a surface such as a floor. Thus, the base 411 can accommodate one or more heavier components such as electronics, motors, power supplies, and components that enable and / or fix the movement of the robot system 110. For example, the base 411 may include rotatable wheels 417 (also referred to as “casters 417” or “movable components 417”) that allow the robot system 110 to move around a room for treatment. After reaching a suitable position, the casters 417 can be fixed using wheel locks to hold the robot system 110 in place during treatment. As shown in the figure, the robot system 110 also includes handles 418 to assist in maneuvering and / or stabilizing the robot system 110. In this example, the robot system 110 is illustrated as a movable cart-based system. However, the robot system 110 can be implemented as a fixed system or integrated into a table, etc.

[0105] The robotic arm 112 may include a robotic arm base 416 and an end effector 419, separated by a series of linkage mechanisms 420 (also referred to as “arm segments 420”) connected by a series of joints 421. Each joint 421 may include an independent actuator, and each actuator may include an independently controllable motor. Each independently controllable joint 421 represents an independent degree of freedom available to the robotic arm 112. For example, each arm 112 may have seven joints and thus seven degrees of freedom. However, any number of joints can be implemented with any number of degrees of freedom. In some embodiments, a large number of joints can provide a large number of degrees of freedom, enabling “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 112 to position each end effector 419 to a specific position, orientation, and / or trajectory in space using different linkage mechanism positions and / or joint angles. In some embodiments, the end effector 419 may be configured to engage with and / or control medical instruments, devices, objects, etc. The degrees of freedom of movement of the arm 112 allow the robotic system 110 to position and / or orient a medical instrument from a desired point in space, and / or allow a physician to move the arm 112 to a clinically advantageous position away from the patient to access it while avoiding collisions with the arm.

[0106] Each end effector 419 of the robotic arm 112 may include an instrument device manipulator (IDM). In some embodiments, the IDM can be removed and replaced with a different type of IDM. For example, a first type of IDM may be able to operate an endoscope, a second type of IDM may be able to operate a catheter, and a third type of IDM may be able to hold an EM field generator, etc. However, the same IDM may be used. In some examples, the IDM may include connectors for transmitting pneumatic, electrical, electrical signals, and / or optical signals between the robotic arms 112. The IDM may be configured to operate medical instruments using techniques including, for example, direct drive, harmonic drive, gear drive, belt / pulley, magnetic drive, etc. In some embodiments, the IDM may be attached to one of each of the robotic arms 112, and the robotic arms 112 are configured to insert or withdraw the respective coupled medical instruments into or from a treatment site.

[0107] In some embodiments, the robotic arm 112 can be configured to control the position, orientation, and / or joint movement of a medical device attached thereto. For example, the robotic arm 112 can be configured to manipulate a scope / catheter using an elongated moving member. Examples of elongated moving members include one or more pull wires, cables, fibers, and / or flexible shafts. For example, the robotic arm 112 can be configured to actuate multiple pull wires of a scope / catheter to deflect the tip of the scope / catheter. The pull wires can include any suitable or desirable material, such as metallic materials and / or non-metallic materials, such as stainless steel, Kevlar, tungsten, and carbon fiber. In some embodiments, the scope / catheter is configured to exhibit nonlinear behavior in response to forces applied by the elongated moving member. The nonlinear behavior may be based on the stiffness and / or compressibility of the scope / catheter, as well as variability in slack or stiffness between different elongated moving members.

[0108] As shown in the figure, the console 412 is positioned at the upper end of column 410 of the robotic system 110. The console 412 may include a display(s) (e.g., a multi-purpose device such as a touchscreen) to provide a user interface for receiving and / or providing user inputs, such as providing preoperative data, intraoperative data, and information for configuring the robotic system 110 to the physician / user. Potential preoperative data may include preoperative planning, navigation and mapping data obtained from preoperative computerized tomography (CT) scans, and / or notes from preoperative patient interviews. Intraoperative data may include optical information provided by tools, sensors and / or coordinate information from sensors, and vital patient statistics such as respiration, heart rate, and / or pulse. The console 412 may be positioned and tilted to allow the physician to access the console 412 from the column 410 side opposite the arm base 416. From this position, the physician may operate the console 412 from behind the robotic system 110 while viewing the console 412, the robotic arm 112, and the patient.

[0109] The robot system 110 may also include a control circuit 422, one or more communication interfaces 423, one or more power supply units 424, one or more input / output components 425, one or more actuators / hardware 426, and / or memory / data storage devices 427. One or more communication interfaces 423 may be configured to communicate with one or more devices / sensors / systems. For example, one or more communication interfaces 423 may transmit / receive data wirelessly and / or via a wired connection over a network.

[0110] One or more power units 424 can be configured to manage and / or provide power to the robot system 110. In some embodiments, one or more power units 424 include one or more batteries, such as lithium-ion batteries, lead-acid batteries, alkaline batteries, and / or other types of batteries. That is, one or more power units 424 can include one or more devices and / or circuits configured to provide power and / or power management functions. Furthermore, in some embodiments, one or more power units 424 include a mains power connector configured to couple to an alternating current (AC) or direct current (DC) mains power supply. Furthermore, in some embodiments, one or more power units 424 include a connector configured to couple to the control system 150 to receive power from the control system 150.

[0111] One or more I / O components / devices 425 can be configured to receive input and / or provide output for purposes such as interface connection with a user. One or more I / O components / devices 425 can be configured to receive touch, speech, gesture, or any other type of input. In embodiments, one or more I / O components / devices 425 can be used to provide input for controlling a device / system, such as controlling / configuring a robotic system 110. One or more I / O components / devices 425 can include one or more displays configured to display data. One or more displays can include one or more liquid crystal displays (LCDs), light-emitting diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and / or any other type(s) of technology. In some embodiments, one or more displays include one or more touchscreens configured to receive input and / or display data. Furthermore, one or more I / O components / devices 425 can include touchpads, controllers, mice, keyboards, wearable devices (e.g., optical head-mounted displays), virtual reality devices or augmented reality devices (e.g., head-mounted displays), etc. In addition, one or more I / O components 425 may include one or more speakers configured to output sound based on an audio signal, and / or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, one or more I / O components 425 may include or be implemented as a console 412. Furthermore, one or more I / O components 425 may include one or more physically pressable buttons, such as a button on the distal end of the robot arm 112 (which can enable / disable the admittance control mode of the robot arm 112 for manual operation / movement of the robot arm 112).

[0112] One or more actuators / hardware 426 can be configured to facilitate the movement of the robot arm 112. Each actuator 426 may include a motor, which can be mounted at a joint or elsewhere within the robot arm 112 to facilitate the movement of the joint and / or connected arm segment / link mechanism. In some embodiments, the user can manually operate the robot arm 112 without using an electronic user control unit. For example, during setup in a surgical room or at any point during a procedure, the user may select a button on the distal end of the robot arm 112 to enable admittance control mode, and then manually move the robot arm 112 to a specific orientation / position.

[0113] Various components of the robot system 110 can be electrically and / or communicatively coupled using certain connection circuits / devices / features, which may or may not be part of the control circuit 422. For example, the coupling mechanism(s) may include one or more printed circuit boards configured to facilitate mounting and / or interconnection of at least some of the various components / circuits of the robot system 110. In some embodiments, two or more components of the robot system 110 can be electrically and / or communicatively coupled to one another.

[0114] As referenced above, systems 150 and 110 may each include control circuits 401 and 422 configured to perform certain functions as described herein. The term “control circuit” can mean one or more processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connection circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, graphics processing units, field-programmable gate arrays, application-specific integrated circuits, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any set of any devices that manipulate signals (analog and / or digital) based on hardcoding of circuits and / or operation instructions. A control circuit may further include one or more memory devices, which can be embodied in a single memory device, multiple memory devices, and / or embedded circuits of a device. Examples of such data storage devices include read-only memory, random-access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and / or any device that stores digital information. In embodiments in which the control circuit includes a hardware state machine (and / or implements a software state machine) and includes analog circuits, digital circuits, and / or logic circuits, it should be noted that any associated data storage device(s) / register(s) that store any associated operation instructions may be embedded inside or outside the circuit including the state machine, analog circuits, digital circuits, and / or logic circuits.

[0115] Although the control circuit is illustrated as a separate component from the other components of the control system 150 / robot system 110, any or all of the other components of the control system 150 / robot system 110 can be at least partially embodied in the control circuit. For example, the control circuit may include various devices (active and / or passive), semiconductor materials and / or areas, layers, regions and / or parts thereof, conductors, leads, vias, connections, etc., and one or more and / or parts thereof of the other components of the control system 150 / robot system 110 can be at least partially formed and / or embodied in such a circuit component / device.

[0116] Furthermore, the memory / data storage devices 406 / 427 can be configured to store data / instructions. For example, the data storage devices / memories 406 / 427 can store instructions that can be executed by a control circuit to perform a particular function / operation. The term “memory” can refer to any preferred or desirable type of computer-readable medium. For example, one or more computer-readable mediums could be one or more volatile data storage devices, non-volatile data storage devices, removable data storage devices, and / or non-removable data storage devices, implemented using any technology, layout, and / or data structure / protocol, which may include any preferred or desirable computer-readable instructions, data structures, program modules, or other types of data. One or more computer-readable media that can be implemented in accordance with embodiments of this disclosure include, but are not limited to, phase-change memory, static random-access memory (SRAM), dynamic random-access memory (DRAM), other types of random-access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technologies, compact disk read-only memory (CD-ROM), digital versatile disk (DVD) or other optical storage devices, magnetic cassettes, magnetic tapes, magnetic disk storage devices or other magnetic storage devices, or any other non-temporary media that can be used to store information for access by a computing device. In this specification, when used in a particular context, one or more computer-readable media may not generally include communication media such as modulated data signals and carrier waves.Therefore, one or more computer-readable media should generally be understood to refer to non-temporary media.

[0117] In some examples, the control system 150 and / or the robotic system 110 are configured to perform one or more localization techniques to determine / track the orientation / position of an object / medical device. For example, one or more localization techniques can process input data to generate position / orientation data for a medical device. The position / orientation data of an object / medical device can indicate the position / orientation of the object / medical device relative to a reference frame. The reference frame can be a reference frame relative to the anatomical structure of a patient, a known object (e.g., an EM field generator, system, etc.), a coordinate system / space, etc. In some implementations, the position / orientation data can indicate the position / orientation of the distal end (and / or, in some cases, the proximal end) of the medical device. For example, the position / orientation data of a scope can indicate the position and orientation of the distal end of the scope, including the amount of rotation of the distal end of the scope. The position and orientation of an object can be said to be the orientation of the object.

[0118] Exemplary input data that can be used to generate position / orientation data for an object / medical device include sensor data from sensors associated with the medical device (e.g., EM field sensor data, visual / image data acquired by imaging devices / depth sensors / radar devices on the medical device, accelerometer data from accelerometers on the medical device, gyroscope data from gyroscopes on the medical device, satellite-based positioning data from satellite-based sensors (e.g., Global Positioning System (GPS))), feedback data (also referred to as "kinematic data") from robotic arms / components (e.g., data showing how the robotic arm / component moved / operated), robot command data for robotic arms / components (e.g., control signals sent to robotic system 110 / robotic arm 112 to control the movement of robotic arm 112 / medical device), shape sensing data from shape sensing fibers (which can provide information about the position / shape of the medical device), model data about the patient's anatomical structure (e.g., models of internal / external parts of the patient's anatomical structure), patient position data (e.g., data showing how the patient is positioned on a table), preoperative data, and so on.

[0119] Figure 5 illustrates a medical system component, including a scope assembly / system 502 and an instrument feeder assembly 504, which may be implemented in one or more embodiments of the medical systems described herein. The scope system 502 and / or the feeder assembly 504 may include various hardware and control components. In the embodiment, the scope system 502 may represent / include the scope 130 and / or other scopes described herein. Furthermore, the instrument feeder assembly 504 may include the instrument feeder device 180 and / or any other instrument feeder devices described herein.

[0120] As shown in Figure 5, the scope system 502 includes a handle / instrument base 506 coupled to an elongated shaft 508. The handle 506 can be configured to be coupled to a robotically operated robotic arm and / or (in some examples) to be held and operated manually by a user. For example, the handle 506 can be configured to control the movement of the elongated shaft 508. The elongated shaft 508 can include a rigid or flexible tube or another element. In some examples, the elongated shaft 508 and / or other components of the scope system 502 are dimensioned to pass through an outer sheath, catheter, introducer, or other tubular device.

[0121] As shown in the figure, the scope system 502 may include one or more lights 510 that are at least partially disposed at the distal end of the elongated shaft 508 and provide light at the distal end. In embodiments, the scope 502 may house an optical fiber and be configured to transport light from a proximal light source, such as a light-emitting diode, to the distal end of the elongated shaft 508. The distal end of the elongated shaft 508 may include a port for a light source to illuminate the anatomical space, which may be useful when using an imaging device / camera 512. The scope system 502 can be implemented with any number of light sources.

[0122] The scope system 502 may also include a camera / imaging device(s) 512 configured to acquire image data, such as image data representing the internal anatomical structure of a patient. In some embodiments, the imaging device 512 may include optical fibers, fiber arrays, and / or lenses. One or more optical components of the imaging device 512 may move with the tip of the scope system 502, so that movement of the tip results in a change in the image acquired by the imaging device 512. Thus, the imaging device 512 can acquire data from the distal end of an elongated shaft 508. In some embodiments, the scope system 502 may house an optical assembly and wires and / or optical fibers for transmitting signals between the optical assembly and the distal end of the scope system 502.

[0123] The scope system 502 may also include work channels 514 for deploying and / or other functions of instruments / tools 516. Exemplary instruments 516 include laser devices configured to provide laser light, basket devices configured to capture / recover objects (e.g., kidney stone fragments), forceps configured to grasp / hold objects, surgical scalpels configured to cut objects, lithotomizers, and irrigation / suction devices configured to provide irrigation / suction to a target site. In the example in Figure 5, the basket device is deployed through the work channel 514. The work channel 514 may extend longitudinally through the scope system 502 from the proximal end to the distal end. In some embodiments, the work channel 514 is offset to one side of the elongated shaft 508 (e.g., offset from the longitudinal axis), as illustrated in Figure 5. In other embodiments, the work channel 514 is located at the center of the scope system 502 or elsewhere. Although the imaging device(s) 512 are shown as being attached to the distal end of the scope system 502 (e.g., integrated with the scope system 502), in some cases the imaging device(s) 512 are separate devices deployed through the working channel(s) 514. Furthermore, although a single working channel 514 is shown, any number of working channels may be implemented.

[0124] In some examples, the scope system 502 may be powered through a power interface 518 and / or controlled through a control interface 520, and each or both of these may interface with the robotic arm / components of the robotic system 110.

[0125] In some embodiments, the scope system 502 includes a sensor(s) 522 (sometimes referred to as “position sensors”) configured to generate and / or transmit sensor data to another device. The sensor data may indicate the position and / or orientation of the scope system 502 (e.g., its distal end) and / or can be used to determine / estimate the position / orientation of the scope system 502. For example, sensor 522 may provide sensor data to a control system, which is then used to determine the position and / or orientation of the scope system 502. Sensor 522 may be positioned at the distal end of the scope system 502 and / or elsewhere. In some embodiments, sensor 522 may be an electromagnetic (EM) sensor having a coil of conductive material, or another form / embodiment of an antenna. However, the scope system 502 may include other types of sensors, such as shape-sensing fibers, accelerometers(s), gyroscopes(s), satellite-based positioning sensors(s)(e.g., Global Positioning System (GPS) sensors), radio frequency transceivers(s), etc.

[0126] The scope system 502 may be articulated, such as with respect to at least the distal portion of the scope, so that the scope system 502 can be maneuvered within the anatomical structure of a human. In some embodiments, the scope system 502 is configured to be articulated with 5 degrees of freedom (DOF), including, for example, XYZ coordinate translation, as well as pitch and yaw. Furthermore, in some embodiments, the scope system 502 is articulated with 6DOF, including XYZ coordinate translation, as well as pitch, yaw, and rotation. In other embodiments, the scope system 502 is articulated with other DOF. In embodiments in which the scope system 502 is equipped with a position sensor, the position sensor can provide position information such as 5DOF position information (e.g., x, y, and z coordinates, as well as pitch and yaw angles) and 6DOF position information (e.g., x, y, and z coordinates, as well as pitch, yaw, and rotation angles). In some embodiments, the scope system 502 may include nesting components, such as an inner leader portion and an outer sheath portion, which can be operated to extend the scope system 502 in a nesting manner.

[0127] The scope system 502 may include one or more elongated moving members (not shown) configured to control the movement of the elongated shaft 508, such as at the distal end of the scope system 502. The elongated moving members may include one or more wires (e.g., pull wires or push wires), cables, fibers, and / or flexible shafts. The pull wire may include any suitable or desirable material, such as metallic and nonmetallic materials, such as stainless steel, Kevlar, tungsten, and carbon fiber. In some embodiments, the scope system 502 is configured to exhibit nonlinear behavior in response to forces applied by the elongated moving members. The nonlinear behavior may be based on the stiffness and / or compressibility of the scope system 502, as well as variability in slack or stiffness between different elongated moving members. In robotic implementations, a robotic arm may be configured to actuate one or more pull wires coupled to the scope system 502 to deflect the tip of the elongated shaft 508. Alternatively, in a user-handheld implementation, the user can provide manual input via an actuator to actuate one or more pull wires of the scope system 502 to deflect the tip of the elongated shaft 508.

[0128] Figure 5 further illustrates an instrument feeder assembly 504, which includes an instrument feeder device 530 (sometimes referred to as "instrument feeder 530") and an access sheath assembly 560 that can be physically coupled to the instrument feeder device 530.

[0129] The instrument feeder device 530 may include an engagement assembly 532 configured to engage with and / or control at least a portion of a shaft-type instrument, such as a scope 130. The engagement assembly 532 may include a channel 534 sized and / or configured to house at least a portion of a shaft-type instrument. For example, when the instrument feeder device 530 positions a scope or the like to allow such an instrument to be driven axially, the instrument may be at least partially nested within the channel 534. The engagement assembly 532 may also include a retaining mechanism 536 for holding the instrument within the channel 534. For example, the retaining mechanism 536 may include a robotically operated cover that allows the channel 534 to be selectively opened and closed. Furthermore, the engagement assembly 532 may include an actuator means / mechanism 538 for moving the shaft / instrument axially, such as when loaded into the channel 534. While various components have been illustrated as being included within the engagement assembly 532, the engagement assembly 532 may contain fewer or more components. In some examples, the instrument feeder device 530 does not include sensors, such as sensors for detecting the state of the instrument feeder device 530, but in other examples, the instrument feeder device 530 includes such sensors, such as sensors.

[0130] The actuator 538 can be configured to move a shaft-type instrument positioned in engagement with it relative to the axis of the instrument. In embodiments, the actuator(s) 538 may include one or more shaft-engaged wheels / rollers, conveyor belts, gears, tracks, finger / needle mechanisms, or other actuator(s). The actuator(s) 538 may be controlled through engagement with one or more drive input units 540, which may allow physical engagement with mechanical components of the instrument feeder device 530 that can actuate the actuator(s) / mechanism(s) 538 and / or directly actuate the actuator(s) / mechanism(s) 538. In one example, the actuator(s) 538 may include one or more feed rollers. As used herein, the term “feed roller” may include any number of roller(s) / wheel(s) configured to produce axial movement of a shaft engaged with it. The “feed roller” may further include an input or output drive unit associated with the instrument feeder device 530 that directly or indirectly causes the movement of the roller(s) / wheel(s). In some embodiments, the roller 538 may comprise or include a deformable material that provides grip, friction, traction, or pressure between the roller 538 and the elongated shaft 508. The deformable material may include silicone rubber or another material.

[0131] The instrument feeder device 530 further includes a sheath coupling member / clip 542 which can be configured to fix or hold at least a portion of the access sheath assembly 560 in place. For example, the sheath clip 542 may be configured to fasten over or cover at least a portion of the funnel port structure 562 of the access sheath assembly 560, as shown in the figure. The clip 542 may be supported by one or more clip support arms 544. The sheath clip 542 can be positioned at the distal end of the instrument feeder device 530.

[0132] In some embodiments, the instrument feeder assembly 504 includes, or is associated with, a specimen collector structure 546 which can be at least partially fixed to one or more components of the instrument feeder assembly 504. The specimen collector 546 may comprise a cup-shaped or other structure configured to allow the placement or dropping of kidney stones or other specimens or fragments retracted through the access sheath assembly 560, for example, by using a basket tool deployed through the instrument shaft. In some embodiments, the specimen collector 546 is positioned between the distal opening of the channel 534 and the funnel port structure 562, and an instrument (e.g., a basket device) may be retracted to a position on the specimen collector so that stones / specimens can drop or be placed into the specimen collector 546.

[0133] As shown in the figure, the access sheath assembly 560 may include an access sheath tube or conduit 564, which may be physically coupled to a funnel port structure 562 at its proximal end. The funnel port structure 562 may provide at least a partially conical inlet opening into the access sheath 564, the proximal opening of the port 562 having an area or diameter larger than the cross-sectional area or diameter of the access sheath 564. In some embodiments, the access sheath 564 is not docked to an instrument feeder device 530, but rather coupled to a robotic arm, stand, or other structure. The access sheath 564 may include a tube or other structure into which an elongated shaft 508 can be inserted. In some embodiments, the access sheath 564 may include an elongated flexible access sheath configured to be inserted into an anatomical lumen. In some embodiments, no access sheath is used, and the elongated shaft 508 of the scope assembly 502 can be inserted directly into the patient (e.g., through the patient's natural opening or other surgical access port or incision). While certain examples described herein refer to access sheath assemblies including port / introducer structures and sheath components, it should be understood that embodiments of this disclosure may implement access sheaths having integrated port and sheath components. Therefore, references to “access sheath” or simply “sheath” herein may refer to the sheath portion, port portion, or both of these of an access sheath / assembly. Furthermore, the access sheath assemblies described herein may not be assemblies of separate components, but rather a single device, form, or structure.

[0134] Figures 6A to 6G illustrate exemplary details of the instrument feeder device 530 according to one or more embodiments. Specifically, Figure 6A illustrates a perspective view of the instrument feeder device 530; Figure 6B illustrates the instrument feeder device 530 with a portion of the housing removed to show various features of the instrument feeder device 530; Figure 6C illustrates the instrument feeder device 530 with a portion of the housing and the retaining mechanism(s) 536 removed; and Figures 6D to 6G illustrate exemplary mechanisms / gears that can be implemented to facilitate the movement of the rollers 538.

[0135] As shown in Figure 6A, the instrument feeder device 530 may include a housing 602 configured to (partially or completely) enclose / surround various internal components of the instrument feeder device 530. The housing 602 may include an upper portion 604 and a lower portion 606, the lower portion 606 of which may be configured to attach to a robotic arm, a sterilization adapter, and / or other mechanism / component. The upper portion 604 may include a channel 534 formed internally and configured to receive an instrument shaft. Such a configuration may allow the instrument shaft to be loaded into the instrument feeder device 530 from the top and / or laterally. The channel 534 may be dimensioned to receive an instrument shaft such that the channel 534 is generally wider than the outer diameter of the instrument shaft. The C-shaped clip support arm 544 may be part of the housing 602 or a separate component.

[0136] In some embodiments, the instrument feeder device 504 may include one or more clip / retaining mechanisms 608 configured to secure the instrument shaft within the channel 534. For example, a first clip (A) 608 may be positioned at the proximal end of the channel 534, and a second clip 608 (B) may be positioned at the distal end of the channel 534. The clips may be configured to secure the instrument shaft without substantially restricting the axial movement of the shaft through the channel 534. The inner diameter of the retaining portion of the clip 608 may generally be larger than the outer diameter of the instrument shaft. In some examples, the clip 608 may be configured to provide tactile feedback to the user indicating that the instrument shaft is properly loaded within the channel 534, such as by snapping it through the entry portion of the clip 608. In some examples, the instrument shaft may exhibit some amount of pivot / tilt motion around the point where the instrument shaft contacts the actuator, as the contact point may be relatively small. Therefore, the channel 534, the clip 608, and / or other mechanisms of the instrument feeder device 504 can help maintain the instrument shaft in the proper orientation within the instrument feeder device 530. In some cases, the channel 534 may be long enough to limit / prevent displacement of the instrument shaft.

[0137] In the illustrated example, channel 534 includes a flared or tapered portion 610 that can be positioned at the proximal end of channel 534. In some examples, an instrument shaft (which may be relatively flexible) may form a service loop or other excess slack between the instrument feeder device 530 and an additional robotic arm positioned coupled to an instrument base / handle associated with the instrument shaft. The tapered portion 610 can facilitate feeding the instrument shaft into the instrument feeder device 530 in an angled state and / or in the presence of a service loop, while avoiding sharp bends in the instrument shaft. For example, the tapered portion 610 can provide space for feeding an elongated shaft to the proximal end of channel 534 at various angles, while the sidewalls of the tapered portion 610 can provide an enlarged bending radius or a smooth entry portion for the instrument shaft in the area where the instrument shaft enters the instrument feeder device 530. The tapered portion 610 can also accommodate some degree of misalignment between the instrument feeder device 530 and the instrument base / handle associated with the instrument shaft. Furthermore, the tapered portion 610 facilitates the feeding of the elongated shaft through the instrument feeder device 530 when the shaft is driven in the axial direction.

[0138] As shown in Figures 6B and 6C, the instrument feeder device 530 may include an actuator 538 configured to drive the axial movement of the instrument shaft. In this example, the actuator 538 is implemented as a feed roller, but other types of actuators may also be implemented. The roller 538 can be positioned on both sides of the channel 534 such that when the instrument shaft is loaded into the instrument feeder device 530, the roller 538 is positioned on both sides of the instrument shaft. Thus, the roller 538 may be referred to as an opposing roller. The roller can be configured to move between a first position generally associated with an engaged state, a second position generally associated with an unengaged state, and / or other positions. For example, in the first position, the roller 538 can press against or otherwise engage with the opposite / both sides of the instrument shaft and / or each other. In this embodiment, when the roller 538 is positioned in the first position, the roller 538 can be rotated to drive the insertion / retraction of the instrument shaft. Furthermore, in the embodiment, when the roller 538 is positioned in a second position, the roller 538 can be separated from the tool shaft and / or channel 534. The second position can be associated with loading the tool shaft, rotating the shaft, and so on. Exemplary states / positions of the roller 538 and / or other mechanisms of the engagement assembly 532 are described in further detail below.

[0139] As shown in Figure 6B, the instrument feeder device 530 may include a retaining mechanism(s) 536. In this example, the retaining mechanism 536 is implemented as a cover, but other retaining mechanisms may be implemented. Here, the cover 536 is coupled / mechanically connected to one or more other mechanisms of the instrument feeder device, such as a roller 538(A). In this embodiment, the cover 536 can be automatically opened and closed as the roller 538(A) moves between various positions / states (e.g., engaged or disengaged). As shown, the cover 536 may include a plate positioned above the roller 538(A). The cover 536 may include slots 616 or other openings for receiving / engaging with cams / shafts 618 that may extend from the roller 538(A). In this example, as the roller 538(A) moves, the cams 618 engage with the slots 616, causing a corresponding movement of the cover 536, such as opening and closing the cover 536 along with the movement of the roller 538(A). Various examples are described in the context of the retaining mechanism 536 implemented as a cover, but other mechanisms may be implemented. For example, the clip 608 may be configured in some examples to be selectively opened and closed to facilitate the opening and closing of the channel 534. In the illustrated embodiments, a cam mechanism is used to open and close a sliding or translational cover, but other mechanisms may be used to form an operable coupling between the drive input and the cover 536. Additionally or alternatively, the cover 536 may be a pivotal cover or may be actuated to open and close by other movements.

[0140] In some embodiments (as illustrated in the example) where the position of the cover 536 is mechanically coupled to the position of the roller 538, the cover 536 can be long enough to continue closing the channel 534 even after the roller 538 is first disengaged from the tool shaft. Then, as the roller 538 continues to move away from the shaft, the cover 536 continues to move and can remove the cover from the channel 534. In other embodiments, the position of the cover 536 can be controlled in a different way. For example, the cover 536 does not need to be mechanically coupled to the roller 538(A). In some examples, the cover 536 is controlled independently and / or not mechanically coupled to the roller 538(A), in which case it can be fully open, closed, or any other intermediate position of the cover 536, controlled by and / or by another drive input. That is, in some examples, the cover 536 is coupled to its own drive input.

[0141] The instrument feeder device 530 may further include one or more springs 612 that can be configured to apply force to the roller 538. In some examples, the springs 612 can bias the roller 538 toward a specific position, such as a first position (e.g., closed / engaged state) toward which the roller 538 is engaged. Here, the drive output unit can provide / apply a force that overcomes the force of the springs 612 in order to move the roller 538 toward a second position toward which the roller 538 is disengaged. In some embodiments, in addition to biasing the roller 538 toward the engaged position, the springs 612 may also be configured to provide a pressure or frictional force to engage the roller 538 with the instrument shaft. Thus, the spring force can be selected such that the roller 538 begins to slide on the instrument shaft with a given load. By adjusting this drive / spring force, the system can maintain a level of applied force that is judged or defined as acceptable or safe for the patient. While various examples are described in the context of a spring 612 that biases roller 538 toward a first position in which the roller is engaged, the spring 612 can be configured to bias roller 538 toward a second position in which the roller is disengaged, and / or to bias roller 538 toward another position. In some examples, one or more springs 612 are part of an engagement assembly 532.

[0142] In the embodiment, one or more springs 612 include mechanical springs such as torsion springs. However, other types of springs, such as coil springs or other types of springs, can be implemented. In the case of mechanical springs, the force of spring 612 can be adjusted (to provide the safety mechanism described above) by adjusting the size of spring 612 and / or the material from which spring 612 is made. In addition, various other parameters of the instrument feeder device 530 can be considered. For example, the material of the contact area of ​​roller 538 can be adjusted to provide different coefficients of friction between the instrument shaft and roller 538. Similarly, the coefficient of friction of the instrument shaft can be adjusted. One or more of these parameters can be configured to reduce or prevent roller 538 from sliding against the instrument shaft and the shaft from applying excessive force to the patient's anatomical structures. In some embodiments, spring 612 can be omitted, and the instrument feeder device 530 may include a virtual spring that applies force to the instrument shaft, controlled via the operation of a drive shaft or drive output unit. For example, instead of including or in addition to the spring 612, the drive input 540 can operate to provide a function similar to that of a mechanical spring, and thus provide a virtual spring that can grip the instrument shaft.

[0143] In this embodiment, the roller 538 is coupled to a drive shaft 614 to facilitate its rotation. For example, the drive shaft 614 can be coupled to a drive input 540 of an instrument feeder device 530 to receive input from a drive output of a robot arm and control the rotation of the roller 538. The drive shaft 614 can be rotated to provide the corresponding rotation in the roller 538. In one example, the drive shaft 614(A) can be coupled to a drive input 540(A) and / or the drive shaft 614(B) can be coupled to a drive input 540(B), as illustrated in Figure 7. In this embodiment, each of the rollers 538 can be driven independently. The rollers 538 can be connected to the drive input 540 and / or the drive shaft 614 through direct connections and / or through gear assemblies, belt drive systems, and / or other means / mechanisms. In this embodiment, two rollers 538 and two drive shafts 614 are illustrated, but any number of rollers and / or drive shafts can be implemented. For example, a single drive shaft can be implemented to drive one or more rollers.

[0144] In the embodiment, the rollers 538 operate in a cooperative relationship, resulting in movement toward or toward each other in a correlated manner. For example, each of the rollers 538 can be coupled to a carrier / support plate, and the two carrier plates are meshed or otherwise coupled together such that the rotation of one carrier plate causes the opposite and corresponding rotation of the other carrier plate, as illustrated in the embodiments of Figures 6D to 6G below. In this way, the rotation of both carrier plates can be driven by a single open / close drive input, such as a drive input 540(C) (as illustrated in Figure 7 and elsewhere). Thus, in some embodiments, a single drive input can control the engagement assembly 532 of the instrument feeder device 530.

[0145] Figure 6D illustrates a perspective view of an exemplary actuator / roller assembly 620 that may be implemented within a tool feeder device 530 to facilitate the movement of the roller 538. This shows one of many exemplary implementations. In the illustrated example, the roller assembly 620 includes a right assembly and a left assembly. Each of the right and left assemblies may include a carrier plate 622. The term "plate" can generally refer to a support structure, and the carrier plate 622 does not necessarily have to be considered flat or planar. Rather, the carrier plate 622 may include various shapes and / or geometric shapes configured to support various components of the roller assembly 620. The carrier plate 622 may also be referred to as a link mechanism or other support structure.

[0146] Generally, the carrier plates 622 support or are connected to various other mechanisms or structures of the roller assembly 620. For example, each carrier plate 622 may support or be connected to one of the rollers 538 and one of the roller drive shafts 614. As shown in Figure 6D, each roller 538 is configured to rotate about the roller axis 626. Each roller drive shaft 614 may be configured to rotate about the drive input axis 628. As shown, the roller axis 626 and the drive input axis 628 do not need to be coaxial. In some examples, the roller axis 626 and the drive input axis 628 are parallel (for example, as shown). Furthermore, the carrier plate 622 can support or connect to the gear assembly 630, as described below with reference to Figures 6E and 6F, and the gear assembly 630 connects the roller drive shaft 614 to the roller 538 so that the rotation of the roller drive inputs 540(A) and 540(B) can cause the rotation of the roller 538.

[0147] In the illustrated example, the carrier plate 622 can be configured to rotate about the drive input axis 628. Rotation of the carrier plate 622 about the drive input axis 628 can move the roller 538 between various positions. As shown in Figure 6G, the instrument feeder device 530 may include a drive input section 540(C) (also referred to as the “open / close drive input section 540(C)”) configured to move the roller 538 between various positions. The open / close drive input section 540(C) can be connected to the open / close drive shaft 632 shown in Figure 6D. Rotation of the open / close drive input section 540(C) can cause rotation of the open / close drive shaft 632. The open / close drive input section 540(C) and the open / close drive shaft 632 can rotate about the open / close drive axis 634. The open / close drive shaft 632 can be further connected to an off-shaft projection 636. Therefore, when the open / close drive shaft 632 rotates, the off-shaft projection 636 also rotates around the open / close drive axis 634. However, the off-shaft projection 636 does not have to be symmetrical with respect to the open / close axis 634. Thus, the off-shaft projection 636 can provide an eccentric member that can move in an arc shape around the open / close axis 634.

[0148] As shown in Figure 6D, each of the carrier plates 622 may contain a pocket / cavity 638. In the illustrated embodiment, the off-axis projection 636 is positioned at least partially within one of the pockets 638 of the carrier plate 622. As the off-axis projection 636 rotates around the open / closed axis 634, it can contact the wall of the pocket 638, thereby allowing the carrier plate 622 to rotate around the drive input axis 628. The off-axis projection 636 can also be rotated to a position where it does not contact the wall of the pocket 638. In this position where the off-axis projection 636 is not in contact with the pocket 638, the force applied by the roller 538 to the shaft of the medical instrument can be entirely determined by the spring 612, which can be adjusted to provide a desired force. In this position, the carrier plate 622 can be biased by the spring 612 to rotate to a position where the roller 538 is in a specific position (e.g., the closed position). When the off-shaft projection 636 is rotated to contact and press against the side wall of the pocket 638, the carrier plate 622 can rotate over the spring force of the spring 612. In some examples, the off-shaft projection 636 includes a roller configured to rotate around an axis that is not coaxial with the open / close drive axis 634. Such a roller can reduce friction between the off-shaft projection 636 and the pocket 638.

[0149] In the example shown in Figure 6D, the roller assembly 620 includes one open / close drive shaft 632 and one off-shaft projection 636. In some examples, such as this one (and as seen in Figures 6E–6G), two carrier plates 622 can mesh together such that rotation of one carrier plate 622 causes the opposite and corresponding rotation of the other carrier plate 622. In this way, the rotation of both carrier plates 622 can be driven by a single open / close drive input 540(C). This also allows the rollers 538 to be positioned symmetrically with respect to the channel 534 of the instrument feeder device 530. In the illustrated example, one off-shaft projection 636 is included, but both carrier plates 622 may include a pocket 638, with one of the pockets 638 being empty. Including an empty pocket may facilitate manufacturing, as the same or similar mold can be used for each carrier plate 622. Additionally or alternatively, the other carrier plate can be rotated independently using a second projection outside the opening / closing shaft or other drive member, in which case it is not necessary for the two carrier plates to mesh together. Furthermore, one of the carrier plates 622 does not have to include a pocket.

[0150] Figures 6E and 6F illustrate isometric and top views of a roller assembly 620 with a portion of the roller 538 and carrier plate 622 removed to illustrate an exemplary gear assembly 630. The gear assembly 630 can transmit rotational motion between the drive inputs 540(A), 540(B) and the roller 538. As shown, the gear assembly 630 may include a first gear 640 (e.g., a sun gear) and a second gear 642 (e.g., a raceway gear) (for each carrier plate 622). In the illustrated example, each first gear 640 may be connected to the roller drive shaft 614 / roller drive inputs 540(A), 540(B) such that the rotation of the roller drive shaft 614 / roller drive inputs 540(A), 540(B) causes the rotation of the first gear 640. The first gear 640 can be mounted on the carrier plate 622 so that the first gear 640 can rotate relative to the carrier plate 622. Each first gear 640 can rotate about its respective drive input axis 628 (shown in Figure 6D).

[0151] Each first gear 640 can engage with the associated second gear 642 such that the rotation of the first gear 640 causes the rotation of the second gear 642. The second gears 642 can be mounted on the carrier plate 622 so that the second gear 642 can rotate relative to the carrier plate 622. The second gears 642 can rotate about their respective roller axes 626 (shown in Figure 6D). The second gears 642 can also be mounted on (or otherwise engaged with) the roller 538 such that the rotation of the second gear 642 causes the roller 538 to rotate. Thus, the rotation of the roller drive inputs 540(A) and 540(B) can cause the roller 538 to rotate through the transmission by the first gears 640 and the second gears 642.

[0152] As described above, the carrier plate 622 rotates around the drive input axis 628, allowing the roller 538 to move between various positions (e.g., closed and open positions). In the illustrated example, the second gear 642 is mounted on the carrier plate 622 at a distance from the drive input axis 628 and therefore rotates around the drive input axis 628 (together with the carrier plate 622). When the second / race gear 642 rotates together with the carrier plate 622 around the drive input axis 628, it also rotates around the first / sun gear 640.

[0153] This arrangement, in which the second / orbital gear 642 rotates around the first / sun gear 640, can be seen in the top view of Figure 6F. As shown, the off-axis projection 636 can be rotated to contact the pocket 638 of the carrier plate 622, thereby driving the rotation of the carrier plate 622 in the direction indicated by the arrow in Figure 6F. In particular, with respect to the orientation shown in the figure, the bottom of the carrier plate 622 can be rotated inward toward the center of the page, and the top of the carrier plate 622 can be rotated outward toward the outer edge of the page. The gear mechanism 644 between the plates 622 can cause the other plate 622 to move / rotate when the corresponding opposite rotation of one carrier plate 622 occurs. Each of the carrier plates 622 can rotate about the corresponding drive input axis 628. When the carrier plates 622 rotate, the second / orbital gear 642 is driven outward and rotates about the sun gear 640. This arrangement allows the roller 538 (not shown in Figure 6F, but coupled to the second / race gear 642) to be driven regardless of the rotational position of the carrier plate 622. This arrangement can accommodate, for example, the shafts of instruments having different diameters.

[0154] Figure 6G is a bottom view of the roller assembly 620 illustrating the relationship between the roller drive input sections 540(A) and 540(B) and the open / close drive input section 540(C) of the roller assembly 620 according to an embodiment.

[0155] Figures 6D–6G illustrate one exemplary actuator / roller assembly 620 that can be implemented within the equipment feeder device 530. Various mechanisms are shown in specific arrangements, but these mechanisms can be implemented in other ways, and / or other mechanisms can be implemented to facilitate the movement of the roller 538.

[0156] An exemplary mechanism of an instrument feeder assembly is described in application No. 16 / 994,504, filed on 14 August 2020, entitled “Axial Motion Drive Devices, System, and Methods for a Robotic Medical System,” the overall content of which is incorporated herein by reference.

[0157] Figure 7 illustrates an exploded view of an exemplary instrument device manipulator assembly 702 associated with a robot arm 112 according to one or more embodiments. The instrument device manipulator assembly 702 includes an end effector 704 associated with the distal end of the robot arm 112. The instrument manipulator assembly 702 further includes an instrument feeder 530 / instrument feeder assembly 504. The instrument feeder 530 / instrument feeder assembly 504 may incorporate electromechanical means for acting on an instrument 706, such as a scope 502 or other shaft-type instrument. In embodiments, the instrument manipulator assembly 702 may also include an adapter 708 configured to provide an actuation joint between the end effector 704 and the instrument feeder 530 / instrument feeder assembly 504. Descriptions of upward and downward surfaces, plates, faces, components, and / or other mechanisms or structures herein may be understood by referring to a specific orientation of the instrument device manipulator assembly 702 shown in Figure 7. In other words, the end effector 704 may be configured to face and / or be oriented in a range of directions and orientations, but for convenience, the description of such configurations herein may be in the context of the generally perpendicular orientation of the end effector 704.

[0158] As shown in the figure, the end effector 704 of the robot arm 112 may include various components / elements configured to connect to and / or align with the components of the adapter 708, the instrument feeder assembly 504, the access sheath assembly 560, and / or the instrument 706. For example, the end effector 704 may include a drive output unit 710 for controlling / operating a medical instrument (e.g., a drive spline, gear, or rotatable disk with an engagement mechanism), a reader 712 for reading data from a medical instrument (e.g., a radio-frequency identification (RFID) reader for reading a serial number from a medical instrument), one or more fasteners 714 for attaching to the instrument feeder 530 / instrument feeder assembly 504 and / or the adapter 708, and a marker 716 for aligning with an instrument that is manually attached to a patient (e.g., an access sheath 564) and / or defining the front of the device manipulator assembly 702. In some embodiments, the end effector 704 and / or the robot arm 112 includes a button 718 for enabling an admittance control mode that allows the robot arm 112 to be moved manually.

[0159] In this example, the instrument device manipulator assembly 702 includes an adapter component 708 configured to provide a drive unit connection between the end effector 704 and the instrument feeder 530 / instrument feeder assembly 504. The adapter 708 and / or the instrument feeder 530 may be removable or detachable from the robotic arm 112 and, in some embodiments, may lack any electromechanical components such as motors. This dichotomy may be caused by the need to sterilize medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to the complex mechanical assembly and sensitive electronics of the medical instruments. Therefore, the instrument feeder 530 / instrument feeder assembly 504 and / or the adapter 708 may be designed to be removed, discarded, and replaced from the end effector 704 (and thus the system) for individual sterilization or disposal. For example, the instrument feeder assembly 504 can be removed and replaced with a different type of instrument. Alternatively, the end effector 704 may not need to be replaced or sterilized in some cases and may be covered for protection (e.g., using a drape 711). The adapter 708 may include connectors for transmitting pneumatic, electric, electrical, and / or optical signals from the robot arm 112 and / or end effector 704 to the instrument feeder 530 / instrument feeder assembly 504. In some embodiments, the adapter 708 includes a coupler(s) / drive mechanism(s) 720 configured to connect the drive output section 710 of the end effector 704 to the drive input section 540 of the instrument feeder assembly 504. Furthermore, in some examples, the adapter 708 may include a fastener(s) 722 configured to connect the adapter 708 to the end effector 704.

[0160] In some configurations, a sterile drape 711, such as a plastic sheet, may be positioned between the end effector 704 and the adapter 708 to provide a sterile barrier between the robot arm 112 and the instrument feeder assembly 504. For example, the drape 711 may be coupled to the adapter 708 to allow the transmission of mechanical torque from the end effector 704 to the adapter 708. The adapter 708 may generally be configured to maintain a seal around its working components so that the adapter 708 itself provides a sterile barrier. The use of the drape 711 coupled to the adapter 708 and / or more other components of the device manipulator assembly 702 can provide a sterile barrier between the robot arm 112 and the surgical field, thereby enabling the use of the robot cart associated with the arm 112 in a sterile surgical field. The end effector 704 may be configured to be coupled to various types of sterile adapters that can be loaded onto and / or removed from the end effector 704 of the robot arm 112. With arm 112 covered in plastic, a physician and / or other technician(s) may interact with arm 112 and / or other components of the robot cart (e.g., screen) during the procedure. Draping can further protect the equipment from biohazard contamination and / or minimize post-procedure cleaning.

[0161] In this example, the instrument feeder 530 includes a plurality of drive input units 540. In the illustrated embodiment, the instrument feeder 530 includes three drive input units 540, but may include any other number of drive input units. The drive input units 540 may be in fixed positions spaced apart along the lower mating surface 724 of the instrument feeder 530, which facilitates coupling the drive input units 540 to the corresponding drive output units (e.g., on the sterilization adapter 708 and / or end effector 704). The drive input units 540 may be in fixed positions spaced apart along corresponding mating surfaces designed for modular use and attachment to various other instruments. While various examples describe drive input units 540 mounted in fixed positions, in some cases the drive input units 540 may be movable within the lower surface 724. For example, drive input units 540(A) and 540(B) may be repositioned within the lower surface 724 to engage and / or disengage opposing rollers 538 from each other and / or from the instrument shaft.

[0162] The mechanical assembly within the instrument feeder 530 can be used to enable the drive input 540 to be used to drive the rotation of actuator 538 for axial motion of the instrument shaft (for example, to drive the rotation of opposing rollers) and / or to facilitate changes in the engagement state between the engagement assembly 532 and the instrument shaft. For example, drive inputs 540(A) and 540(B) can receive inputs to control actuator 538 to drive a shaft disposed within channel 534 in the axial direction. Drive inputs 540(A) and / or 540(B) can receive torque / force applied by drive output units, thereby enabling the feed rollers or other actuators to drive the shaft-like instrument in the axial direction. Furthermore, the drive input unit 540(C) (also referred to as the “open / close drive input unit”) receives input from the drive output unit and controls the engagement assembly 532 to engage / disengage with the instrument shaft, opening / closing the channel 534 (for example, using a holding mechanism 536) or implementing other states, as will be described in more detail below. The various states of the engagement assembly 532 can facilitate loading or unloading the instrument shaft, engaging with the instrument shaft, driving the instrument shaft, or other functions. In the illustrated example, three drive input units 540 are shown, but any number of drive input units can be implemented. Each of the drive input units 540 may be configured to engage with a corresponding drive output unit on the robot arm 112 and / or the sterilization adapter 708. For example, each drive input unit 540 may include a receptacle configured to mate with a drive output unit configured as a spline. The drive input units and drive output units may be configured to engage to transmit motion between them. Therefore, by rotating the drive output unit, the corresponding rotation of the drive input unit 540 can be caused to control the various functions of the instrument feeder 530.

[0163] In this specification, references to “appliance device manipulator assembly,” “appliance manipulator assembly,” “manipulator,” “manipulator assembly,” and other variations thereof may refer to any subset of the components of assembly 702 shown in Figure 702, including a robot arm, an end effector of the robot arm, an adapter configured to be coupled to the robot end effector, an appliance feeder configured to be coupled to the end effector and / or adapter, an actuator of the appliance feeder (e.g., feed rollers, shaft channels, holding mechanisms, and / or other components), and / or means / mechanisms associated with the appliance feeder. Furthermore, it should be understood that references to “actuator” in this specification may refer to any component of assembly 702 that is engaged with, coupled to, or otherwise directly or indirectly affects or causes movement of an appliance that is actuated by the appliance feeder. For example, according to embodiments disclosed herein, “actuator” may include any set or subset of devices or components such as feed rollers, shaft-driven wheels / rollers, feed roller channels, tool feed drive inputs, adapter drive outputs, adapter drive inputs, and / or end effector drive outputs.

[0164] Figures 8 to 11 illustrate exemplary states / positions of the engagement assembly 532 of the instrument feeder device 530 according to one or more embodiments. Generally, a drive output unit engages with one or more drive input units 540 (not shown) of the instrument feeder device 530 to actuate one or more components of the engagement assembly 532, thereby bringing the engagement assembly 532 / instrument feeder device 530 into a certain state / position. In this example, the engagement assembly 532 is implemented using opposing feed rollers 538, channels 534, and / or a cover 536. However, the feed rollers 538 can be implemented as other types of actuators, and / or the cover 536 can be implemented as other types of retaining mechanisms. Furthermore, one or more of the illustrated components of the engagement assembly 532 can be removed and / or implemented in other ways. For example, the cover 536 may, in some cases, not be implemented at all.

[0165] Figures 8-1 and 8-2 illustrate a state in which the rollers 538 are engaged and the cover 536 is closed. In the embodiment, when engaged, the rollers 538 can exert some force on each other and / or on a hard stop mechanism (not shown), which may result from the biasing force of one or more springs 612 (not shown), a force applied by a drive output unit, and / or another force applied to actuate the rollers 538 toward each other. In the embodiment, the rollers 538 may be in contact with each other. However, the rollers 538 may not be in contact with each other, but may be within a threshold distance of each other (this can be facilitated by a hard stop mechanism).

[0166] In this example, the cover 536 is closed to prevent objects from entering or exiting the channel 534. As described above, in some examples, the cover 536 can be coupled to one or more of the rollers 538 so that the movement of the rollers 538 causes the cover 536 to open and close. However, the cover 536 can operate independently. The cover 536 can have various shapes and / or sizes. In this example, the cover 536 includes dimensions that substantially close / cover the channel 534 when positioned over it.

[0167] In some examples, the outer edge portion 538(A)(1) / 538(B)(1) of the roller 538(A) / 538(B) may be formed of a different material than the inner portion 538(A)(2) / 538(B)(2) of the roller 538. For example, the outer / circumferential portion 538(A)(1) / 538(B)(1) may include a deformable material configured to drive an elongated shaft axially and / or grip / contact the tool shaft to avoid damage to the elongated shaft. However, the outer edge portion 538(A)(1) / 538(B)(1) and the inner portion 538(A)(2) / 538(B)(2) may be formed of the same material.

[0168] Figures 9-1 and 9-2 illustrate a state in which the roller 538 is engaged with the instrument shaft 902 and the cover 536 is closed. As shown, the roller 538 can engage with or otherwise contact the opposite or opposing side of the elongated shaft 902, which is positioned between the rollers 538 in the channel 534. As illustrated, the elongated shaft 902 is loaded into the channel 534 and inserted into the access sheath assembly 560. The roller 538 is press-fitted onto the elongated shaft 902 or otherwise engaged with the elongated shaft 902. In embodiments, some amount of force can be applied to the roller 538 to engage with the elongated shaft 902, which may result from the biasing force of one or more springs 612 (not shown), a force applied by a drive output unit, and / or another force applied to actuate the rollers 538 toward each other.

[0169] In this position / state, the roller 538 can rotate to drive the axial movement of the tool shaft 902 (for example, inserting / retracting the shaft 902). For example, rotating the roller 538 in a first direction can cause the insertion of the shaft 902 (e.g., distally toward the patient), and rotating the roller 538 in the opposite second direction can cause the retraction of the shaft 902 (e.g., proximally toward the patient). Here, the direction of the roller 538 can refer to the direction of movement of a part of the roller 538. For example, rotation in the first direction for insertion of the shaft 902 can refer to rotation of the engaging part of the roller 538 distally, and rotation for retraction can refer to rotation of the engaging part of the roller 538 proximally. With respect to the diagram of the roller 538 in Figure 9-2, the left roller 538(B) can rotate counterclockwise, and the right roller 538(A) can rotate clockwise to rotate the roller 538 distally (e.g., insert the shaft 902), and vice versa to rotate the roller 538 proximally (e.g., retract the shaft 902).

[0170] In this example, the cover 536 is at least partially closed to help hold the instrument shaft 902 within the channel 534, such as by preventing the roller 538 from ejecting the shaft 902 upward and / or laterally from the channel 534. In other words, the cover 536 surrounds at least a portion of the channel 534 in which the instrument shaft 902 is located to prevent the shaft 902 from moving away from the channel 534. However, as mentioned above, the cover 536 may be removed in some cases.

[0171] Figures 10-1 and 10-2 illustrate the state in which the roller 538 is disengaged and the cover 536 is closed. Such a state / position can be an intermediate state between the closed / engaged state and the open / loaded state. As shown, the roller 538 can be disengaged from the elongated shaft 902 or moved in any other way away from contact with the elongated shaft 902. Furthermore, the cover 536 can be closed to cover at least a portion of the channel 534 so that the instrument shaft 902 is still held within the channel 534. In this state / position, the roller 538 can be disengaged from the instrument shaft 902, allowing the shaft 902 to slide or rotate freely within the channel 534.

[0172] In the embodiment, this position / state is used in various cases during a procedure when retention of the instrument shaft is desired, but greater freedom of movement of the shaft relative to the instrument feeder device 530 is desired. For example, this state / position can be used to allow the instrument shaft 902 to rotate about its longitudinal axis, to allow a robot arm coupled to the instrument feeder device 530 to be repositioned (while avoiding insertion / retraction of the shaft 902), to allow a robot arm coupled to the handle / instrument base of the shaft 902 to be repositioned (and to allow the shaft 902 to slide freely within the channel 534), and / or to enable other functions without engaging with the shaft 902. In some cases, the robot arm can be moved while operating in admittance / manual mode. However, the robot arm can be controlled to move based on a control signal or other input.

[0173] In one example, a robotic arm coupled to an instrument feeder device 530 can be moved during a procedure (or at other times) to adjust the position / position of an access sheath coupled to the robotic arm. The access sheath is at least partially placed within the patient and can be used to insert a medical instrument into the patient. To maintain within the instrument feeder device 530, the instrument feeder device 530 implements this intermediate state, allowing the elongated shaft 610 to move freely within the instrument feeder device 530, while the robotic arm coupled to the instrument feeder device is repositioned. In this embodiment, the robotic arm moves using admittance control mode, but the robotic arm can move in other ways.

[0174] Figures 11-1 and 11-2 illustrate a state in which the rollers 538 are disengaged and the cover 536 is open. Such a state / position may be referred to as a fully open / disengaged state or a loaded state. As shown, the rollers 538 can be disengaged from the elongated shaft 902 or otherwise moved away from contact with the elongated shaft 902, and the cover 536 is fully open to allow access to the channel 534. Although the rollers 538 are shown positioned further apart from each other than in the intermediate state in Figures 10-1 and 10-2, the rollers 538 can be positioned in the same position as in Figures 10-1 and 10-2 and / or in a different disengaged position. The cover 536 can be opened or otherwise repositioned to provide access to the channel 534 (e.g., from above). In the illustrated example, the cover 536 is positioned completely below the upper housing 604. However, the cover 536 may be located elsewhere, at least partially within the channel 534, or it may be located elsewhere, which may allow the instrument shaft 902 to be loaded into or removed from the channel 534.

[0175] In the embodiment, the open / fully disengaged state can facilitate loading or unloading the instrument shaft 902 into or from the instrument feeder device 530, thereby simplifying the use of the device and / or reducing operating time. For example, the open channel can facilitate loading and / or unloading the instrument shaft 902 before, during, or after a medical procedure. In one example, the fully open / disengaged state can allow the user to manually adjust the shaft 902 and / or associated medical instruments without having to fully retract the shaft 902 from the patient.

[0176] Figures 12 and 13 illustrate various details relating to exemplary states of the engagement assembly 532 and the exemplary drive output unit 1202 of the engagement assembly 532 according to one or more embodiments. Specifically, Figure 12 illustrates state 1204 of the engagement assembly 532 (within block 1206) without the fixture shaft disposed / loaded inside, and Figure 13 illustrates state 1204 of the engagement assembly 532 with the fixture shaft disposed / loaded inside. These figures illustrate some of the many exemplary states of the engagement assembly 532 described herein. Although various states are illustrated, any number of states can be implemented, for example, to transition between illustrated states and / or to implement other states not explicitly shown.

[0177] In Figures 12 and 13, images within block 1208 illustrate exemplary positions (e.g., rotation angles) of a drive output unit 1202 associated with the end effector 1210 of a robot arm. Here, the end effector 1210 is coupled to an instrument feeder device 530, which is shown separated from the end effector 1210 for illustrative purposes. In these examples, the drive output unit 1202 rotates to implement various states 1204 of the engagement assembly 532. For ease of explanation, the drive output unit 1202 is shown as a gear (including markings to indicate the rotational position of the gear), but the drive output unit 1202 can be implemented in other ways. The illustrated positions of the drive output unit 1202 indicate their relative positions to each other and do not necessarily indicate the actual amount of rotation of the drive output unit 1202 to facilitate a particular state of the engagement assembly 532. For example, the drive output unit 1202 can rotate any number of times to facilitate a particular position.

[0178] In some examples, the drive output unit 1202 is configured to apply different amounts of force to the drive input unit 540 of the engagement assembly 532 to facilitate different states 1204. Graphs 1212 and 1312 in Figures 12 and 13 illustrate, respectively, the exemplary forces that can be applied / received by the drive output unit 1202 to the position of the drive output unit 1202. The applied forces may be linear (e.g., solid lines) or nonlinear (e.g., dotted lines). The lines in these graphs are provided for illustrative purposes only and may not reflect the actual amounts of force applied by the drive output unit 1202. In this example, different forces are applied to control the state of the engagement assembly 532, but in other examples, the engagement assembly 532 may be controlled in other ways.

[0179] In these examples, the engagement assembly 532 can generally be configured to bias toward an engaged / closed state. Such biasing can be facilitated through one or more springs 612 (not shown) and / or other means / mechanisms, as described herein. Representations 1214 of one or more springs 612 are provided within block 1206 to indicate the amount of compression and / or force exerted by one or more springs 612 and / or other components of the instrument feeder device 530. It should be understood that these representations 1214 are provided for illustrative purposes only and should not be used to limit the mechanism of the instrument feeder device 530 (including one or more springs 612). In embodiments, the engagement assembly 532 can be positioned toward an engaged state, for example, when the instrument feeder device 530 is not attached to a robot arm, or when a force below a threshold amount is applied to the drive input 540. Therefore, the drive output unit 1202 can generally be configured to apply force (e.g., torque) to the drive input unit 540 to actuate the engagement assembly 532 toward the open / disengaged state.

[0180] While some examples describe an instrument feeder device 530 configured to be biased toward an engaged state, the instrument feeder device 530 can be implemented in other ways. For example, the engagement assembly 532 can be configured to be biased toward an unengaged / open state by using a spring of a different configuration and / or by implementing other mechanisms. Furthermore, in some examples, the engagement assembly 532 may not be configured to be biased toward any state. Here, the engagement assembly 532 may be configured to remain in any state even when the instrument feeder device 530 is detached from the robot arm.

[0181] Figure 12 illustrates an exemplary state 1204 of the engagement assembly 532 when the instrument shaft is not positioned / loaded within the engagement assembly 532. As shown in 1218, states 1204(1) through 1204(3) are generally associated with disengaged states in which the rollers 538 are disengaged, while states 1204(3) through 1204(5) are generally associated with engaged states in which the rollers 538 are engaged. An engaged state can refer to the rollers 538 being in contact with each other, positioned in a hard stop position (which can be facilitated by a hard stop mechanism on the instrument feeder device 530 that prevents the rollers 538 from contacting each other), positioned at a predetermined distance from each other, positioned at a predetermined distance from the axis / region, etc. In contrast, a disengaged state can refer to the rollers 538 not being in contact with each other, not being in contact with the instrument shaft, not being positioned in a hard stop position, being positioned beyond a predetermined distance from each other, being positioned beyond a predetermined distance from the axis / region, etc. Furthermore, the cover 538 can be implemented to facilitate open or closed states. For example, the cover 538 can be in an open / partially open state from 1204(1) to 1204(2), and in a closed state from 1204(2) to 1204(5). Block 1218 is provided for illustrative purposes only, and the states of these elements may differ from those illustrated. For example, transitions between different states (e.g., from engaged to disengaged, and / or from cover open to cover closed) may occur at points other than those illustrated.

[0182] In Figure 12, states 1204(1) to 1204(5) are associated with rotational positions 1202(A) to 1202(E) and applied forces 1216(A) to 1216(E), respectively. For example, state 1204(2) can be implemented when the drive output unit 1202 is positioned at rotational position 1202(B) and / or when a certain amount of force 1216(B) is applied. In some examples, positions 1202(A) and / or 1202(E) are associated with hard stop positions facilitated by a hard stop mechanism on the instrument feeder device 530. Hard stop positions can be detected based on changes in the force applied by the drive output unit 1202 (e.g., spikes in the applied force). In some cases, positions 1202(A) and / or 1202(E) are used as reference positions.

[0183] Exemplary state 1204 is shown with a floating zone in which the engagement assembly 532 remains engaged with various rotational positions of the drive output unit 1202 (e.g., positions 1202(C) to 1202(E)). This can be implemented to provide some amount of play / backlash between the components of the instrument feeder device 530, which can be facilitated by a hard stop mechanism and / or other mechanism within the instrument feeder device 530. However, in other examples, the floating zone is not implemented and / or fewer engagement states are implemented.

[0184] In the example in Figure 12, the drive output unit 1202 can rotate and / or apply a certain amount of force to transition the engagement assembly 532 from an engaged state to a disengaged state. For example, when the drive output unit 1202 rotates clockwise from position 1202(D) to the rotated position 1202(C), one or more springs 612 of the instrument feeder device 530 can begin to return force to the drive output unit 1202 such that a force 1220 exceeding a threshold amount (as shown in Graph 1212) is required to transition the engagement assembly 532 to a disengaged state. This change in force at position 1202(C) can be detected (e.g., as a force spike). In some cases, position 1202(C) is used as the reference position. In this example, with no instrument shaft loaded, state 1204(3) is generally associated with the transition from an engaged state to a disengaged state.

[0185] As shown in Figure 12, the drive output unit 1202 can continue to rotate clockwise and / or apply additional force to bring the engagement assembly 532 to state 1204(2). For example, as the drive output unit 1202 rotates clockwise, the distance between the rollers 538 increases and / or the cover 536 begins to move / open. One or more springs 610 can be compressed to require the drive output unit 1202 to increase the amount of force (e.g., torque) applied to reach state 1204(2). In state 1204(2), the rollers 538 are disengaged (e.g., separated by a certain distance from each other), and the cover 536 remains closed, covering the channel 534, even though the cover 536 has begun to open. State 1204(2) may be referred to as an intermediate state between the closed / engaged state and the fully open / loaded state. Furthermore, the drive output unit 1202 can continue to rotate clockwise to reach state 1204(1), the rollers 538 are disengaged (for example, further separated from each other), and the cover 536 opens completely.

[0186] In this example, an increasing amount of force (e.g., torque) is required to transition the engagement assembly 532 from state 1204(3) to state 1204(1) (as shown in Graph 1212), but such a transition can be achieved in other ways, such as by applying a decreasing amount of force, applying a constant amount of force, or simply changing the rotational position of the drive output unit 1202. Furthermore, although this example describes a clockwise rotation for transitioning from the engaged state to the disengaged state, the drive output unit 1202 can rotate counterclockwise or in any other way.

[0187] Figure 13 illustrates an exemplary state 1204 of the engagement assembly 532 when the instrument shaft is positioned / loaded within the engagement assembly 532. Here, the engagement assembly 532 can transition between at least some of the states 1204 at different rotational positions of the drive output unit 1202. Specifically, as the instrument shaft is loaded into the engagement assembly 532, the point at which one or more springs 612 begin to exert force on the drive output unit 1202 shifts (for example, to the left in this figure). As shown in the figure, the engagement assembly 532 transitions from the engaged state to the disengaged state, here when the drive output unit 1202 is rotated to position 1202(C)(1). The engagement assembly 532 can begin to transition from the engaged state 1204(3)(A) when the drive output unit 1202 applies a force 1318 exceeding a threshold amount, as shown in Graph 1312. Furthermore, in this example, the floating zone is shifted so that its edges are associated with the rotational position 1202(E)(1) and engagement state 1204(5)(A) of the drive output unit 1202. This may, in some cases, result from a rotational displacement or shift of components of the engagement assembly 532 that facilitates a hard stop position. For example, the rotational position 1202(E)(1) may be associated with the hard stop mechanism of the instrument feeder device 530. However, in other examples, the floating zone may be further extended to allow the drive output unit 1202 to reach a previous rotational position 1202(E). Furthermore, the floating zone may be extended to include other rotational positions of the drive output unit 1202 and / or implemented in other ways.

[0188] While various examples are described in the context of determining the state of an instrument feeder device based on the force applied by the drive output and / or the position of the drive output, the state of an instrument feeder device can additionally or alternatively be determined based on other information. For example, an instrument feeder device may include one or more sensors for / on rollers, covers, channels, and / or other components configured to detect proximity, pressure, and / or other characteristics. In one example, sensors may be mounted on rollers and / or other components around rollers to determine the proximity of rollers to each other and / or the proximity of instrument shafts. Furthermore, the drive input of an instrument feeder device may include a sensor / mechanism for detecting the rotational position of the drive input, and this sensor / mechanism can be used to determine the state of the instrument feeder device. Additionally, a sensor may be mounted on a cover to detect when the cover is open, partially open, or closed. Additionally or alternatively, the elongated shaft of a medical instrument may include a sensor configured to detect pressure / proximity, such as the pressure applied by the rollers of the engagement assembly. In some cases, the instrument feeder device may not require the implementation of a spring(s) to bias the roller into a specific state (e.g., to clamp onto the instrument shaft). Here, the state of the instrument feeder device may be based on the position of the drive output and / or the force applied by the drive output (this may include detecting a fully engaged state based on a force spike due to contact with the instrument shaft). In some cases where a spring(s) are not implemented, the drive output may apply some amount of force to fully engage / clamp the instrument shaft.

[0189] In some examples, the instrument feeder device can be implemented using a first drive input configured to control the engagement of rollers (e.g., the distance between rollers) and a second drive input configured to control the operation of a cover (e.g., opening and closing the cover). Thus, separate drive outputs can be implemented to control different states of the engagement assembly, and the roller states can be controlled independently of the cover states. Furthermore, in some examples, the state of the first component (e.g., rollers or cover) can be manually controlled and detected by sensors, and such detected states can be used to control the second component (e.g., cover or roller) to facilitate a specific state for the engagement assembly.

[0190] Figures 14–18 illustrate exemplary flow charts of processes 1400, 1500, 1600, 1700, and 1800, respectively, for carrying out the various techniques described herein. The various actions / operations associated with processes 1400, 1500, 1600, 1700, and 1800 can be carried out by control circuits implemented in any or a combination thereof of the devices / systems described herein, such as the control system 150, the robotic system 110, the table 170, medical instruments, instrument feeder devices, and / or other devices. While various blocks are illustrated as parts of processes 1400, 1500, 1600, 1700, and / or 1800, any such blocks can be removed. Furthermore, additional blocks can be implemented as part of processes 1400, 1500, 1600, 1700, and / or 1800. The order in which the blocks are illustrated is for illustrative purposes only; the blocks can be implemented in any order. In some embodiments, one or more blocks of process 1400, 1500, 1600, 1700, and / or 1800 are implemented as executable instructions that, when executed by a control circuit, cause the control circuit to perform the described function / operation. However, one or more blocks of process 1400, 1500, 1600, 1700, and / or 1800 may be implemented in other ways, such as by other devices / systems, users, etc.

[0191] Figure 14 illustrates an exemplary process 1400 for determining the state of the engagement assembly of an instrument feeder device according to one or more embodiments.

[0192] In block 1402, process 1400 may include detecting one or more events. For example, the control circuit may detect one or more events associated with an instrument feeder device, a medical instrument, a robotic system, and / or another device / component of a medical system configured to perform a medical procedure. For example, the control circuit may detect the coupling of an instrument feeder device to a robotic arm of a robotic system (e.g., based on sensor data from the robotic arm / instrument feeder device), the coupling / uncoupling of the instrument base of a medical instrument to a robotic arm (e.g., based on sensor data from the robotic arm / medical instrument base), the elapsed time, the coupling of the instrument base to the robotic arm, a request / command to rotate an elongated shaft (e.g., based on user input, system decision, etc.), a request / command to enable / disable manual movement of the robotic arm (e.g., the enablement of admittance control mode), and the like.

[0193] As described herein, a medical system may include a robotic system having one or more robotic arms configured to couple with a medical instrument, an instrument feeder device, and / or another device / component. For example, the robotic system may include a first robotic arm having an end effector configured to couple with an instrument feeder device (which can engage with the elongated shaft of a medical instrument), and a second robotic arm configured to couple with the instrument base of a medical instrument. The first robotic arm may include one or more drive outputs configured to couple with and / or actuate one or more drive inputs of the instrument feeder device. For example, the first drive output may be configured to actuate a first drive input of the instrument feeder device to control the engagement between the instrument feeder and the elongated shaft of a medical instrument, and the second drive output may be configured to actuate a second drive input of the instrument feeder device to move the elongated shaft axially.

[0194] Furthermore, the instrument feeder device may include an engagement assembly configured to receive and / or engage with the elongated shaft of a medical instrument. The engagement assembly may include an actuator configured to move the elongated shaft axially, a channel configured to receive the elongated shaft, and / or a holding mechanism configured to selectively open and close the channel. In some examples, the instrument feeder device is configured to bias the actuator into an engaged or disengaged state.

[0195] In block 1404, process 1400 may include acting on a first drive output to activate an engagement assembly of an instrument feeder device. For example, a control circuit may act on a first drive output of a robot arm, thereby causing the actuation of a first drive input associated with the engagement assembly of an instrument feeder device. The first drive input may be configured to control the engagement state of the engagement assembly.

[0196] In some examples, the control circuit activates a first drive output based on the detection of one or more events in block 1402. This allows for intelligent / automatic control of the engagement assembly, such as without user interaction with the engagement assembly. In some examples, the control circuit can control the engagement assembly to move from an engaged state to a fully released / disengaged state when it detects that an associated instrument feeder device is loaded / coupled to the robot arm, such as during setup for a procedure. This allows the user to load the shaft of a medical instrument into the engagement assembly.

[0197] Furthermore, in some examples, the control circuit can control the engagement assembly to act from a disengaged state (e.g., fully open) to an engaged state / engaged state when it detects that the instrument base of the medical device has been coupled to a robot arm, and / or after a predetermined period has elapsed since the detection of the coupling of the instrument base to the robot arm. For example, the user may first load the instrument shaft into an instrument feeder device coupled to a first robot arm, and then couple the instrument base to a second robot arm. However, the user may couple / load the components of the medical device in any order. Here, by transitioning the instrument feeder device to an engaged state after detecting the coupling of the instrument base to the second robot arm, the control circuit can engage with the medical device and begin driving the medical device.

[0198] Furthermore, in some examples, the control circuit can control the engagement assembly to operate from an engaged state to an unengaged / intermediate state when it decides to rotate the elongated shaft of a medical instrument and / or to activate the admittance control mode of the robot arm. For example, the user can provide input to rotate the shaft or activate the admittance control mode of a robot arm coupled to an instrument feeder device and / or a robot arm coupled to an instrument base. The admittance control mode can be used to adjust the position of the robot arm for various purposes. In response to rotation / admittance control detection, the control circuit can transition the engagement assembly from an engaged state to an intermediate state in which the cover is substantially closed and the roller is unengaged from the shaft. This allows the engagement assembly to hold the shaft without restricting its movement. When the rotation is complete and / or the admittance control mode is deactivated, the control circuit can return the engagement assembly to the engaged state.

[0199] Furthermore, in some examples, the control circuit can control the engagement assembly to act from an engaged state to an unengaged state when it decides to detach the instrument base from the robot arm. For example, the user may detach the instrument base from the robot arm upon completion of a procedure and / or to facilitate manual driving of the medical instrument. Here, the control circuit can detect that the instrument base has been removed from the robot arm and control the engagement assembly to act to a fully open state, allowing the shaft to be detached from the engagement assembly.

[0200] Although various explanations have been provided, the control circuit can operate the first drive output in other scenarios, such as transitioning the engagement assembly between any states, transitioning the engagement assembly toward a certain state without changing its state, or transitioning the engagement assembly to a hard stop position (for example, when coupling an instrument feeder device to a robot arm). Thus, the control circuit can operate the first drive output for a variety of purposes.

[0201] In the embodiment, the control circuit can detect when an instrument / device is coupled to / detached from a robotic arm based on data from sensors such as an end effector, instrument feeder device, medical instrument base, and instrument shaft. Such sensors may include proximity sensors, magnetic sensors, and the like. For example, an instrument feeder device / instrument base may include a magnet, radio frequency identification (RFID) tag, quick response / barcode, and / or other elements, and the end effector of the robotic arm may include a sensor / device configured to detect such elements, for example, when the instrument feeder device / instrument base is positioned close to the end effector.

[0202] In block 1406, process 1400 may include determining the amount of force applied by the first drive output unit and / or the position of the first drive output unit. For example, the control circuit may determine the amount of force applied by the first drive output unit and / or the position of the first drive output unit based on readings / data from one or more sensors (e.g., force / torque sensors of the first drive output unit), one or more signals generated / transmitted to control the first drive output unit, etc. In some examples, the amount of force applied by the first drive output unit represents the net resultant force taking into account the amount of force (e.g., torque) applied by the motor / mechanism driving the first drive output unit and / or the amount of feedback force applied by the drive input of the instrument feeder device (e.g., which may result from one or more springs biasing the engagement assembly). Furthermore, in some examples, the position of the first drive output unit may include the rotational position of the first drive output unit, which may include / indicate any number of rotations / turns of the first drive output unit.

[0203] In block 1408, process 1400 may include determining the state of the engagement assembly based on the amount of force applied by the first drive output unit and / or the position of the first drive output unit. For example, the control circuit can determine whether the amount of force applied by the first drive output unit is above / below one or more thresholds, or within a predetermined force range. Thus, in some examples, the control circuit can compare the amount of force applied by the first drive output unit with one or more thresholds. Furthermore, the control circuit can compare the position of the first drive output unit with one or more predetermined positions / reference positions, ranges of positions, etc. The state of the engagement assembly may indicate whether the engagement assembly is engaged / disengaged, whether the retaining mechanism of the engagement assembly is open / closed (or partially open / closed), or whether the elongated shaft of the medical device is received / properly received within the engagement assembly.

[0204] In one example, the control circuit may determine that the engagement assembly is associated with an engaged state (e.g., a fully engaged state) when the amount of force applied by the first drive output unit is less than a first threshold. Exemplary engaged states are illustrated in Figures 8-1 to 8-2 and Figures 9-1 to 9-2. Furthermore, the control circuit may determine that the engagement assembly is associated with a first disengaged state (e.g., an intermediate state) when the amount of force applied by the first drive output unit exceeds a first threshold but is less than a second threshold. The first disengaged state may be a state in which the actuator of the engagement assembly is disengaged from the elongated shaft and the retaining mechanism of the engagement assembly is substantially closed to hold the elongated shaft, such as the engaged states illustrated in Figures 10-1 and 10-2. Furthermore, the control circuit may determine that the engagement assembly is associated with a second disengaged state (e.g., a fully open state) when the amount of force applied by the first drive output unit exceeds a second threshold. An example of such a disengaged state is illustrated in Figures 11-1 and 11-2.

[0205] In another example, the control circuit can determine a reference position(s) associated with force changes exceeding a threshold amount (e.g., a force spike applied by the first drive output). For example, the control circuit can actuate the first drive output to a hard stop position and / or actuate it toward the hard stop position when the instrument feeder device is first coupled to the robot arm. The control circuit can detect a force spike(s) applied by the first drive output during such actuation and designate the position of the first drive output at that force spike as a reference position(s). For example, a transition position between the engaged and disengaged states, the hard stop position of the engagement assembly, or another position / state. The control circuit can then determine the state of the engagement assembly based on the proximity of the current position of the first drive output to the reference position(s). For example, the proximity of the current rotation position to the reference rotation position.

[0206] In yet another example, the control circuit may determine the state of the engagement assembly in a different way based on the force applied by the first drive output and / or the position of the first drive output.

[0207] In block 1410, process 1400 may include activating a second drive output to move an elongated shaft axially. For example, when the engagement assembly is positioned in an engaged state (e.g., ready to drive), the control circuit may control the second drive output of the robot arm to trigger the activation of a second drive input of the engagement assembly, which may be configured to control the axial motion of the elongated shaft. Thus, the second drive output can move the elongated shaft axially (e.g., insert or retract). In embodiments, the second drive output may be controlled based on signals from an I / O device for inserting / retracting the elongated shaft, a system decision for inserting / retracting the elongated shaft (e.g., without receiving user input), etc.

[0208] Figure 15 illustrates an exemplary process 1500 for determining whether the elongated shaft of a medical instrument is loaded / properly loaded into an instrument feeder device, according to one or more embodiments.

[0209] In block 1502, process 1500 may include the drive output unit acting on the engagement assembly from an engaged state, where the actuator is engaged, to a disengaged state, where the actuator is disengaged. For example, the control circuit may actuate (e.g., rotate) the drive output unit of a robot arm to actuate (e.g., rotate) the associated drive input unit of the engagement assembly of an instrument feeder device coupled to the robot arm. The actuatement of the drive input unit can change the engagement assembly from an engaged state (which may be the default state of the instrument feeder device) to a disengaged state. In some examples, the engagement assembly can transition to a fully disengaged / open state, as illustrated in Figures 11-1 and 11-2. A fully disengaged / open state can allow an instrument shaft to be loaded into the engagement assembly.

[0210] In block 1504, process 1500 may include determining a first position of the drive output unit associated with a first change in force (e.g., torque) applied by the drive output unit during the transition of the engagement assembly from an engaged state to an unengaged state. For example, while transitioning the engagement assembly from an engaged state to an unengaged state, the control circuit may monitor the amount of force applied by the drive output unit. When the drive output unit receives / applies a change exceeding a threshold change in force in order to move the drive output unit by a certain amount (e.g., a threshold increase / decrease in force for a given amount of rotation), the control circuit may determine the position of the drive output unit at that point in time (also referred to as the "initial position of the force change" or "reference position"). In one example, in the context of Figure 12, the control circuit may transition the engagement assembly 532 from an engaged state 1204(4) to an unengaged state 1204(1) and detect a change in force applied by the drive output unit 1202 at position 1202(C), such a change being greater than a threshold.

[0211] In block 1506, process 1500 may include instructing the drive output to actuate the engagement assembly from a disengaged state to an engaged state. For example, the control circuit may instruct the drive output to actuate the engagement assembly from a fully disengaged / open state to an engaged state. In some examples, this can be done when it is detected that the instrument base of a medical device has been coupled to a robot arm (e.g., a second robot arm) after a predetermined period has elapsed since operations 1502 / 1504 were performed, after a predetermined period has elapsed since the instrument base was coupled to the robot arm (which may be based on starting a timer when coupling occurs), and / or when another event is detected. In one example, operation 1506 may be performed in an attempt to engage the engagement assembly with an elongated shaft of a medical device, such as when determining / estimating that an elongated shaft has been loaded into the engagement assembly.

[0212] In block 1508, process 1500 may include determining a second position of the drive output unit associated with a second force change. In one embodiment, the engagement assembly can transition from a fully disengaged / open state to an engaged state (e.g., block 1506). Once engagement is complete, the engagement assembly may move in the direction toward the disengaged state, and the control circuit may monitor the amount of force applied by the drive output unit. This may include moving only a relatively small amount (e.g., less than a certain amount) in the disengagement direction. When the drive output unit receives / applies a change exceeding a threshold force change amount to move the drive output unit by a certain amount (e.g., a threshold force increase / decrease for a given amount of rotation), the control circuit may determine the position of the drive output unit at that point (also referred to as the "secondary position of the force change"). The threshold force change amount may be greater than the threshold and / or other thresholds described above for block 1504. Thus, the secondary position of the force change can be determined by detecting a change in force (contact force) toward the disengagement direction. However, in other examples, the secondary position of a force change can be detected in other ways, such as by detecting a change in force (contact force) in the engagement direction (e.g., loss of contact during transition to the engaged state). In some examples, once the secondary position of the force change is identified, the engagement assembly can enter a floating zone.

[0213] In block 1510, process 1500 may include identifying a third position of the drive output unit associated with a state in which the retaining mechanism begins to open. For example, the control circuit may identify a position of the drive output unit associated with an intermediate state in which the cover of the engagement assembly is closed (but beginning to open) and the roller is disengaged from the elongated shaft. In some examples, such a position may be a predetermined position defined / referenced in relation to another position of the drive output unit, such as a position associated with a fully disengaged / open state, a position associated with an engaged state, a reference position, and / or another position. In one example, in the context of Figure 12, the control circuit may identify position 1202(B) (where the cover 536 transitions between the closed and open states) based on knowing that position 1202(B) is at a predetermined rotational angle from position 1202(A) / 1202(C) and / or another position (e.g., any reference position that can be detected based on a change in force).

[0214] In block 1512, process 1500 can determine whether the elongated shaft of the medical device is received and / or properly received within the engagement assembly. For example, the control circuit can determine whether the elongated shaft is loaded into the channel of the engagement assembly and / or whether the elongated shaft is properly loaded into the channel. Such a determination may be based on the location of the second position relative to the first and third positions (i.e., the secondary position of the force change) (e.g., the secondary position of the force change between the first and third positions).

[0215] In one example, in the context of Figure 12, assume that the instrument shaft is not loaded into the engagement assembly 532. For example, the engagement assembly 532 can transition to a fully open / disengaged state (in block 1502) to facilitate loading the instrument shaft into the engagement assembly 532, but the instrument shaft is not loaded. The control circuit can detect position 1202(C) (in block 1504) as the initial position of the force change. Here, the control circuit can transition the engagement assembly 532 (in block 1506) from a fully open / disengaged state 1204(1) to an engaged state 1204(3), and detect the change in force applied by the drive output unit 1202 (in block 1508) at position 1202(C) (i.e., the secondary position of the force change). In block 1512, the control circuit can determine that the instrument shaft is not loaded into the engagement assembly 532 based on the fact that the secondary position of the force change (1202(C)) is the same as the initial position of the force change (1202(C)). Here, the control circuit determined the same position for both cases of the force change. Similarly, the control circuit can determine that the instrument shaft is not loaded when the secondary position of the force change is closer to position 1202(E) (for example, when the secondary position of the force change is between position 1202(C) and position 1202(E)).

[0216] In another example, in the context of Figure 13, assume that the instrument shaft is properly loaded into the engagement assembly 532. For example, the engagement assembly 532 can transition to a fully open / disengaged state (in block 1502), and the instrument shaft is loaded by the user. The control circuit (in block 1504) can determine position 1202(C) as the initial position of the force change when transitioning to the fully open / disengaged state. Furthermore, the control circuit can transition the engagement assembly 532 (in block 1506) from the fully open / disengaged state 1204(1) to the engaged state 1204(3), and (in block 1508) can detect the change in force applied by the drive output unit 1202 at position 1202(C)(1) (i.e., the secondary position of the force change). The control circuit (in block 1510) can identify position 1202(B) as a third position (i.e., an intermediate position). In block 1512, the control circuit can determine that the instrument shaft is properly loaded into the engagement assembly 532 based on the fact that the secondary position of the force change (1202(C)(1)) is between the initial position (1202(C)) and the intermediate position (1202(B)) of the force change (with respect to rotation).

[0217] In a further example, assume that the instrument shaft is improperly loaded into the engagement assembly 532, for example, by partially positioning the instrument shaft in the channel 534 to prevent the cover 536 from closing completely. For example, the engagement assembly 532 can transition to a fully open / disengaged state (in block 1502), with the instrument shaft positioned in the upper part of the channel 534. The control circuit can determine position 1202(C) (in block 1504) as the initial position of the force change. Furthermore, the control circuit can transition the engagement assembly 532 (in block 1506) from the fully open / disengaged state 1204(1) to the engaged state 1204(3), and detect the force change applied by the drive output unit 1202 at a position prior to position 1202(B) (i.e., a secondary position of the force change) (in block 1508), which may result from improper loading of the instrument shaft. The control circuit can identify position 1202(B) as a third position (i.e., an intermediate position) in block 1510. In block 1512, the control circuit can determine that the instrument shaft is improperly loaded into the engagement assembly 532 based on the fact that the secondary position of the force change is located before the intermediate position (1202(B)).

[0218] In a further example, the instrument shaft can be determined to be improperly loaded when the second position of the force change is after / past the first position of the force change.

[0219] In any case, if it is determined in 1512 that the elongated shaft is received / properly received within the engagement assembly, process 1500 may proceed to block 1514 (i.e., YES branch). Alternatively, if it is determined that the elongated shaft is not received / properly received within the engagement assembly, process 1500 may proceed to block 1516 (i.e., NO branch).

[0220] In block 1514, process 1500 may include acting the drive output unit toward / into the engaged state of the engagement assembly and / or driving the elongated shaft. For example, the control circuit may act the drive output unit toward the engaged state of the engagement assembly, and the control circuit may drive the elongated shaft / medical device with the elongated shaft properly loaded into the engagement assembly. In one example, in the context of Figure 13, the control circuit may transition the engagement assembly 532 to state 1204(4) and then drive / control the medical device (e.g., receive an input from the user to insert / retract and control to insert / retract the elongated shaft).

[0221] In block 1516, process 1500 may include operating the drive output unit to disengage the engagement assembly. For example, the control circuit may operate the drive output unit to fully open / disengage the engagement assembly to facilitate loading / reloading the elongated shaft of a medical instrument. In one example, in the context of Figure 12, the control circuit may transition the engagement assembly 532 to state 1204(1).

[0222] In block 1518, process 1500 may include generating a signal indicating that the elongated shaft is not received / not properly received in the channel. For example, the control circuit may generate a signal (e.g., a fault / error signal) indicating that the elongated shaft is not loaded / not properly loaded in the engagement assembly and / or send the signal to another component / device to facilitate additional processing. In some examples, the signal may provide a notification via a user interface, such a notification may inform the user to load / reload the elongated shaft of the medical instrument.

[0223] In block 1520, process 1500 may include determining whether a signal is addressable. For example, the control circuit may determine whether (i) a user input has been received indicating that the elongated shaft is currently loaded / properly loaded; (ii) whether a period of time has elapsed since a fault / error notification was provided; (iii) whether data from sensors on the instrument feeder device / engagement assembly (e.g., light barrier sensor, force sensor, etc.) indicates that the elongated shaft is loaded / properly loaded; (iv) whether the elongated shaft is properly positioned relative to the instrument feeder device / engagement assembly (e.g., based on data from a shape sensor in the elongated shaft); and / or another determination.

[0224] If it is determined that the signal is addressable, process 1500 can return to block 1506 (i.e., the YES branch). Alternatively, if it is determined that the signal is not addressable, process 1500 can return to block 1520 (i.e., the NO branch) and perform operation 1520 again (for example, after some time has elapsed).

[0225] Figures 16-1 and 16-2 illustrate exemplary processes 1600 for determining and / or removing slack in the elongated shaft of a medical instrument, according to one or more embodiments.

[0226] In Figure 16-1, in block 1602, process 1600 may include deciding to check for slack in the elongated shaft of a medical instrument. For example, the medical instrument may include an elongated shaft and an instrument handle, the elongated shaft may be coupled to / engaged with an instrument feeder device coupled to a first robot arm / component, and the instrument handle may be coupled to a second robot arm / component. In some examples, the control circuit may decide to evaluate the amount of slack in the elongated shaft between the instrument handle and the instrument feeder device. Such an evaluation may be initiated when decisions are made such as inserting (or possibly retracting) the elongated shaft, rotating the instrument shaft, enabling the admittance control mode of the robot arm, completing a procedure, a period of time elapsed since the last check of elongated shaft slack, the medical instrument has recently been coupled to a robot arm(s) (e.g., the instrument handle / elongated shaft has been loaded to start driving the medical instrument), or a procedure is about to begin. In some cases, this decision may be based on the reception of user input, system processing (e.g., the system deciding that an event has occurred), etc.

[0227] For example, checking for slack in an elongated shaft can be initiated when user input for inserting an elongated shaft is received, or when insertion of an elongated shaft is determined by other means. To insert an elongated shaft of a medical instrument, robotic arms can work together. For example, a first robotic arm can be coupled to an instrument feeder device, and a second robotic arm can be coupled to an instrument handle. The instrument feeder device can cause axial movement of the elongated shaft in the insertion direction, while the second robotic arm moves toward the first robotic arm in a manner correlated with the velocity of the axial movement of the shaft. If there is slack in the elongated shaft (e.g., a service loop) when the shaft is inserted, the curvature of the slack may increase, which could potentially damage the elongated shaft (e.g., by bending the shaft beyond a threshold amount) and / or cause delays in the procedure for reloading / replacing the medical instrument. Therefore, checking for slack in the elongated shaft can be initiated to prevent such undesirable problems.

[0228] In another example, checking for slack in an elongated shaft may be initiated when rotation of the instrument shaft is commanded, when admittance control mode is enabled / requested for the robot arm, and / or when another event occurs associated with implementing an intermediate / disengaged state for the instrument feeder device. For example, during a procedure / procedure setup, a physician may provide user input to enable admittance control mode to manually move the robot arm coupled to the instrument feeder device, and / or to rotate the instrument shaft. In response to such user input, the control circuit may generate / receive a signal to insert the shaft / enable admittance control mode. As described above, admittance control mode may allow the physician to manually adjust the robot arm and / or the access sheath coupled to the robot arm. To facilitate the movement of the robotic arm / access sheath and / or the rotation of the elongated shaft, the instrument feeder device may transition to an intermediate state, such as those shown in Figures 10-1 and 10-2, where the instrument feeder device is disengaged from the elongated shaft and the elongated shaft is held within the instrument feeder device to allow the movement of the instrument shaft. If there is slack in the elongated shaft (e.g., the service loop) when the instrument feeder device is disengaged from the elongated shaft (e.g., the roller separates from the shaft), the elongated shaft may move in the insertion direction when the energy / service loop is released, which could cause undesirable insertion of the elongated shaft. This could be harmful to the patient (e.g., due to the tip of the elongated shaft contacting the patient's tissue with relatively strong force). Therefore, to prevent such undesirable problems, checking for slack in the elongated shaft can be initiated.

[0229] In yet another example, a slack check can be initiated when the decision is made that the procedure is complete. For example, upon completion of the procedure, the physician may wish to detach the medical instrument from one or more robotic arms (e.g., remove the elongated shaft from the instrument feeder device). This may involve moving the instrument feeder device to a fully open / disengaged state. Similarly, as described above, if there is slack in the elongated shaft when the instrument feeder device is disengaged from it, the elongated shaft may move in the insertion direction. Therefore, a slack check can be initiated to prevent such a problem.

[0230] In further examples, slack checks can be initiated periodically when the robotic arm is idle (e.g., not moved for a period of time), when a medical device is attached to the robotic arm, and / or when various other types of events / decisions occur.

[0231] In the example shown in block 1603 of Figure 16-1, the medical instrument may include an elongated shaft 508 coupled to / engaged with an instrument feeder device 530 (coupled to the first robotic arm 112(B)) and an instrument handle 506 coupled to the second robotic arm 112(C). The elongated shaft 508 is shown with some amount of slack for illustrative purposes.

[0232] In block 1604, process 1600 may include applying force to the elongated shaft of a medical instrument to prevent axial movement of the elongated shaft. For example, the control circuit may control one or more drive outputs of the first robotic arm (coupled to the instrument feeder device) to cause the instrument feeder device to apply force to the elongated shaft to prevent axial movement of a portion of the elongated shaft positioned within the instrument feeder device (e.g., by gripping the elongated shaft). This force may also be applied to prevent the elongated shaft 508 from retracting (or possibly inserting) from the patient while other embodiments of process 1600 or other processes are being performed, as described below.

[0233] In the example shown in blocks 1605(A) to 1605(C) of Figure 16-1, the rollers 538 can be controlled to apply force to the elongated shaft 508, for example, by clamping the elongated shaft 508 between the rollers 538 with a specific amount of force (for example, greater than the spring force that biases the rollers 538 toward each other). For example, as described above, the instrument feeder device 530 may include a carrier plate 622 that rotates based on the position of the extraaxial projection 636 in the pocket 638. The rotation / movement of the carrier plate 622 can move the rollers 538 toward or apart from each other, thereby positioning the rollers 538 and / or adjusting the amount of force applied to the elongated shaft 508.

[0234] For example, the open / close drive shaft 632 can be rotated clockwise relative to the image in Figure 16-1 (by a drive input unit not shown) to bring the off-shaft projection 636 (coupled to the open / close drive shaft 632) into contact with a first surface / edge in the pocket 638, shown in darker lines in block 1605(B). The off-shaft projection 636 can apply force to the first surface, causing the carrier plate 622 to rotate around the axis 628, thereby moving the rollers 538 away from each other (e.g., disengaged / open). In contrast, the open / close shaft 632 can be rotated counterclockwise to move the off-shaft projection 636 toward and into contact with a second surface, shown in darker lines in block 1605(C). The off-shaft projection 636 can apply force to the second surface, causing the carrier plate 622 to rotate in the opposite direction, allowing the roller 538 to apply additional force to the elongated shaft 508. In some examples, as shown, the off-shaft projection 636 can move freely between the first and second surfaces of the pocket 638 (for example, without applying force to either surface). Here, a spring force allows the roller 538 to apply force to the elongated shaft 508.

[0235] In the example of Figure 16-1, the elongated shaft 508 may be positioned between rollers 538 to facilitate its movement. In block 1604, the rollers 538 can be controlled to apply force to the elongated shaft 508, as shown in block 1605(C). This prevents the elongated shaft 508 from slipping between the rollers 538 when other actions are performed, such as when the robotic arm 112(C) moves away from the robotic arm 112(B), as will be described in more detail below. For example, this may prevent the elongated shaft 508 from retracting from a patient who is not issuing a command / instruction. This process of applying force to the elongated shaft 508 may be referred to as “active pinching”.

[0236] In block 1606 of Figure 16-2, process 1600 may include activating a drive output unit(s) of a first robot arm and / or activating a second robot arm. For example, an instrument feeder device may include one or more drive input units configured to control the axial motion of an elongated shaft, such as inserting or retracting a shaft, and one or more drive input units may be configured to be coupled to one or more drive outputs of the first robot arm. In an embodiment, the control circuit may activate (e.g., rotate) one or more drive outputs of the first robot arm to cause axial motion of the elongated shaft. Alternatively or additionally, the control circuit may move a second robot arm coupled to an instrument handle away from the first robot arm. The control circuit may optionally activate one or more drive outputs and / or the second robot arm by a specific amount. In the embodiment, the second robotic arm moves away from the first robotic arm (or vice versa), and / or the instrument feeder device moves the elongated shaft in the insertion direction until any slack (if any) is removed / reduced and / or tension is applied to the elongated shaft. Such tension can be detected by a control circuit, as described below.

[0237] In the embodiment shown in block 1607(A) of Figure 16-2, the robot arm 112(C) moves away from the robot arm 112(B) (e.g., in the retraction direction). This can be done while the robot arm 112(B) remains relatively stationary and / or without activating the drive output of the robot arm 112(B) coupled to the instrument feeder device 530 to facilitate the rotation of the roller 538. In some examples, the robot arm 112(C) moves away from the robot arm 112(B), while the roller 538 actively grips / applies force to the elongated shaft 508. In other words, block 1604 can be implemented when the robot arm 112(C) moves away from the robot arm 112(C). This can prevent undesirable retraction of the elongated shaft 508 from the patient (e.g., retraction without a command / instruction).

[0238] Furthermore, in the embodiment shown in block 1607(B) of Figure 16-2, the roller 538 is actuated to move the elongated shaft 508 in the insertion direction. This can be done while the robot arm 112(C) remains relatively stationary (for example, without moving the robot arm 112(C)).

[0239] In block 1608, process 1600 may include determining a first force applied by / applied to (or detected by) a drive output unit, a second force applied by a second robot arm, the shape of an elongated shaft, and / or the position of at least a portion of the elongated shaft. For example, the control circuit may detect a first force (e.g., torque) applied to the instrument feeder device by the drive output unit(s) of the first robot arm to control the axial motion of the elongated shaft. In the embodiment of block 1607(B), the control circuit may determine / detect a force applied by / applied to the drive output unit(s) of the robot arm 112(B) when the roller 538 is idle or moving (e.g., a force to maintain or change the rotational position of the roller 538). Additionally or alternatively, the control circuit may detect a second force applied by / to the second robot arm when the second robot arm is idle or moving (e.g., to control the position of the second robot arm). This force may constitute the initial reference force applied by the second robot arm when there is no tension on the elongated shaft, as will be described in more detail below. In the embodiment of block 1607(A), the control circuit may determine the force applied by the robot arm 112(C) to maintain (or move) the position of the robot arm 112(C). Furthermore, the control circuit may receive / generate shape-sensing data indicating the shape of the elongated shaft (which may include data indicating tensile stress from a stress-sensing fiber, for example), position-sensing data indicating the position of at least one portion of the elongated shaft (e.g., the tip of the elongated shaft or the position of another portion of the elongated shaft associated with a sensor), position data indicating the position of the first / second robot arm, and / or other data.

[0240] In Figure 16-3, in block 1610, process 1600 may include determining the amount of slack in the elongated shaft between the first robot arm and the second robot arm. For example, the control circuit may determine the amount of slack in the elongated shaft based on the amount of a first force applied by / to the drive output unit (or detected by the drive output unit), the amount of a second force applied by the second robot arm, the shape indicated by shape sensing data, and / or the position indicated by the elongated shaft / robot arm position data, in order to control the axial motion of the elongated shaft. In some examples, the control circuit may determine that the elongated shaft is relatively straight when the first force (force from the drive output unit) exceeds a first threshold amount, the second force (force from the robot arm) exceeds a second threshold amount (which may be the same as or different from the first threshold), the shape sensing data indicates that the elongated shaft is relatively straight, and / or the position data of the elongated shaft / robot arm indicates that the elongated shaft is relatively straight.

[0241] In one example, the control circuit can use position data of an elongated shaft to determine the position of the tip of the elongated shaft. The control circuit can also determine the positions of the robot arms (such as the distance between the robot arms) and / or the dimensions of the elongated shaft (e.g., a known / predetermined length of the shaft). Based on this information, the control circuit can calculate the length of the elongated shaft between the robot arms. If the length of the elongated shaft between the robot arms is greater than the distance between the robot arms, the control circuit can determine that there is slack in the elongated shaft. In an embodiment, the control circuit can use the information described above to calculate the amount of slack between the robot arms.

[0242] In block 1612, process 1600 may include determining whether the amount of slack in the elongated shaft is less than a predetermined amount. For example, the control circuit may determine whether the amount of slack in the elongated shaft between the first robot arm and the second robot arm is relatively small (e.g., zero / no slack in the shaft, or the amount of slack is less than a threshold amount).

[0243] If it is determined that the amount of slack in the elongated shaft exceeds a predetermined amount, process 1600 returns to block 1606 (i.e., branch NO) in Figure 16-2, and the drive output units of the first and / or second robotic arms can be actuated again, for a specific amount, etc. This can be repeated any number of times to remove any slack in the elongated shaft and / or to apply tension to the elongated shaft. In the embodiment shown in block 1611 in Figure 16-3, the elongated shaft 508 contains some amount of slack. Therefore, block 1611 is associated with returning to block 1606.

[0244] If it is determined that the amount of slack in the elongated shaft is less than a predetermined amount (for example, there is virtually no slack in the elongated shaft), process 1600 can proceed to block 1614 (i.e., the YES branch). In the embodiment shown in block 1613 of Figure 16-3, there is no slack in the elongated shaft 508. Therefore, block 1613 is associated with proceeding to block 1614.

[0245] In block 1614, process 1600 may include controlling an instrument feeder device and / or a second robotic arm. For example, the control circuit may control the instrument feeder device to move an elongated shaft axially and / or move the second robotic arm in cooperation to insert the elongated shaft for any remaining insertion amount that has been commanded but not yet completed. Specifically, the instrument feeder device may cause axial motion of the elongated shaft in the insertion direction (e.g., using rollers), while the second robotic arm moves toward the first robotic arm in a manner correlated with the speed of the axial motion of the elongated shaft (e.g., the rotational speed of the rollers). Such movement may continue until the elongated shaft is inserted to a determined / commanded amount. Alternatively or additionally, the control circuit may disengage the instrument feeder device from the elongated shaft, thereby facilitating the rotation of the elongated shaft (by implementing an intermediate state for the instrument feeder device), the movement of the robot arm in admittance control mode (by implementing an intermediate state for the instrument feeder device), and / or the removal of the elongated shaft (by implementing a fully open / disengaged state).

[0246] In some examples, the control circuit can release tension (e.g., overtension) on the elongated shaft before performing the operation of block 1614. For example, the control circuit can move the elongated shaft relatively small in the axial direction backward to the drive output of the first robot arm and / or actuate the second robot arm relatively small in the direction toward the first robot arm. Such movement can release any tension on the elongated shaft that may have been applied while process 1600 was being performed.

[0247] Figure 17 illustrates an exemplary process 1700 for determining and / or removing slack in an elongated shaft of a medical device in the context of inserting an elongated shaft, according to one or more embodiments. In some examples, the process 1700 can be initiated when it is decided to insert an elongated shaft, such as when a user input, system decision, etc., is received for the insertion of the shaft.

[0248] In block 1702, process 1700 may include determining the initial force of a first robotic arm coupled to the instrument base of a medical device. For example, the control circuit may determine the initial force / reference force applied by the first robotic arm coupled to the instrument base when there is no tension on the elongated shaft. Such a force can be determined before the elongated shaft is inserted.

[0249] In block 1704, process 1700 may include determining whether to insert the elongated shaft of a medical device. For example, the control circuit may determine whether a user input / input signal has been received requesting the insertion of the elongated shaft, and whether a decision is made to insert the elongated shaft.

[0250] If a decision is made to insert the elongated shaft, process 1700 can proceed to block 1706 (i.e., the YES branch). Alternatively, if a decision is made not to insert the elongated shaft, process 1700 can return to block 1704 (i.e., the NO branch). Thus, the control circuit can wait for an insertion command to be received / decided.

[0251] In block 1706, process 1700 may include determining the force of a drive output unit associated with a drive output unit and / or the force of a robot arm associated with a robot arm. For example, the control circuit may determine the driving force (e.g., torque) applied by a drive output unit(s) coupled to an instrument feeder device to facilitate the insertion / retraction of a shaft. Furthermore, the control circuit may determine the force of a robot arm applied by a robot arm coupled to an instrument base. In some examples, the force of a robot arm may consist of the current force applied / implemented to control the position of the robot arm (also referred to as "external force, net instrument force, or resultant force") and / or the initial force / reference force (determined in block 1702) applied by the robot arm. For example, the force of a robot arm can be calculated by subtracting the initial force / reference force from the external force (i.e., force of robot arm = external force - reference force). The force of a robot arm may refer to the external force (e.g., sensed by the robot arm) excluding gravity. However, the force of a robot arm can be calculated in other ways.

[0252] In block 1708, process 1700 may include determining whether the force of the drive output unit is greater than a first threshold and / or whether the force of the robot arm is greater than a second threshold. The second threshold may be the same as or different from the first threshold. For example, the control circuit may determine whether the force of the drive output unit and / or the force of the robot arm determined in block 1706 are greater than their respective thresholds, thereby indicating that there is tension on the elongated shaft between the first and second robot arms. In this example, two thresholds are used, but the technique can be implemented using a single threshold, and the force of the drive output unit and the force of the robot arm may be combined and compared to a single threshold.

[0253] If it is determined that the force of the drive output unit is greater than a first threshold and / or the force of the robot arm is greater than a second threshold, process 1700 may proceed to block 1712 (i.e., the YES branch). Alternatively, if it is determined that the force of the drive output unit is less than or equal to the first threshold and / or the force of the robot arm is less than or equal to the second threshold, process 1700 may proceed to block 1710 (i.e., the NO branch).

[0254] In block 1710, process 1700 may include controlling the instrument feeder device to insert an elongated shaft without acting a first robotic arm coupled to the instrument base. For example, the control circuit may control the drive output to cause the instrument feeder device to insert the elongated shaft while preventing the first robotic arm coupled to the instrument base from acting beyond a threshold amount (e.g., allowing the first robotic arm to move less than a threshold amount). That is, the control circuit does not have to actively move the first robotic arm, but may allow the first robotic arm to move a relatively small amount (e.g., less than a threshold amount) if some force is exerted on the first robotic arm due to tension applied to the elongated shaft, for example. In any case, the control circuit may cause the elongated shaft to be inserted by a specific amount, which can be an increment within the insertion limit defined by user input / processing. Operation 1710 can be repeated any number of times until the tension on the elongated shaft exceeds a threshold (such as determined in block 1708) and / or until the insertion limit is reached. Therefore, the elongated shaft cannot generally be inserted beyond the amount required by user input and / or the system.

[0255] In block 1712, process 1700 may include controlling an instrument feeder device and a first robotic arm coupled to the instrument base. For example, the control circuit may control the instrument feeder device to move the elongated shaft axially in the insertion direction and move the first robotic arm (coupled to the instrument base) in the insertion direction to insert / continue inserting the elongated shaft for any remaining insertion amount that has been commanded but not yet completed. The instrument feeder device and the first robotic arm may work together to insert the elongated shaft.

[0256] In some examples, the control circuit can release tension (e.g., overtension) on the elongated shaft before performing the operation of block 1712. For example, the control circuit can cause the drive output of the second robot arm to control the instrument feeder device to move the elongated shaft axially a relatively small amount in the backward direction and / or to actuate the first robot arm, which is coupled to the instrument handle, a relatively small amount toward the second robot arm. Such movement can release tension on the elongated shaft that could have been applied while performing process 1700. In some embodiments, the tension can be released during insertion by, for example, inserting the elongated shaft into the instrument feeder device at a first speed and moving the first robot arm, which is coupled to the instrument handle, toward the second robot arm at a second speed faster than the first speed.

[0257] In the embodiment, process 1700 can be performed to remove slack from the elongated shaft of a medical instrument. Subsequently, when an insert / retract command is received, the control circuit can control the instrument feeder device and a robotic arm coupled to the instrument base to move in cooperation to insert / retract the elongated shaft.

[0258] Figures 18-1 and 18-2 illustrate exemplary process 1800 for determining and / or removing slack in the elongated shaft of a medical instrument in connection with enabling an admittance control mode and / or rotating the elongated shaft, according to one or more embodiments. In some examples, process 1800 may be initiated when it is determined to disengage the instrument feeder device from the elongated shaft (e.g., transition to an intermediate state, a fully open / disengaged state, etc.), such as when an input is received to enable an admittance control mode of the robotic arm or when an input is received to rotate the elongated shaft. However, process 1800 may be initiated at other times and / or for other circumstances in which the elongated shaft may contain slack.

[0259] In Figure 18-1, in block 1802, process 1800 may include controlling a medical device. For example, the medical device may include an elongated shaft coupled to a first robotic arm (via an instrument feeder device) and / or a handle / base coupled to a second robotic arm. The control circuit may control the first robotic arm, the second robotic arm, and / or other components during normal operation of the medical device, such as to operate the elongated shaft and / or handle of the medical device.

[0260] In block 1804, process 1800 may include determining whether an admittance control signal and / or a rotation signal has been received. For example, the control circuit may receive a signal to enable an admittance control mode for a robotic arm (e.g., coupled to an instrument feeder device) and / or a signal to rotate the elongated shaft of a medical instrument. Based on such signals, the control circuit may decide to transition the instrument feeder device to a disengaged state (e.g., an intermediate state, a fully open state / disengaged state, etc.).

[0261] If an admittance control signal and / or rotation signal is received, the process may proceed to block 1806 (i.e., YES branch). Alternatively, if no admittance control signal and / or rotation signal is received, process 1800 may return to block 1802 (i.e., NO branch) and proceed with the normal control / drive of the medical device.

[0262] In block 1806, process 1800 may include determining the force of the first robot arm / reference force of the robot arm. For example, the control circuit may determine the initial force / reference force applied by the second robot arm coupled to the base of the device when there is no tension on the elongated shaft. Such a force can be determined before the admittance control mode is activated and / or before rotation occurs.

[0263] In block 1808, process 1800 may include acting the second robot arm away from the first robot arm. For example, the control circuit may move the second robot arm, coupled to an instrument handle, in a backward direction away from the first robot arm, coupled to an instrument feeder device. In some cases, the control circuit may actuate the second robot arm by a specific amount. In some embodiments, the second robot arm can move without acting the drive output of the first robot arm, which is configured to control the axial motion of an elongated shaft (for example, without actively acting the drive output because some actuation may occur naturally as the second robot arm moves). Thus, in some cases, the control circuit may allow the drive output to actuate / rotate by less than a threshold amount while the second robot arm moves away from the first robot arm.

[0264] In block 1810, process 1800 may include determining the force of a drive output unit associated with a drive output unit and / or the force of a robot arm associated with a robot arm. For example, the control circuit may determine the driving force (e.g., torque) applied by a drive output unit(s) coupled to an instrument feeder device to facilitate the insertion / retraction of a shaft. Furthermore, the control circuit may determine the force of a robot arm applied by a robot arm (e.g., a second robot arm) coupled to an instrument base. In some examples, the force of the robot arm may constitute the current force applied / implemented to control the position of the robot arm (also referred to as "external force, net instrument force, or resultant force") and / or the initial force / reference force applied by the robot arm (determined in block 1806). For example, the force of the robot arm can be calculated by subtracting the initial force / reference force from the external force (i.e., robot arm force = external force - reference force). However, the force of the robot arm can be calculated in other ways.

[0265] In block 1812, process 1800 may include determining whether the second robotic arm (coupled to the instrument handle) has moved beyond a threshold amount and / or has reached the workspace boundary. For example, the control circuit may monitor / detect the distance the second robotic arm (coupled to the instrument handle) has traveled from the first robotic arm (coupled to the instrument feeder device) and / or detect the position of the second robotic arm, which can then be used to determine whether the second robotic arm has reached a distance limit and / or has reached the workspace boundary. The distance limit and / or workspace boundary may be set / defined to avoid collisions with objects / patients in the environment. For example, the workspace boundary may be a virtual boundary.

[0266] If it is determined that the second robot arm has acted beyond a threshold and / or reached the workspace boundary, process 1800 may proceed to block 1814 (i.e., YES branch). Alternatively, if it is determined that the second robot arm has not acted beyond a threshold and / or reached the workspace boundary, process 1800 may proceed to block 1816 (i.e., NO branch).

[0267] In block 1814, process 1800 may include generating a signal indicating that the second robot arm has acted beyond a threshold amount and / or reached the workspace boundary. For example, the control circuit may generate / transmit a signal based on the determination in block 1812 that the second robot arm has acted beyond a threshold amount and / or reached the workspace boundary. The signal may provide notification to instruct the user to reload the medical instrument, such as by removing the instrument handle and reattaching it to the second robot arm, or by moving the second robot arm to manually remove the slack, and / or adjust the second robot arm. In some examples, the signal may be generated / transmitted when there is excessive slack in an elongated shaft, such as exceeding a threshold amount that can be removed by the system.

[0268] Blocks 1812 and 1814 are illustrated in the example in Figure 18-1, but in some examples, such blocks (and / or other blocks in process 1800) may be deleted.

[0269] In block 1816, process 1800 may include determining whether the force of the drive output unit is greater than a first threshold and / or whether the force of the robot arm is greater than a second threshold. The second threshold may be the same as or different from the first threshold. For example, the control circuit may determine whether the force of the drive output unit and / or the force of the robot arm determined in block 1810 are greater than their respective thresholds, thereby indicating that there is tension on the elongated shaft between the first and second robot arms. Thus, in block 1816, the control circuit may determine whether there is less than a predetermined amount of slack in the elongated shaft (e.g., no slack / zero slack).

[0270] In this example, two thresholds are used, but this technique can be implemented using a single threshold, and the force of the drive output and the force of the robot arm can be combined and compared to a single threshold.

[0271] If it is determined that the force of the drive output unit is greater than a first threshold and / or the force of the robot arm is greater than a second threshold, process 1800 can proceed to block 1818 (i.e., YES branch) in Figure 18-2. Alternatively, if it is determined that the force of the drive output unit is less than or equal to the first threshold and / or the force of the robot arm is less than or equal to the second threshold, process 1800 can return to block 1808 (e.g., NO branch). The control circuit may loop through blocks 1808, 1810, and 1812 any number of times as needed to remove slack in the elongated shaft.

[0272] In Figure 18-2, in block 1818, process 1800 may include releasing tension on the elongated shaft. For example, the control circuit may move a second robotic arm coupled to the instrument handle toward the first robotic arm in the insertion direction and / or move the elongated shaft toward the instrument feeder device in the retraction direction. In some examples, in block 1808, the elongated shaft may be excessively pulled by moving the second robotic arm toward the first robotic arm. Therefore, the operation of block 1818 may be performed to release such tension (e.g., slightly).

[0273] In block 1820, process 1800 may include determining whether the second robot arm has moved a first predetermined distance and / or whether the elongated shaft has moved back a second predetermined distance. For example, the control circuit may determine (in block 1818) whether the second robot arm has moved in the insertion direction by at least a first predetermined amount (e.g., moved a certain amount closer to the first robot arm) and / or (in block 1818) whether the elongated shaft has moved by the instrument feeder device by at least a second predetermined distance. The second predetermined distance may be the same as or different from the first predetermined distance. Additionally or alternatively, in block 1820, the control circuit may determine whether the amount of force applied by / to the drive output unit and / or the amount of force implemented / applied by the first robot arm / second robot arm used to control the instrument feeder device / engagement assembly / roller has changed by a threshold amount or is below a threshold (e.g., indicating that the tension has been released).

[0274] If it is determined that the second robotic arm has moved a first predetermined distance and / or the elongated shaft has retracted a second predetermined distance, process 1800 can proceed to block 1822 (i.e., the YES branch). Alternatively, if it is determined that the second robotic arm has not moved a first predetermined distance and / or the elongated shaft has not retracted a second predetermined distance, process 1800 can return to block 1818 (i.e., the NO branch). The operations in block 1818 can be performed any number of times to gradually relieve the tension on the elongated shaft until one or more criteria are met (e.g., in block 1818, each time the second robotic arm is actuated and / or the elongated shaft is axially moved by a specific amount).

[0275] Blocks 1818 and 1820 are illustrated in exemplary process 1800, but in some examples, such blocks can be deleted. In one example, block 1818 is implemented in a single instance (e.g., block 1820 is deleted).

[0276] In block 1822, process 1800 can include disengaging the elongated shaft and / or controlling the tool feeder device to allow the elongated shaft to rotate. For example, the control circuit can transition the tool feeder device to a disengaged state (e.g., an intermediate state where the elongated shaft is held, a full open / disengaged state, or another disengaged state). In one example, the tool feeder device can transition to an intermediate state where the roller / actuator is disengaged from the elongated shaft and the cover / holding mechanism is closed. This enables the admittance control mode to be enabled (e.g., for manual adjustment of the first robotic arm coupled to the tool feeder device) and / or allows the elongated shaft to rotate (e.g., move freely within the channel while being held within the tool feeder device).

[0277] Further embodiments Depending on the embodiment, any particular action, event, or function of any of the algorithms or processes described herein may be performed in a different order, added, merged, or completely excluded. Therefore, in a particular embodiment, not all of the described actions or events are necessary for the execution of the process.

[0278] In particular, conditional language used herein, such as “can,” “could,” “might,” “may,” “eg,” and equivalents, is intended in its ordinary sense unless otherwise specifically described or understood in the context in which it is used, and is generally intended to convey that a particular embodiment includes a particular feature, element, and / or step, but other embodiments do not. Therefore, such conditional language is not generally intended to suggest that features, elements, and / or steps are required in any way for one or more embodiments, or that one or more embodiments necessarily include logic for determining whether these features, elements, and / or steps are included in or implemented in any particular embodiment, with or without author input or prompting. Terms such as “comprising,” “including,” “having,” and equivalents are used in their ordinary sense, in a non-restrictive and comprehensive manner, and do not exclude further elements, features, actions, behaviors, etc. Furthermore, when the term “or” is used, for example, to connect an enumeration of elements, the term “or” is used in its inclusive sense (and not its exclusive sense), meaning one, some, or all of the enumerated elements. Unless otherwise specifically stated, connecting language such as “at least one of X, Y, and Z” is understood in the context in which it is commonly used to convey that an item, term, element, etc., could be any of X, Y, or Z. Thus, such connecting language is not intended in general to imply that a particular embodiment requires the presence of at least one of X, at least one of Y, and at least one of Z, respectively.

[0279] In the above description of embodiments, it should be understood that various features are sometimes grouped together in a single embodiment, figure, or description for the purpose of streamlining the disclosure and aiding in the understanding of one or more of the various aspects of the invention. However, the method of the disclosure should not be construed as reflecting an intention that any claim requires more features than expressly described in that claim. Furthermore, any component, feature, or step illustrated and / or described in a particular embodiment of this specification may be applied to or used in conjunction with any other embodiment(s). Moreover, no component, feature, step, or group of components, features, or steps is required or essential for any particular embodiment. Accordingly, the scope of the disclosure in this specification should not be limited by the particular embodiments described above and should be determined solely by a fair reading of the following claims.

[0280] It should be understood that certain ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply any physical characteristics or order. Therefore, when used herein, ordinal terms (e.g., "first," "second," "third," etc.) used to modify elements such as structure, components, and actions do not necessarily indicate the priority or order of an element relative to any other element, but rather, generally, they may distinguish an element from another element having a similar or identical name (apart from the use of ordinal terms). In addition, when used herein, the indefinite articles ("a" and "an") may indicate "one or more" rather than "one." Furthermore, actions performed "on the basis" of a condition or event may also be performed on the basis of one or more other conditions or events not explicitly enumerated.

[0281] Unless otherwise defined, all terms used herein (including technical and scientific terms) have the same meaning as those generally understood by those skilled in the art in the field to which the exemplary embodiments belong. Terms such as those defined in commonly used dictionaries should be interpreted as having the meaning consistent with their meanings in the context of the relevant art, and should not be interpreted in an ideal or overly formal sense unless expressly defined herein.

[0282] The spatially relative terms “outside,” “inside,” “upside,” “downward,” “upward,” “vertical,” and “horizontal,” and similar terms, may be used herein to facilitate explanations of the relationship between one element or component and another, as illustrated in the drawings. It should be understood that the spatially relative terms are intended to encompass different orientations of the device during use or operation, in addition to the orientations shown in the drawings. For example, if the device shown in the drawings is inverted, a device positioned “below” or “below” another device may be positioned “above” another device. Thus, the illustrative term “downward” may include both downward and upward positions. The device may also be oriented in other directions, and therefore, the spatially relative terms may be interpreted differently depending on the orientation.

[0283] Unless otherwise specified, comparative and / or quantitative terms such as "less," "more," and "greater" are intended to encompass the concept of equality. For example, "less" can mean not only "less" in the strict mathematical sense, but also "less than or equal to."

[0284] [Implementation Method] (1) A system, A first robotic arm configured to be coupled to an elongated shaft of a medical device, wherein the first robotic arm includes a drive output unit configured to control the axial movement of the elongated shaft, A second robotic arm configured to be attached to the base of the medical device, A control circuit, To operate at least one of the drive output unit or the second robot arm, A system comprising a control circuit configured to determine, at least in part, the amount of slack in the elongated shaft between the first robot arm and the second robot arm, based on the aforementioned operation. (2) The control circuit is Determining at least one of the first force associated with the drive output unit or the second force associated with the second robot arm, The system is further configured to determine that at least one of the first force or the second force is greater than a threshold, The system according to Embodiment 1, wherein the amount of slack in the elongated shaft is determined at least in part on the determination that at least one of the first force or the second force is greater than the threshold, and the amount of slack in the elongated shaft is less than a predetermined amount. (3) The system according to Embodiment 1, wherein the control circuit is configured to actuate the second robot arm, and the actuate of the second robot arm causes the second robot arm to move away from the first robot arm. (4) The system according to Embodiment 1, wherein the control circuit is configured to operate the drive output unit while enabling the second robot arm to operate below a threshold amount. (5) The control circuit is It is further configured to receive an input signal indicating the insertion of the elongated shaft, The control circuit is configured to activate the drive output unit in response to receiving the input signal, and the activation of the drive output unit causes the insertion of the elongated shaft, according to Embodiment 4 of the system.

[0285] (6) The system according to Embodiment 1, wherein the first robot arm is configured to be coupled to an instrument feeder device, and the instrument feeder device is configured to implement an engaged state in which the instrument feeder device is engaged with the elongated shaft, and an unengaged state in which the instrument feeder device is disengaged from the elongated shaft. (7) The control circuit is The instrument feeder device is further configured to determine whether to transition from the engaged state to the disengaged state, The control circuit is configured to actuate the second robot arm in response to the decision to move the instrument feeder device from the engaged state to the disengaged state, wherein the actuate of the second robot arm causes the second robot arm to move away from the first robot arm, according to Embodiment 6 of the system. (8) The control circuit is, Determining that the amount of slack in the elongated shaft is less than a predetermined amount, The system according to Embodiment 1, further configured to perform the following actions: based at least in part on the determination that the amount of slack in the elongated shaft is less than a predetermined amount, the drive output unit and the second robot arm cooperate to move the elongated shaft in the axial direction. (9) The first robot arm is configured to be coupled to an instrument feeder device, and the control circuit is The instrument feeder device is further configured to apply force to the elongated shaft to prevent axial movement of a portion of the elongated shaft located within the instrument feeder device. The control circuit is configured to actuate the second robot arm, and the actuate of the second robot arm causes the second robot arm to move away from the first robot arm, according to Embodiment 1 of the system. (10) A method, The control circuit acts to activate at least one of the drive output unit of a first robot arm or a second robot arm, wherein the first robot arm is coupled to an elongated shaft of a medical device, the second robot arm is coupled to the base of the medical device, and the drive output unit is configured to control the axial movement of the elongated shaft. A method comprising, at least in part, the control circuit determining the amount of slack in the elongated shaft between the first robot arm and the second robot arm based on the aforementioned operation.

[0286] (11) Further including determining at least one of the first force applied by the drive output unit or the second force applied by the second robot arm, The method according to Embodiment 10, wherein determining the amount of slack in the elongated shaft is based on at least one of the first force or the second force. (12) The method according to embodiment 10, wherein the act of acting includes acting the second robot arm away from the first robot arm. (13) The method according to embodiment 10, wherein the act of activating the drive output unit is performed while preventing the second robot arm from operating beyond a threshold amount. (14) Further includes receiving an input signal indicating that the elongated shaft is to be inserted, The method according to embodiment 13, wherein activating the drive output unit includes activating the drive output unit in response to receiving the input signal, and the activation of the drive output unit causes the insertion of the elongated shaft. (15) Further including deciding to move an instrument feeder device configured to engage with the elongated shaft from an engaged state to an unengaged state, The actuating includes actuating the second robotic arm in a direction away from the first robotic arm in response to determining to transition the instrument feeder device from the engaged state to the disengaged state, the method according to embodiment 10.

[0287] (16) determining that an amount of slack in the elongate shaft is less than a predetermined amount, and based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount, causing the drive output portion and the second robotic arm to cooperate to axially move the elongate shaft, the method according to embodiment 10. (17) further including applying a force to the elongate shaft to prevent withdrawal of the elongate shaft from the patient, The actuating includes actuating the second robotic arm in a direction away from the first robotic arm, the method according to embodiment 10. (18) A system, an instrument feeder device configured to axially move an elongate shaft of a medical instrument, the medical instrument including an instrument handle, the instrument feeder device; and a control circuit, determining an amount of slack in the elongate shaft between the instrument handle and the instrument feeder device; and a control circuit configured to control the instrument feeder device based at least in part on the amount of slack in the elongate shaft. (19) The control circuit, is further configured to determine at least one of a first force applied by a drive output portion or a second force applied by a second robotic arm to control the instrument feeder device, The system according to embodiment 18, wherein the amount of slack in the elongated shaft is determined based on at least one of the first force or the second force. (20) The system according to embodiment 18, wherein the control circuit is configured to control the instrument feeder device by causing the instrument feeder device to perform at least one of the following: move the elongated shaft in the axial direction, disengage from the elongated shaft, or maintain engagement with the elongated shaft.

[0288] (21) The system according to embodiment 18, wherein the control circuit is configured to determine the amount of slack in the elongated shaft based on at least one of a first force applied to the instrument feeder device, a second force applied by a robotic arm coupled to the instrument handle, shape sensing data indicating the shape of the elongated shaft, or position sensor data indicating the position of at least a portion of the elongated shaft. (22) The control circuit is further configured to actuate the second robot arm away from the first robot arm, the second robot arm being coupled to the tool handle, The amount of slack is determined at least in part on the operation of the second robot arm, according to the system of embodiment 18. (23) The system according to embodiment 22, wherein the control circuit is configured to operate the second robot arm without controlling the instrument feeder device. (24) The control circuit is Determining at least one of the following: that the second robot arm has been operated beyond a threshold amount, or that it has been operated to the boundary of the workspace; The system according to embodiment 22, further configured to generate a signal indicating that the second robot arm has been operated beyond a threshold amount or has been operated to the working space boundary, at least one of the above. (25) The control circuit is Determining that the amount of slack in the elongated shaft is less than a predetermined amount, The system according to embodiment 18, further configured to disengage the instrument feeder device from the elongated shaft, at least in part on the determination that the amount of slack in the elongated shaft is less than the predetermined amount.

[0289] (26) The control circuit is The instrument feeder device is made to move the elongated shaft axially in the insertion direction, or to move the instrument handle away from the instrument feeder device, at least one of the above. Determining that the amount of slack in the elongated shaft is less than a predetermined amount, The system according to embodiment 18, further configured to cause the instrument feeder device to move the elongated shaft axially in a retraction direction or move the instrument handle toward the instrument feeder device, at least on the basis of the determination that the amount of slack in the elongated shaft is less than a predetermined amount. (27) The control circuit is The instrument feeder device applies force to the elongated shaft to prevent axial movement of a portion of the elongated shaft located within the instrument feeder device, The instrument handle is further configured to move away from the instrument feeder device, The amount of slack is determined when the instrument handle is moved, according to the system of embodiment 18. (28) A system, An instrument feeder device configured to be coupled to a first robotic arm and configured to move an elongated shaft of a medical instrument in the axial direction, wherein the medical instrument includes an instrument handle, and the instrument feeder device is configured to move an elongated shaft of a medical instrument. A control circuit, The slender shaft is determined to have substantially no slack between the instrument handle and the instrument feeder device, A system comprising: a control circuit configured to control the instrument feeder device, at least in part on the fact that there is substantially no slack between the instrument handle and the instrument feeder device on the elongated shaft; and a control circuit configured to do so. (29) The control circuit is The second robotic arm is further configured to act in a direction away from the first robotic arm, and the second robotic arm is coupled to the instrument handle, The system according to embodiment 28, wherein the determination that the elongated shaft is substantially free of slack is at least partially based on the operation of the second robotic arm. (30) The control circuit is The drive output unit of the first robot arm is further configured to control the instrument feeder device while preventing the instrument handle from moving, The system according to embodiment 28, wherein the determination that the elongated shaft is substantially free of slack is at least partially based on the operation of the drive output unit.

[0290] (31) The control circuit is It is further configured to determine at least one of a first force applied by a drive output unit to control the instrument feeder device, or a second force applied by a second robotic arm coupled to the instrument handle, The system according to embodiment 28, wherein the determination that the elongated shaft is substantially free of slack is based on at least one of the first force or the second force. (32) The system according to embodiment 28, wherein the control circuit is configured to control the instrument feeder device by causing the instrument feeder device to move the elongated shaft axially in the insertion direction, or to disengage from the elongated shaft. (33) The system according to Embodiment 28, wherein the control circuit is configured to determine that there is substantially no slack in the elongated shaft based on at least one of a first force applied to the instrument feeder device, a second force applied by a second robotic arm coupled to the instrument handle, shape sensing data indicating the shape of the elongated shaft, or position sensor data indicating the position of at least a portion of the elongated shaft. (34) The control circuit is The instrument feeder device applies force to the elongated shaft to prevent axial movement of a portion of the elongated shaft located within the instrument feeder device, The second robot arm is operated in a direction away from the first robot arm, and the second robot arm is further configured to operate the tool handle, The system according to embodiment 28, wherein the determination that the elongated shaft is substantially free of slack is at least partially based on the operation of the second robotic arm.

Claims

1. It is a system, A first robot arm configured to be coupled to an elongated shaft of a medical instrument, the first robot arm comprising a drive output unit configured to control the axial movement of the elongated shaft, configured to implement an engaged state in which it is engaged with the elongated shaft and an unengaged state in which it is disengaged, and configured to cause the elongated shaft to move axially based at least partially on the operation of the drive output unit, and the first robot arm configured to be coupled to an instrument feeder device, A second robotic arm configured to be attached to the base of the medical device, A control circuit, To operate the drive output unit or the second robot arm, Based at least in part on the aforementioned operation, a first force is determined to cause the elongated shaft to move axially, or a second force is determined to move the second robot arm away from or towards the first robot arm. To determine whether the first force is greater than the first threshold, or whether the second force is greater than the second threshold, A system comprising: a control circuit configured to determine that the amount of slack in the elongated shaft between the first robot arm and the second robot arm is less than a threshold slack amount, based on the first force being greater than the first threshold or the second force being greater than the second threshold.

2. The system according to claim 1, wherein the operation of the second robot arm moves the second robot arm away from the first robot arm.

3. The system according to claim 1, wherein the control circuit is configured to operate the drive output unit while enabling the second robot arm to move by less than a threshold amount.

4. The aforementioned control circuit is It is further configured to receive an input signal indicating the insertion of the elongated shaft, The system according to claim 3, wherein the operation of the drive output unit is in response to receiving the input signal, and the operation of the drive output unit causes the insertion of the elongated shaft based on the axial motion.

5. The aforementioned control circuit is The system according to claim 1, wherein the second robot arm is activated when the instrument feeder device is moved from the engaged state to the disengaged state, and the activation of the second robot arm causes the second robot arm to move away from the first robot arm.

6. The aforementioned control circuit is The system according to claim 1, further configured to move the elongated shaft in the axial direction by cooperating the drive output unit and the second robot arm based on the fact that the amount of slack in the elongated shaft is less than the threshold amount of slack.

7. The control circuit is The system according to claim 1, wherein the instrument feeder device is configured to apply force to the elongated shaft to prevent axial movement of a portion of the elongated shaft positioned within the instrument feeder device, and to perform a process to move the second robot arm away from the first robot arm.

8. The system according to claim 1, wherein the control circuit is further configured to apply force to the elongated shaft to prevent the elongated shaft from retracting from the patient.

9. The medical device includes an instrument handle, The system according to claim 1, wherein the control circuit is further configured to control the instrument feeder device based at least in part on the amount of slack in the elongated shaft.

10. The system according to claim 9, wherein controlling the instrument feeder device includes causing the instrument feeder device to perform at least one of the following: moving the elongated shaft in the axial direction, disengaging from the elongated shaft, or maintaining engagement with the elongated shaft.

11. The system according to claim 1, wherein the control circuit is configured to determine the amount of slack in the elongated shaft based on at least one of shape sensing data indicating the shape of the elongated shaft, or position sensor data indicating the position of at least a part of the elongated shaft.

12. The system according to claim 9, wherein operating the second robotic arm is independent of controlling the instrument feeder device.

13. The aforementioned control circuit is Determining at least one of the following: that the second robot arm has been operated beyond a threshold working amount, or that it has been operated to the boundary of the working space; The system according to claim 1, further configured to generate a signal indicating that the second robot arm has been operated beyond the threshold actuation amount or has been operated to the working space boundary, at least one of the above.

14. The aforementioned control circuit is The system according to claim 9, further configured to disengage the instrument feeder device from the elongated shaft, at least in part on the determination that the amount of slack in the elongated shaft is less than the threshold amount of slack.

15. The aforementioned control circuit is The system according to claim 9, further configured to cause the instrument feeder device to move the elongated shaft axially in a backward direction or move the instrument handle toward the instrument feeder device, based at least in part on the determination that the amount of slack in the elongated shaft is less than the threshold amount of slack.

16. The medical device includes an instrument handle, The aforementioned control circuit The system according to claim 1, further configured to control the instrument feeder device based at least in part on the determination that the amount of slack in the elongated shaft is less than the threshold amount of slack.

17. The second robot arm is connected to the tool handle, The system according to claim 16, wherein the determination that the amount of slack in the elongated shaft is less than the threshold amount of slack is at least in part based on the operation of the second robot arm.

18. The aforementioned control circuit is The drive output unit is further configured to control the instrument feeder device while preventing the instrument handle from moving, The system according to claim 16, wherein the determination that the amount of slack in the elongated shaft is less than the threshold amount of slack is at least partially based on the operation of the drive output unit.

Images