Robotic arm and method for tissue resection and imaging

JP7901139B2Active Publication Date: 2026-08-05PROCEPT BIOROBOTICS CORP

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Patent Information

Authority / Receiving Office: JP · JP
Patent Type: Patents
Current Assignee / Owner: PROCEPT BIOROBOTICS CORP
Filing Date: 2024-12-17
Publication Date: 2026-08-05

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【0015】 これらおよび他の実施形態は、添付の図面に関連する以下の説明においてさらに詳細に説明される。本発明は、例えば、以下を提供する。 (項目1) 患者の組織を治療または撮像するシステムであって、前記システムは、前記患者の中への挿入のためにサイズを決定されたプローブと、前記プローブに結合するように構成されたロボットアームと、前記ロボットアームに動作可能に結合された1つ以上のコンピューティングデバイスとを備え、前記1つ以上のコンピューティングデバイスは、前記プローブのための許容可動域を確立することであって、前記許容可動域は、1つ以上のコンピューティングデバイスのメモリ上に記憶されている、ことと、前記プローブを用いて、前記患者の標的組織を治療または撮像することと、前記ロボットアームを移動させ、前記プローブのための前記許容可動域内の前記プローブの移動に影響を及ぼすこととを行うための命令で構成されている、システム。 (項目2) 前記プローブは、前記ロボットアームが受動モードである間に前記ロボットアームに結合するように構成されている、項目1に記載のシステム。 (項目3) 前記プローブのための前記許容可動域は、前記ロボットアームが受動モードである間に確立される、項目1に記載のシステム。 (項目4) 前記プローブのための前記許容可動域を確立することは、ユーザ入力に応答して前記プローブのための前記許容可動域を確立することを含む、項目1に記載のシステム。 (項目5) 前記プローブのための前記許容可動域を確立することは、前記プローブの位置に応答して前記プローブのための前記許容可動域を確立することを含む、項目1に記載のシステム。 (項目6) 前記標的組織に対する前記プローブの位置は、前記標的組織の1つ以上の画像内の1つ以上の組織目印に応答して決定される、項目5に記載のシステム。 (項目7) リアルタイムで前記プローブのための前記許容可動域を更新することをさらに含む、項目1に記載のシステム。 (項目8) 1つ以上のコンピューティングデバイスと動作可能に結合されたユーザ入力デバイスをさらに備え、前記ユーザ入力デバイスは、前記ロボットアームの移動を制御するための1つ以上のユーザ命令を提供し、前記1つ以上のコンピューティングデバイスの制御下で前記ロボットアームを移動させることは、前記ロボットアームの移動を制御するための前記1つ以上のユーザ命令に応答して前記ロボットアームを移動させることを含む、項目1に記載のシステム。 (項目9) 前記ユーザ入力デバイスは、前記ロボットアームの端部の近傍のコントローラ、ディスプレイ画面上のユーザインターフェース、コンソール上のユーザインターフェース、または、定位置に前記ロボットアーム上のプローブを誘導するために前記ユーザによって提供される前記アームの前記端部上の力に応答するコントローラのうちの1つ以上を備えている、項目8に記載のシステム。 (項目10) 前記プローブおよび1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の力センサをさらに備え、前記1つ以上の力センサは、前記プローブを用いた前記患者の組織の圧縮を検出する、項目1に記載のシステム。 (項目11) 前記1つ以上のコンピューティングデバイスは、圧縮の事前決定された閾値レベルを超える前記組織の検出された圧縮に応答して前記治療を中断するための命令で構成されたプロセッサを備えている、項目10に記載のシステム。 (項目12) 前記1つ以上の力センサは、前記ロボットアームに動作可能に結合されている、項目10に記載のシステム。 (項目13) 前記プローブおよび前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の運動センサをさらに備え、前記1つ以上の運動センサは、前記患者の移動を検出し、前記1つ以上のコンピューティングデバイスは、前記患者の検出された移動に応答して前記プローブの位置を調節するように構成されている、項目12に記載のシステム。 (項目14) 前記ロボットアームは、前記プローブを手動で設定された位置に手動で調節するための受動モードを備えている、項目1に記載のシステム。 (項目15) 前記受動モードにおいて、前記プローブは、前記ロボットアームを用いて支持され、前記プローブは、前記ロボットアームと前記プローブとの間のインターフェースにおける複数のセンサを備え、前記複数のセンサは、前記ユーザが前記プローブを導くための複数のセンサに結合されたハンドルからユーザ入力を受信する、項目14に記載のシステム。 (項目16) 前記複数のセンサに結合されたハンドルは、前記ハンドルのユーザ操作に応じるように構成され、前記インターフェースにおける前記複数のセンサは、前記ハンドルのユーザ操作に応答して前記プローブを操作するための前記1つ以上のコンピューティングデバイスのプロセッサに結合されている、項目15に記載のシステム。 (項目17) 前記複数のセンサは、6自由度を伴う前記ハンドルのユーザ操作を検出するように構成され、前記プロセッサは、6自由度で前記プローブを移動させるように構成され、前記6自由度に対応する運動は、前記ユーザ操作に応答している、項目16に記載のシステム。 (項目18) 前記受動モードで前記ロボットアームを手動で調節することは、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において前記プローブを手動で調節することを含む、項目14に記載のシステム。 (項目19) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目18に記載のシステム。 (項目20) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目19に記載のシステム。 (項目21) 前記プローブの前記手動で設定された位置は、前記ロボットアームが手動調節から解放された後、維持される、項目14に記載のシステム。 (項目22) 前記ロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差を伴って前記手動で設定された位置を維持するように構成され、随意に、前記公差は、3つの軸のうちの1つ以上のまわりの回転に関して5°、3つの軸のうちの1つ以上に沿った平行移動に関して5mm以内であり、随意に、3つの軸のうちの1つ以上の各々に関して、随意に、回転公差は、3°以内であり、随意に、平行移動公差は、3mm以内、随意に、2mmである、項目21に記載のシステム。 (項目23) 前記プローブは、撮像プローブを備えている、項目21に記載のシステム。 (項目24) 前記プローブは、治療プローブを備え、前記ロボットアームは、第1のロボットアームを備え、前記システムは、前記患者の中への挿入のためにサイズを決定された撮像プローブと、前記撮像プローブに結合された第2のロボットアームとをさらに備え、前記1つ以上のコンピューティングデバイスは、前記撮像プローブのための許容可動域を確立するための命令で構成されている、項目21に記載のシステム。 (項目25) 前記撮像プローブは、前記撮像プローブを用いて前記患者の標的部位を撮像するように構成され、前記第2のロボットアームは、前記1つ以上のコンピューティングデバイスの制御下で移動し、前記撮像プローブのための前記許容可動域内の前記撮像プローブの移動に影響を及ぼすように構成されている、項目24に記載のシステム。 (項目26) 前記1つ以上のコンピューティングデバイスは、前記組織の撮像および治療のための命令を備えている、項目1に記載のシステム。 (項目27) 患者の標的部位における標的組織を治療する方法であって、前記方法は、プローブを前記患者の中に手動で挿入することと、前記プローブをロボットアームに結合することと、前記プローブのための許容可動域を確立することであって、前記許容可動域は、前記ロボットアームと動作可能に結合された1つ以上のコンピューティングデバイスのメモリ上に記憶されている、ことと、前記プローブを用いて、前記患者の標的組織を治療または撮像することと、前記プローブと動作可能に結合された前記1つ以上のコンピューティングデバイスの制御下で、前記ロボットアームを移動させ、前記プローブのための前記許容可動域内の前記プローブの移動に影響を及ぼすこととを含む、方法。 (項目28) 前記プローブは、前記ロボットアームが受動モードである間に前記ロボットアームに結合される、項目27に記載の方法。 (項目29) 前記プローブのための前記許容可動域は、前記ロボットアームが受動モードである間に確立される、項目27に記載の方法。 (項目30) 前記プローブのための前記許容可動域を確立することは、ユーザ入力に応答して前記プローブのための前記許容可動域を確立することを含む、項目27に記載の方法。 (項目31) 前記プローブのための前記許容可動域を確立することは、前記プローブの位置に応答して前記プローブのための前記許容可動域を確立することを含む、項目27に記載の方法。 (項目32) 前記標的組織に対する前記プローブの位置は、前記標的組織の1つ以上の画像内の1つ以上の組織目印に応答して決定される、項目31に記載の方法。 (項目33) リアルタイムで前記プローブのための前記許容可動域を更新することをさらに含む、項目27に記載の方法。 (項目34) 1つ以上のコンピューティングデバイスと動作可能に結合されたユーザ入力デバイスから、前記ロボットアームの移動を制御するための1つ以上のユーザ命令を受信することをさらに含み、前記1つ以上のコンピューティングデバイスの制御下で前記ロボットアームを移動させることは、前記ロボットアームの移動を制御するための前記1つ以上のユーザ命令に応答して前記ロボットアームを移動させることを含む、項目27に記載の方法。 (項目35) 前記ユーザ入力デバイスは、前記ロボットアームの端部上のコントローラ、ディスプレイ画面上のユーザインターフェース、コンソール上のユーザインターフェース、または、定位置に前記ロボットアーム上のプローブを誘導するための前記ユーザによって提供される前記アームの端部上の力に応答するコントローラのうちの1つ以上を備えている、項目34に記載の方法。 (項目36) 前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の力センサから、センサデータを受信することをさらに含み、前記1つ以上の力センサは、前記プローブを用いた前記患者の組織の圧縮を検出するように構成されている、項目27に記載の方法。 (項目37) 前記1つ以上のコンピューティングデバイスは、圧縮の事前決定された閾値レベルを超える前記組織の検出された圧縮に応答して前記治療を中断するための命令で構成されたプロセッサを備えている、項目36に記載の方法。 (項目38) 前記1つ以上の力センサは、前記ロボットアームに動作可能に結合されている、項目36に記載の方法。 (項目39) 前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の運動センサから、センサデータを受信することをさらに含み、前記1つ以上の運動センサは、前記患者の移動を検出するように構成され、前記1つ以上のコンピューティングデバイスの制御下で前記ロボットアームを移動させることは、前記患者の検出された移動に応答して前記プローブの位置を調節することを含む、項目38に記載の方法。 (項目40) 受動モードで前記ロボットアームを手動で調節し、前記プローブを手動で設定された位置に手動で調節することをさらに含む、項目27に記載の方法。 (項目41) 前記受動モードにおいて、前記プローブは、前記ロボットアームを用いて支持され、前記プローブは、前記ロボットアームと前記プローブとの間のインターフェースにおける複数のセンサを備え、前記複数のセンサは、前記ユーザが前記プローブを導くための複数のセンサに結合されたハンドルからユーザ入力を受信する、項目40に記載の方法。 (項目42) 前記複数のセンサに結合されたハンドルは、前記ハンドルのユーザ操作に応じるように構成され、前記インターフェースにおける前記複数のセンサは、前記ハンドルのユーザ操作に応答して前記プローブを操作するための前記1つ以上のコンピューティングデバイスのプロセッサに結合されている、項目41に記載の方法。 (項目43) 前記複数のセンサは、6自由度を伴う前記ハンドルのユーザ操作を検出するように構成され、前記プロセッサは、6自由度で前記プローブを移動させるように構成され、前記6自由度に対応する運動は、前記ユーザ操作に応答している、項目42に記載の方法。 (項目44) 前記受動モードで前記ロボットアームを手動で調節し、前記プローブを手動で調節することは、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において前記プローブを手動で調節することを含む、項目40に記載の方法。 (項目45) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目44に記載の方法。 (項目46) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目45に記載の方法。 (項目47) 前記プローブの手動で設定された位置は、前記ロボットアームが手動調節から解放された後、維持される、項目40に記載の方法。 (項目48) 前記ロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差を伴って前記手動で設定された位置を維持するように構成され、随意に、前記公差は、3つの軸のうちの1つ以上のまわりの回転に関して5°、3つの軸のうちの1つ以上に沿った平行移動に関して5mm以内であり、随意に、3つの軸のうちの1つ以上の各々に関して、随意に、回転公差は、3°以内であり、随意に、平行移動公差は、3mm以内、随意に、2mmである、項目47に記載の方法。 (項目49) 前記プローブは、撮像プローブを備えている、項目27に記載の方法。 (項目50) 前記プローブは、治療プローブを備え、前記ロボットアームは、第1のロボットアームを備え、前記方法は、撮像プローブを前記患者の中に手動で挿入することと、前記撮像プローブを第2のロボットアームに結合することと、前記撮像プローブのための許容可動域を確立することであって、前記許容可動域は、前記第1のロボットアームおよび前記第2のロボットアームと動作可能に結合された1つ以上のコンピューティングデバイスのメモリ上に記憶されている、こととをさらに含む、項目47に記載の方法。 (項目51) 前記撮像プローブは、前記第2のロボットアームが受動モードである間に前記第2のロボットアームに結合される、項目50に記載の方法。 (項目52) 前記撮像プローブのための前記許容可動域は、前記第2のロボットアームが受動モードである間に確立される、項目50に記載の方法。 (項目53) 前記撮像プローブのための前記許容可動域を確立することは、前記治療プローブと前記撮像プローブとの間の距離または整列に応答して前記許容可動域を確立することを含む、項目50に記載の方法。 (項目54) 前記撮像プローブのための前記許容可動域を確立することは、ユーザ入力に応答して前記撮像プローブのための前記許容可動域を確立することを含む、項目50に記載の方法。 (項目55) 前記撮像プローブのための前記許容可動域を確立することは、前記標的組織に対する前記撮像プローブの位置に応答して前記許容可動域を確立することを含む、項目50に記載の方法。 (項目56) 前記標的組織に対する前記撮像プローブの位置は、前記標的組織の1つ以上の画像内の1つ以上の組織目印に応答して決定される、項目55に記載の方法。 (項目57) リアルタイムで前記撮像プローブのための前記許容可動域を更新することをさらに含む、項目50に記載の方法。 (項目58) 1つ以上のコンピューティングデバイスと動作可能に結合されたユーザ入力デバイスから、前記第2のロボットアームの移動を制御するための1つ以上のユーザ命令を受信することをさらに含み、前記1つ以上のコンピューティングデバイスの制御下で前記第2のロボットアームを移動させることは、前記第2のロボットアームの移動を制御するための前記1つ以上のユーザ命令に応答して前記第2のロボットアームを移動させることを含む、項目50に記載の方法。 (項目59) 前記第2のロボットアームの移動を制御するための前記1つ以上のユーザ命令に応答して前記第2のロボットアームの許容可動域を確立することをさらに含む、項目58に記載の方法。 (項目60) 前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の力センサから、センサデータを受信することをさらに含み、前記1つ以上の力センサは、前記撮像プローブを用いた前記患者の組織の圧縮を検出するように構成され、前記1つ以上のコンピューティングデバイスの制御下で前記第2のロボットアームを移動させることは、前記組織の検出された圧縮が圧縮の事前決定された閾値レベルを超えるという決定に応答して前記組織から離れるように前記撮像プローブを移動させることを含む、項目50に記載の方法。 (項目61) 前記1つ以上の力センサは、前記第2のロボットアームに動作可能に結合されている、項目60に記載の方法。 (項目62) 前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の位置センサから、センサデータを受信することをさらに含み、前記1つ以上の位置センサは、前記第1のロボットアーム、前記治療プローブ、前記第2のロボットアーム、または前記撮像プローブの1つ以上の位置を検出するように構成されている、項目50に記載の方法。 (項目63) 前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上の運動センサから、センサデータを受信することをさらに含み、前記1つ以上の運動センサは、前記患者の移動を検出するように構成され、前記1つ以上のコンピューティングデバイスの制御下で前記第2のロボットアームを移動させることは、前記患者の検出された移動に応答して前記撮像プローブの位置を調節することを含む、項目50に記載の方法。 (項目64) 前記第2のロボットアームに対するその位置を識別するために前記第1のロボットアームを較正することと、前記第1のロボットアームに対するその位置を識別するために前記第2のロボットアームを較正することとをさらに含む、項目50に記載の方法。 (項目65) 前記1つ以上のコンピューティングデバイスの制御下で前記第1のロボットアームまたは前記第2のロボットアームを移動させることは、前記第2のロボットアームの移動に応答して前記第1のロボットアームの移動を自動的に調節すること、または、前記第1のロボットアームの移動に応答して前記第2のロボットアームの移動を自動的に調節することを含む、項目50に記載の方法。 (項目66) 前記1つ以上のコンピューティングデバイスの制御下で前記第1のロボットアームまたは前記第2のロボットアームを移動させることは、前記第1のロボットアームまたは前記第2のロボットアームを移動させ、前記患者の外側に配置された前記治療プローブの一部と前記撮像プローブの一部との間の接触を防止することを含む、項目50に記載の方法。 (項目67) 前記1つ以上のコンピューティングデバイスの制御下で前記第1のロボットアームまたは前記第2のロボットアームを移動させることは、前記第1のロボットアームまたは前記第2のロボットアームを移動させ、前記治療プローブと前記撮像プローブとの間の整列を維持することを含む、項目66に記載の方法。 (項目68) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の平行整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに平行である、項目67に記載の方法。 (項目69) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の同一平面内整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに同一平面内にある、項目67に記載の方法。 (項目70) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の非平行整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに横断する、項目67に記載の方法。 (項目71) 前記治療プローブと前記撮像プローブとの間の距離または整列のうちの1つ以上を検出することをさらに含む、項目50に記載の方法。 (項目72) 前記1つ以上のコンピューティングデバイスの制御下で前記第1のロボットアームまたは前記第2のロボットアームを移動させることは、前記第1のロボットアームまたは前記第2のロボットアームを移動させ、前記1つ以上のコンピューティングデバイス上に記憶された走査プロファイルに沿って、前記治療プローブまたは前記撮像プローブを自動的に移動させることを含む、項目50に記載の方法。 (項目73) 前記1つ以上のコンピューティングデバイスの制御下で前記第1のロボットアームを移動させることは、前記第1のロボットアームを移動させ、治療プロファイルを備えている前記走査プロファイルにわたって前記治療プローブを自動的に移動させることを含む、項目72に記載の方法。 (項目74) 前記1つ以上のコンピューティングデバイスの制御下で前記第2のロボットアームを移動させることは、前記第2のロボットアームを移動させ、撮像プロファイルを備えている前記走査プロファイルにわたって前記撮像プローブを自動的に移動させることを含む、項目72に記載の方法。 (項目75) 前記撮像プロファイルは、前記標的部位の複数回の横断像走査または複数回の矢状像走査を含み、方法は、前記標的部位の3次元画像を発生させることをさらに含む、項目74に記載の方法。 (項目76) 前記第2のロボットアームは、前記治療プローブが前記標的組織を治療している間、前記撮像プロファイルを備えている前記走査プロファイルにわたって前記撮像プローブを自動的に移動させるように移動させられる、項目74に記載の方法。 (項目77) 前記撮像プローブを用いて前記標的部位を撮像することは、ドップラモードで動作する前記撮像プローブを用いて前記標的部位を撮像することを含み、前記方法は、前記撮像プローブを用いて取得された前記標的部位の1つ以上の画像に基づいて前記標的部位内の高血流の領域を識別することをさらに含む、項目50に記載の方法。 (項目78) 止血を前記標的部位内の識別された高血流の領域に適用することをさらに含む、項目77に記載の方法。 (項目79) 前記標的部位内の識別された高血流の領域に位置する組織の生検を実施することをさらに含む、項目77に記載の方法。 (項目80) 前記高血流の領域を癌組織として識別することをさらに含む、項目77に記載の方法。 (項目81) 前記撮像プローブを用いて前記標的部位を撮像することは、前記撮像プローブを回転させることを含む、項目77に記載の方法。 (項目82) 前記撮像プローブを用いて前記標的部位を撮像することは、前記標的部位の術中画像を発生させることを含む、項目50に記載の方法。 (項目83) 前記術中画像を前記標的部位の術前画像とマッピングすることをさらに含む、項目82に記載の方法。 (項目84) 前記標的部位の術前画像は、X線画像、蛍光透視画像、コンピュータ断層撮影(CT)画像、超音波画像、またはMRI画像のうちの1つ以上を備えている、項目83に記載の方法。 (項目85) 前記術中画像を前記術前画像とマッピングすることは、前記術中および術前画像内の1つ以上の解剖学的領域を互いにマッピングすることを含む、項目83に記載の方法。 (項目86) 前記1つ以上の解剖学的領域は、膀胱頸部、外括約筋、または精丘のうちの1つ以上を備えている、項目85に記載の方法。 (項目87) ロボットアームを動作させ、患者の標的部位における標的組織を撮像または治療する方法であって、前記方法は、少なくとも1つのプローブを少なくとも1つのロボットアームに結合することと、受動モードで前記少なくとも1つのロボットアームを手動で調節し、前記少なくとも1つのプローブを手動で設定された位置に手動で調節することと、前記受動モードから前記少なくとも1つのロボットアームを解放することとを含み、前記少なくとも1つのロボットアームは、手動調節からの解放後、前記少なくとも1つのプローブの手動で設定された位置を維持し、前記少なくとも1つのプローブは、前記維持された手動で設定された位置から、前記患者の前記標的部位における前記標的組織の撮像または治療のうちの1つ以上を行う、方法。 (項目88) 前記少なくとも1つのプローブは、前記少なくとも1つのプローブを前記患者の中に挿入することに先立って、前記少なくとも1つのロボットアームに結合される、項目87に記載の方法。 (項目89) 前記少なくとも1つのプローブは、前記少なくとも1つのプローブを前記患者の中に挿入した後、前記少なくとも1つのロボットアームに結合される、項目87に記載の方法。 (項目90) 前記少なくとも1つのロボットアームは、前記少なくとも1つのロボットアームの係止構成を用いて、前記少なくとも1つのプローブの手動で設定された位置を維持し、随意に、前記少なくとも1つのロボットアームの継手のセンサと前記ロボットアームの前記継手に結合されたアクチュエータとが、前記係止構成で前記少なくとも1つのロボットアームの手動で設定された位置を維持する、項目87に記載の方法。 (項目91) 前記受動モードで前記少なくとも1つのロボットアームを手動で調節することは、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において前記少なくとも1つのプローブを手動で調節することを含む、項目87に記載の方法。 (項目92) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目91に記載の方法。 (項目93) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目92に記載の方法。 (項目94) 前記少なくとも1つのロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差以内に前記手動で設定された位置を維持し、随意に、前記公差は、3つの軸のうちの1つ以上のまわりの回転に関して5°、3つの軸のうちの1つ以上に沿った平行移動に関して5mm以内であり、随意に、3つの軸のうちの1つ以上の各々に関して、随意に、回転公差は、3°以内であり、随意に、平行移動公差は、3mm以内、随意に、2mmである、項目87に記載の方法。 (項目95) 前記少なくとも1つのプローブを前記少なくとも1つのロボットアームに結合することは、治療プローブを第1のロボットアームに結合すること、または撮像プローブを第2のロボットアームに結合することのうちの1つ以上を含む、項目87に記載の方法。 (項目96) 前記受動モードで前記少なくとも1つのロボットアームを手動で調節することは、前記治療プローブと前記撮像プローブとを互いに整列させることを含む、項目95に記載の方法。 (項目97) 前記治療プローブと前記撮像プローブとは、平行または同一平面内のうちの1つ以上であるように互いに整列させられている、項目96に記載の方法。 (項目98) 前記少なくとも1つのロボットアームは、手動調節からの解放後、前記撮像プローブと治療プローブとの間の前記整列を維持する、項目96に記載の方法。 (項目99) 前記撮像プローブと治療プローブとの間の前記整列は、回転軸または平行移動軸のうちの1つ以上における公差以内に維持され、随意に、前記公差は、3つの軸のうちの1つ以上のまわりの回転に関して5°、3つの軸のうちの1つ以上に沿った平行移動に関して5mm以内であり、随意に、3つの軸のうちの1つ以上の各々に関して、随意に、回転公差は、3°以内であり、随意に、平行移動公差は、3mm以内、随意に、2mmである、項目98に記載の方法。 (項目100) システムであって、前記システムは、項目1-99のいずれか1項に記載の方法を実施するための命令で構成されたプロセッサを備えている、システム。 (項目101) ロボットアームを動作させ、患者の標的部位における標的組織を撮像または治療するためのシステムであって、前記システムは、前記患者の前記標的組織の治療または撮像のうちの1つ以上のための少なくとも1つのプローブに結合された少なくとも1つのロボットアームと、前記少なくとも1つのロボットアームと動作可能に結合された1つ以上のコンピューティングデバイスとを備え、前記1つ以上のコンピューティングデバイスは、前記少なくとも1つのロボットアームが手動で設定された位置に前記少なくとも1つのロボットアームを手動で調節するように手動で調節されることが可能であるように、前記少なくとも1つのプローブを受動モードで動作させることと、前記少なくとも1つのプローブが前記手動で設定された位置に手動で調節された後、前記受動モードから前記少なくとも1つのロボットアームを解放することと、前記手動調節からの解放後、前記少なくとも1つのプローブの前記手動で設定された位置を維持することとを行うための命令を実行するように構成されている、システム。 (項目102) 前記少なくとも1つのプローブは、前記少なくとも1つのプローブを前記患者の中に挿入することに先立って、前記少なくとも1つのロボットアームに結合するように構成されている、項目101に記載のシステム。 (項目103) 前記少なくとも1つのプローブは、前記少なくとも1つのプローブを前記患者の中に挿入した後、前記少なくとも1つのロボットアームに結合するように構成されている、項目101に記載のシステム。 (項目104) 前記少なくとも1つのロボットアームは、前記少なくとも1つのロボットアームの係止構成を用いて、前記少なくとも1つのプローブの前記手動で設定された位置を維持し、随意に、前記少なくとも1つのロボットアームの継手のセンサと前記ロボットアームの前記継手に結合されたアクチュエータとが、前記係止構成で前記少なくとも1つのロボットアームの前記手動で設定された位置を維持する、項目101に記載のシステム。 (項目105) 前記1つ以上のコンピューティングデバイスは、前記少なくとも1つのロボットアームの移動を制御するための命令を実行するようにさらに構成されている、項目101に記載のシステム。 (項目106) 前記少なくとも1つのロボットアームは、手動で調節され、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において前記少なくとも1つのプローブを手動で調節するように構成されている、項目101に記載のシステム。 (項目107) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目106に記載のシステム。 (項目108) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目107に記載のシステム。 (項目109) 前記少なくとも1つのロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差を伴って前記手動で設定された位置を維持するように構成され、随意に、前記公差は、3つの軸のうちの1つ以上のまわりの回転に関して5°、3つの軸のうちの1つ以上に沿った平行移動に関して5mm以内であり、随意に、3つの軸のうちの1つ以上の各々に関して、随意に、回転公差は、3°以内であり、随意に、平行移動公差は、3mm以内、随意に、2mmである、項目106に記載のシステム。 (項目110) 前記少なくとも1つのプローブは、治療プローブまたは撮像プローブのうちの1つ以上を備えている、項目101に記載のシステム。 (項目111) 前記少なくとも1つのプローブは、前記治療プローブと、前記撮像プローブとを備え、前記少なくとも1つのロボットアームは、前記治療プローブに結合された第1のロボットアームと、前記撮像プローブに結合された第2のロボットアームとを備えている、項目110に記載のシステム。 (項目112) 前記少なくとも1つのプローブは、前記治療プローブと、前記撮像プローブとを備え、前記治療プローブおよび前記撮像プローブは、手動で調節され、前記治療プローブと前記撮像プローブとを互いに整列させるように構成されている、項目110に記載のシステム。 (項目113) 前記治療プローブと前記撮像プローブとは、平行または同一平面内のうちの1つ以上であるように互いに整列させられている、項目112に記載のシステム。 (項目114) 前記少なくとも1つのロボットアームは、手動調節からの解放後、前記撮像プローブと治療プローブとの間の前記整列を維持する、項目113に記載のシステム。 (項目115) 前記撮像プローブと治療プローブとの間の前記整列は、回転軸または平行移動軸のうちの1つ以上における公差以内に維持される、項目114に記載のシステム。 (項目116) 患者の標的部位における標的組織を治療するためのシステムであって、前記システムは、前記患者の前記標的組織を治療するための治療プローブに結合された第1のロボットアームと、前記患者の前記標的組織を撮像するための撮像プローブに結合された第2のロボットアームと、前記第1のロボットアームおよび前記第2のロボットアームと動作可能に結合された1つ以上のコンピューティングデバイスとを備え、前記1つ以上のコンピューティングデバイスは、前記第1のロボットアームまたは前記第2のロボットアームのうちの1つ以上の移動を制御するための命令を実行するように構成されている、システム。 (項目117) 前記1つ以上のコンピューティングデバイスは、前記患者の中への前記治療プローブまたは前記撮像プローブの進入軸に沿って、前記治療プローブまたは前記撮像プローブのピッチ、ヨー、ロールまたは線形位置のうちの1つ以上を調節するように前記第1のロボットアームまたは前記第2のロボットアームの移動を制御するための命令を実行するように構成されている、項目116に記載のシステム。 (項目118) 前記1つ以上のコンピューティングデバイスは、前記治療プローブまたは前記撮像プローブを前記進入軸に沿って後退させるように、それぞれ、前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目119) 前記1つ以上のコンピューティングデバイスは、前記治療プローブまたは前記撮像プローブを前記進入軸に沿って後退させるが、前進させないように、それぞれ、前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目118に記載のシステム。 (項目120) 前記1つ以上のコンピューティングデバイスは、前記1つ以上のコンピューティングデバイスと動作可能に結合されたユーザ入力デバイスを用いて受信されるユーザ命令に応答して前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目121) 前記1つ以上のコンピューティングデバイスは、前記1つ以上のコンピューティングデバイス内に記憶された前記治療プローブまたは前記撮像プローブのための許容可動域内で、前記治療プローブまたは前記撮像プローブを移動させるように、それぞれ、前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目122) 前記1つ以上のコンピューティングデバイスは、ユーザ入力に応答して前記治療プローブまたは前記撮像プローブのための前記許容可動域を確立することを含む命令を実行するように構成されている、項目121に記載のシステム。 (項目123) 前記1つ以上のコンピューティングデバイスは、前記治療プローブと前記撮像プローブとの間の距離または整列に応答して前記治療プローブまたは前記撮像プローブのための前記許容可動域を確立することを含む命令を実行するように構成されている、項目121に記載のシステム。 (項目124) 前記1つ以上のコンピューティングデバイスは、前記標的組織に対する前記治療プローブまたは前記撮像プローブの位置に応答して前記治療プローブまたは前記撮像プローブのための前記許容可動域を確立することを含む命令を実行するように構成されている、項目121に記載のシステム。 (項目125) 前記1つ以上のコンピューティングデバイスは、前記標的組織の1つ以上の画像に基づいて前記標的組織に対する前記治療プローブまたは前記撮像プローブの位置を検出することを含む命令を実行するように構成され、前記1つ以上の画像は、1つ以上の組織目印を備えている、項目124に記載のシステム。 (項目126) 前記1つ以上のコンピューティングデバイスは、リアルタイムで前記治療プローブまたは前記撮像プローブのための前記許容可動域を更新するための命令を実行するように構成されている、項目121に記載のシステム。 (項目127) 前記1つ以上のコンピューティングデバイスは、前記治療プローブと前記撮像プローブとの間の整列を維持するように前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成され、随意に、前記整列は、前記撮像プローブの視野内に前記治療プローブを維持する、項目116に記載のシステム。 (項目128) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の実質的に平行な整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに実質的に平行である、項目127に記載のシステム。 (項目129) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の同一平面内整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに同一平面内にある、項目127に記載のシステム。 (項目130) 前記治療プローブと前記撮像プローブとの間で維持される前記整列は、前記治療プローブと前記撮像プローブとの間の非平行整列を含み、前記治療プローブの縦軸と前記撮像プローブの縦軸とは、互いに横断する、項目127に記載のシステム。 (項目131) 前記1つ以上のコンピューティングデバイスは、前記治療プローブと前記撮像プローブとの間の距離または整列のうちの1つ以上を検出することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目132) 前記1つ以上のコンピューティングデバイスは、前記患者の外側に配置された前記治療プローブの一部と前記撮像プローブの一部との間の接触を防止するように前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目133) 前記1つ以上のコンピューティングデバイスは、前記第2のロボットアームの移動に応答して前記第1のロボットアームの移動を自動的に調節するための命令を実行するように構成されている、項目116に記載のシステム。 (項目134) 前記1つ以上のコンピューティングデバイスは、前記第1のロボットアームの位置に応答して前記第2のロボットアームの移動を自動的に調節するための命令を実行するように構成され、随意に、前記第2のロボットアームは、前記治療プローブの位置に応答して前記撮像プローブを移動させ、前記撮像プローブの視野内に前記治療プローブを維持する、項目116に記載のシステム。 (項目135) 前記1つ以上のコンピューティングデバイスは、前記1つ以上のコンピューティングデバイス上に記憶された走査プロファイルに沿って、前記治療プローブまたは前記撮像プローブを自動的に移動させるように前記第1のロボットアームまたは前記第2のロボットアームの移動を制御するための命令を実行するように構成されている、項目116に記載のシステム。 (項目136) 前記1つ以上のコンピューティングデバイスは、治療プロファイルを備えている前記走査プロファイルに沿って前記治療プローブを自動的に移動させるように前記第1のロボットアームの移動を制御するための命令を実行するように構成されている、項目135に記載のシステム。 (項目137) 前記1つ以上のコンピューティングデバイスは、撮像プロファイルを備えている前記走査プロファイルに沿って前記撮像プローブを自動的に移動させるように前記第2のロボットアームの移動を制御するための命令を実行するように構成されている、項目135に記載のシステム。 (項目138) 前記撮像プロファイルは、前記標的部位の複数回の横断像走査または複数回の矢状像走査を含み、前記1つ以上のコンピューティングデバイスは、前記標的部位の3次元画像を発生させることを含む命令を実行するようにさらに構成されている、項目137に記載のシステム。 (項目139) 前記1つ以上のコンピューティングデバイスは、前記治療プローブが前記標的組織を治療している間、前記撮像プロファイルを備えている前記走査プロファイルに沿って前記撮像プローブを自動的に移動させるための前記命令を実行するように構成されている、項目137に記載のシステム。 (項目140) 前記1つ以上のコンピューティングデバイスは、前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上のセンサから受信されるセンサデータに応答して前記第1のロボットアームまたは前記第2のロボットアームの移動を制御することを含む命令を実行するように構成されている、項目116に記載のシステム。 (項目141) 前記1つ以上のセンサは、前記第1または第2のロボットアームのうちの1つ以上に動作可能に結合されている、項目140に記載のシステム。 (項目142) 前記1つ以上のセンサは、前記第1のロボットアーム、前記治療プローブ、前記第2のロボットアーム、または前記撮像プローブのうちの1つ以上に結合された1つ以上の位置センサを備えている、項目140に記載のシステム。 (項目143) 前記1つ以上のセンサは、前記治療プローブまたは前記撮像プローブを用いた前記患者の組織の圧縮を検出するように構成されている1つ以上の力センサを備え、前記1つ以上のコンピューティングデバイスは、前記組織の前記検出された圧縮が圧縮の事前決定された閾値レベルを超えるという決定に応答して前記組織から離れるように前記治療プローブまたは前記撮像プローブを移動させることを含む命令を実行するように構成されている、項目140に記載のシステム。 (項目144) 前記1つ以上のセンサは、前記患者の移動を検出するように構成されている1つ以上の運動センサを備え、前記1つ以上のコンピューティングデバイスは、前記患者の前記検出された移動に応答して前記治療プローブまたは前記撮像プローブの位置を調節することを含む命令を実行するように構成されている、項目140に記載のシステム。 (項目145) 前記第1のロボットアームおよび前記第2のロボットアームの各々は、複数のアクチュエータと動作可能に結合された複数の継手を備え、前記複数のアクチュエータは、前記1つ以上のコンピューティングデバイスと動作可能に結合され、前記第1のロボットアームまたは前記第2のロボットアームの移動を制御するための前記命令は、前記複数のアクチュエータのうちの1つ以上の作動を制御するための命令を備えている、項目116に記載のシステム。 (項目146) 前記第1のロボットアームおよび前記第2のロボットアームに結合された移動式基部をさらに備えている、項目116に記載のシステム。 (項目147) 前記移動式基部は、前記1つ以上のコンピューティングデバイスと動作可能に結合された1つ以上のユーザ入力デバイスを備え、前記1つ以上のユーザ入力デバイスは、前記第1のロボットアームまたは前記第2のロボットアームのうちの1つ以上の移動を制御するためのユーザ命令を受信するように構成されている、項目146に記載のシステム。 (項目148) 前記移動式基部は、前記第1のロボットアームまたは前記第2のロボットアームのうちの1つ以上の移動を制御するための命令を実行するように構成された前記1つ以上のコンピューティングデバイスを備えている、項目146に記載のシステム。 (項目149) 前記1つ以上のコンピューティングデバイスは、前記治療プローブまたは前記撮像プローブのうちの1つ以上と動作可能に結合され、前記1つ以上のコンピューティングデバイスは、前記治療プローブを用いた治療または前記撮像プローブを用いた撮像のうちの1つ以上を制御するための命令を実行するようにさらに構成されている、項目116に記載のシステム。 (項目150) 前記1つ以上のコンピューティングデバイスは、前記1つ以上のコンピューティングデバイスと動作可能に結合されたディスプレイ上に撮像プローブを用いて取得された前記標的部位の1つ以上の画像を表示することを含む命令を実行するようにさらに構成されている、項目116に記載のシステム。 (項目151) 前記第1のロボットアームまたは前記第2のロボットアームは、それぞれ、前記治療プローブまたは前記撮像プローブに磁気的に結合するように構成された結合構造を備えている、項目116に記載のシステム。 (項目152) 前記第1のロボットアームまたは前記第2のロボットアームは、それぞれ、迅速解放機構を用いて前記治療プローブまたは前記撮像プローブに除去可能に結合するように構成された結合構造を備え、前記迅速解放機構は、エラーが前記第1のロボットアームまたは前記第2のロボットアームの動作において検出されたとき、前記治療プローブまたは前記撮像プローブから、それぞれ、前記第1のロボットアームまたは前記第2のロボットアームを結合解除するように構成されている、項目116に記載のシステム。 (項目153) 共通アームをさらに備え、前記第1のロボットアームは、第1の場所において前記共通アームに動作可能に結合され、前記第2のロボットアームは、第2の場所において前記共通アームに動作可能に結合されている、項目116に記載のシステム。 (項目154) 前記共通アームに動作可能に結合された移動式基部をさらに備えている、項目153に記載のシステム。 (項目155) 前記撮像プローブは、前記標的組織の超音波画像を捕捉するように構成された超音波トランスデューサを備えている、項目116に記載のシステム。 (項目156) 前記超音波トランスデューサは、前記標的部位内の高血流の領域が識別可能であるように、ドップラモードで動作させられるように構成されている、項目155に記載のシステム。 (項目157) 前記1つ以上のコンピューティングデバイスは、受動モードで前記第1のロボットアームを動作させるための命令を実行するように構成され、前記第1のロボットアームは、前記受動モードにおいて、手動で調節され、前記治療プローブを手動で設定された位置に位置付けるように構成されている、項目116に記載のシステム。 (項目158) 前記治療プローブは、前記第1のロボットアームが前記受動モードであるとき、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において手動で調節されるように構成されている、項目157に記載のシステム。 (項目159) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目158に記載のシステム。 (項目160) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目159に記載のシステム。 (項目161) 前記1つ以上のコンピューティングデバイスは、前記第1のロボットアームが手動調節から解放された後に前記治療プローブの手動で設定された位置を維持するための命令を実行するように構成されている、項目157に記載のシステム。 (項目162) 前記第1のロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差を伴って前記手動で設定された位置を維持するように構成されている、項目161に記載のシステム。 (項目163) 前記1つ以上のコンピューティングデバイスは、受動モードで前記第2のロボットアームを動作させるための命令を実行するように構成され、前記第2のロボットアームは、前記受動モードにおいて、手動で調節され、前記撮像プローブを手動で設定された位置に位置付けるように構成されている、項目116に記載のシステム。 (項目164) 前記撮像プローブは、前記第2のロボットアームが前記受動モードであるとき、少なくとも1つの回転軸または少なくとも1つの平行移動軸のうちの1つ以上において手動で調節されるように構成されている、項目163に記載のシステム。 (項目165) 前記少なくとも1つの回転軸は、第1の回転軸と、前記第1の回転軸に直交する第2の回転軸と、前記第1および第2の回転軸に直交する第3の回転軸とを備え、前記少なくとも1つの平行移動軸は、第1の平行移動軸と、前記第1の平行移動軸に直交する第2の平行移動軸と、前記第1および第2の平行移動軸に直交する第3の平行移動軸とを備えている、項目164に記載のシステム。 (項目166) 前記第1の回転軸は、ピッチ軸を備え、前記第2の回転軸は、ヨー軸を備え、前記第3の回転軸は、ロール軸を備え、前記第1の平行移動軸は、X軸を備え、前記第2の平行移動軸は、Y軸を備え、前記第3の平行移動軸は、Z軸を備えている、項目165に記載のシステム。 (項目167) 前記1つ以上のコンピューティングデバイスは、前記第2のロボットアームが手動調節から解放された後に前記撮像プローブの手動で設定された位置を維持するための命令を実行するように構成されている、項目163に記載のシステム。 (項目168) 前記第2のロボットアームは、回転軸または平行移動軸のうちの1つ以上における公差のうちの1つ以上を伴って前記手動で設定された位置を維持するように構成されている、項目167に記載のシステム。 (項目169) 患者を治療するためのシステムであって、前記システムは、プローブと、前記プローブを受け取るための結合構造と、前記患者を受け取るための支持体と、前記支持体に結合されたアームと、第1の方向に平行移動するように前記アームに結合された第1のスライダと、前記第1の方向を横断する第2の方向に平行移動するように前記第1のスライダ、前記アーム、および前記支持体に結合された第2のスライダと、前記第2のスライダと前記結合構造との間の調節可能拡張部とを備え、前記調節可能拡張部は、前記第1の方向および前記第2の方向を横断する第3の方向に拡張および後退するように構成された拡張継手を備え、前記結合構造は、前記結合構造が3次元体積内で移動することを可能にするために、前記アーム、前記第1のスライダ、前記第2のスライダ、および前記拡張部を用いて支持されている、システム。 (項目170) 前記結合構造と前記拡張継手との間で前記アームおよび前記結合構造に結合された旋回部をさらに備え、前記旋回部は、前記患者に対して上下に前記結合構造を回転させるように構成され、随意に、回転の旋回軸は、実質的に水平方向に延び、随意に、実質的に水平は、水平の約10度以内の角度を備えている、項目169に記載のシステム。 (項目171) 前記結合構造と前記拡張継手との間で前記アームおよび前記結合構造に結合されたタレットをさらに備え、前記タレットは、回転軸まわりの前記結合構造の回転を可能にするように構成され、随意に、前記タレットの回転軸は、垂直の約10度以内であり、随意に、前記タレットは、前記結合構造と前記旋回部との間で前記結合構造および前記アームに結合されている、項目170に記載のシステム。 (項目172) 前記第1のスライダ、前記第2のスライダ、前記拡張継手、前記タレット、および前記旋回部の各々は、ブレーキを備え、前記ブレーキは、前記プローブが前記患者の中に挿入され、結合構造を用いて前記アームに結合されているとき、前記第1のスライダ、前記第2のスライダ、前記拡張継手、前記タレット、および前記旋回部の位置を係止し、前記プローブの位置および向きを維持する、項目171に記載のシステム。 (項目173) 前記第1のスライダ、前記第2のスライダ、前記拡張継手、前記タレット、または前記旋回部のうちの1つ以上に結合されたプロセッサ制御アクチュエータをさらに備え、前記プロセッサ制御アクチュエータは、前記プローブが前記患者の中に挿入されているとき、前記プローブの結合構造に向かって前記結合構造を移動させる、項目171に記載のシステム。 (項目174) 前記結合構造の位置または向きのうちの1つ以上を制御するためにプロセッサに結合された連鎖部をさらに備え、前記連鎖部は、対応するアクチュエータに結合された前記第1のスライダ、前記第2のスライダ、前記拡張継手、前記タレット、および前記旋回部のうちの1つ以上を備えている、項目173に記載のシステム。 (項目175) 第2のプローブに結合するための第2の結合構造をさらに備え、随意に、前記第2の結合構造は、前記プローブの上方に前記第2のプローブを支持するように構成されている、項目171に記載のシステム。 (項目176) 第2のプローブに結合するための第2の結合構造をさらに備え、前記第2の結合構造は、第2の拡張継手、第2のタレット、および第2の旋回部に結合され、前記第2の結合構造、前記第2の拡張継手、前記第2のタレット、および前記第2の旋回部は、前記第2のプローブを支持するように前記アームを用いて支持されている、項目171に記載のシステム。 (項目177) 前記第1の方向は、前記第2の方向と垂直である、項目169に記載のシステム。 (項目178) 前記プローブの結合構造は、前記プローブの下面上の突出部または溝のうちの1つ以上を備え、前記アームを用いて支持された前記結合構造は、前記プローブの結合構造を前記アームを用いて支持された前記結合構造に結合するための前記結合表面の上面上の突出部または溝のうちの1つ以上を備えている、項目1-177のいずれか1項に記載のシステム。 (項目179) 患者支持体に結合するための搭載アセンブリであって、前記搭載アセンブリは、前記患者支持体の第1の側面上の第1のレールに取り付くための第1のクランプと、第1の端部および第2の端部を有する第1のアームであって、前記第1の端部は、前記第1のクランプに旋回可能に接続されている、第1のアームと、前記患者支持体の第2の側面上の第2のレールに取り付くための第2のクランプと、第1の端部および第2の端部を有する第2のアームであって、前記第1の端部は、前記第2のクランプに旋回可能に接続されている、第2のアームとを備え、伸長支持体が、前記第1のアームと前記第2のアームとの間に延び、前記患者の中に挿入されるべきプローブを支持する、搭載アセンブリ。 (項目180) 第1のアームおよび前記第2のアームの各々は、前記伸長支持体に旋回可能に接続され、前記第1のレールと前記第2のレールとの間の距離の変動に適応する、項目179に記載の搭載アセンブリ。 (項目181) 前記第1のレールは、前記第2のレールと実質的に平行であり、前記第1のアームおよび前記第2のアームは、それぞれ、前記第1のクランプおよび前記第2のクランプに旋回可能に接続され、前記第1および第2のクランプが、実質的に平行な構成で前記第1のレールおよび前記第2のレールに係合することを可能にする、項目180に記載の搭載アセンブリ。 (項目182) 前記第1のクランプおよび第1のアームに旋回可能に接続するための第1の結合器であって、前記第1の結合器は、前記第1のアームの前記第1の端部に解放可能に結合するように構成されている、第1の結合器と、前記第2のクランプおよび第2のアームに旋回可能に接続するための第2の結合器であって、前記第2の結合器は、前記第2のアームの前記第1の端部に解放可能に結合するように構成されている、第2の結合器とをさらに備えている、項目179に記載の搭載アセンブリ。 (項目183) 前記第1の結合器および前記第2の結合器の各々は、前記アームの第1の端部を受け取るための縦軸と、前記縦軸を横断する旋回軸とを有する、項目182に記載の搭載アセンブリ。 (項目184) 前記第1の結合器は、前記第1のアームの第1の端部を受け入れるように構成された第1の中空空洞を画定し、前記第2の結合器は、前記第2のアームの第1の端部を受け入れるように構成された第2の中空空洞を画定する、項目183に記載の搭載アセンブリ。 (項目185) 前記第1のクランプおよび前記第2のクランプの各々は、第1のジョーと第2のジョーとを備え、前記第1のジョーと第2のジョーとは、前記レールにしっかりと接続するためにそれらの間の相対移動のために構成されている、項目179に記載の搭載アセンブリ。 (項目186) 前記第1のジョーは、レバーを用いて前記第2のジョーに向かって移動可能である、項目185に記載の搭載アセンブリ。 (項目187) 前記第1のレールおよび前記第2のレールは、前記患者支持体の1つ以上のレールの一部を備え、随意に、前記患者支持体は、ベッドを備えている、項目179に記載の搭載アセンブリ。 (項目188) 前記患者支持体の第1の側面上の前記第1のレールと前記患者支持体の第2の側面上の前記第2のレールとの間の可変空間に適応するために、前記第1のアームは、前記第1のクランプに対して旋回するように構成され、前記第2のアームは、前記第2のクランプに対して旋回するように構成されている、項目179に記載の搭載アセンブリ。 (項目189) 搭載アセンブリは、前記伸長支持体への150kg荷重に応答して、前記第1のレールおよび前記第2のレールに対する前記伸長支持体の移動を5mm以下に限定するように構成され、随意に、前記移動は、前記伸長支持体への100kg荷重に応答して、3mm以下である、項目179に記載の搭載アセンブリ。 (項目190) 前記伸長支持体、前記第1のクランプ、前記第1のアーム、前記第2のクランプ、および前記第2のアームは、前記伸長支持体への150kg荷重に応答して、前記伸長支持体の移動を5mm以下に限定するために構成され、随意に、前記移動は、前記伸長支持体への100kg荷重に応答して、3mm以下である、項目179に記載の搭載アセンブリ。 (項目191) 前記患者の中に挿入されるべき前記プローブは、約20cm~約60cmの範囲内の距離を備え、前記搭載アセンブリは、前記伸長支持体への前記荷重に応答して、前記プローブの遠位端を6mm以下移動させるように構成されている、項目190に記載の搭載アセンブリ。 (項目192) 前記伸長支持体に取り付けられたロボットアームをさらに備えている、項目179に記載の搭載アセンブリ。 (項目193) 前記プローブは、前記ロボットアームに接続されている、項目192に記載の搭載アセンブリ。 (項目194) 前記プローブは、治療プローブまたは撮像プローブのうちの1つ以上を備えている、項目193に記載の搭載アセンブリ。 (項目195) 前記ロボットアームは、前記伸長支持体に取り付けられた第1のロボットアームと、第2のロボットアームとを備えている、項目194に記載の搭載アセンブリ。 (項目196) 前記治療プローブは、前記第1のロボットアームに結合され、前記撮像プローブは、前記第2のロボットアームに結合されている、項目195に記載の搭載アセンブリ。 (項目197) 前記治療プローブおよび前記撮像プローブは、実質的に同一平面内にあるように互いに整列させられている、項目196に記載の搭載アセンブリ。 (項目198) 前記伸長支持体、前記第1のアーム、前記第2のアーム、前記第1のクランプ、または前記第2のクランプのうちの1つ以上に接続され、それから下向きに延び、床面に係合する1つ以上の拡張可能脚部をさらに備えている、項目179に記載の搭載アセンブリ。 (項目199) 前記伸長支持体に接続され、それから下向きに延び、床面に係合する拡張可能脚部をさらに備えている、項目179に記載の搭載アセンブリ。 (項目200) 前記第1のクランプに接続され、それから下向きに延び、床面に係合する第1の拡張可能脚部と、前記第2のクランプに接続され、それから下向きに延び、床面に係合する第2の拡張可能脚部とをさらに備えている、項目179に記載の搭載アセンブリ。 (項目201) 前記第1のレールに係合するための第3のクランプと、前記第2のレールに係合するための第4のクランプとをさらに備え、前記第1のクランプは、それらの間に延びている第1のブレースを用いて前記第3のクランプに結合され、前記第1のレールに沿って第1の荷重を分配し、前記第2のクランプは、それらの間に延びている第2のブレースを用いて前記第4のクランプに結合され、前記第2のレールに沿って第1の荷重を分配する、項目179に記載の搭載アセンブリ。 (項目202) 前記伸長支持体は、前記第1のアームと前記第2のアームとの間に延びているクロスバーを備えている、項目179に記載の搭載アセンブリ。 (項目203) 患者の標的部位における標的組織を治療するためのシステムであって、前記システムは、項目179-198のいずれか1項に記載の搭載アセンブリと、前記伸長支持体に結合された第1のロボットアームと、前記第1のロボットアームに結合された治療プローブと、前記伸長支持体に結合された第2のロボットアームと、前記第2のロボットアームに結合された撮像プローブとを備えている、システム。 (項目204) 前記治療プローブは、連鎖部に結合され、前記連鎖部は、伸長軸に沿って前記治療プローブを平行移動させることと、前記第1のロボットアームの端部が静止したままで、前記伸長軸まわりに前記治療プローブを回転させることとを行うように構成され、前記撮像プローブは、連鎖部に結合され、前記連鎖部は、前記第2のロボットアームの端部が静止したままで、前記撮像プローブの伸長軸に沿って前記撮像プローブを平行移動させる、項目203に記載のシステム。 (項目205) 前記第1のロボットアームは、前記治療プローブを平行移動および回転させるための第1の複数の継手を備え、前記第2のロボットアームは、前記治療プローブを平行移動および回転させるための第2の複数の継手を備えている、項目203に記載のシステム。 (項目206) 前記ロボットアームの各々は、5~7自由度を備えている、項目203に記載のシステム。 (項目207) 患者を治療するためのシステムであって、前記システムは、ロボットアームと、前記ロボットアームに結合するためのプローブであって、前記プローブは、前記患者の中への挿入のためにサイズおよび形状を決定されている、プローブと、前記ロボットアームに結合された複数のセンサであって、前記複数のセンサは、前記プローブが前記ロボットアームから分断された状態の前記ロボットアームに関して、前記プローブの相対位置および向きを示す、ことと、前記ロボットアームおよび前記複数のセンサに動作可能に結合されたプロセッサとを備え、前記プロセッサは、前記ロボットアームを係合位置および向きに移動させ、前記プローブを前記ロボットアームと係合させるための命令で構成されている、システム。 (項目208) 前記プロセッサは、前記ロボットアームを用いて前記プローブを探求することと、前記プローブを前記ロボットアームと係合させることとを行うための命令で構成されている、項目207に記載のシステム。 (項目209) 前記プロセッサは、前記プローブが前記患者の中に挿入された状態でユーザが前記プローブを安定して保持している間に前記ロボットアームを用いて前記プローブを探求するための命令で構成され、随意に、間隙が、前記プローブを探求することに先立って、前記プローブと前記ロボットアームとの間に延びており、前記ロボットアームの遠位端部分は、前記プローブに接触し、前記プローブに係合する、項目208に記載のシステム。 (項目210) 前記ロボットアームは、前記プローブに係合するための係合構造を備え、前記プローブは、前記係合位置および向きで前記ロボットアームに係合するための係合構造を備えている、項目207に記載のシステム。 (項目211) 前記プロセッサは、前記プローブに接触することに先立って、前記ロボットアームを前記係合向きに対応する向きまで移動させることと、前記係合向きで前記プローブ上に前記ロボットアームを平行移動させることとを行うための命令で構成されている、項目210に記載のシステム。 (項目212) 前記複数のセンサは、前記ロボットアームが遠距離において前記プローブを感知するための粗センサと、近接性センサとを備え、随意に、前記複数のセンサは、前記ロボットアーム上に位置している、項目207に記載のシステム。 (項目213) 前記粗センサは、赤外線伝送機と、ビーコンとを備えている、項目212に記載のシステム。 (項目214) 前記粗センサは、赤外線伝送機と、ビーコンとを備えている、項目212に記載のシステム。 (項目215) 前記複数のセンサは、前記ロボットアームに結合されたセンサアレイと、前記ロボットアームに関して前記プローブの位置および向きを決定するための前記プローブ上の1つ以上の基準とを備えている、項目207に記載のシステム。 (項目216) 前記複数のセンサは、前記プローブが前記ロボットアームに係合したとき、前記プローブの方に向けられている、項目207に記載のシステム。 (項目217) 患者を治療するためのシステムであって、前記システムは、ロボットアームと、前記ロボットアームに結合するためのプローブであって、前記プローブは、前記患者の中への挿入のためにサイズおよび形状を決定されている、プローブと、ロボットアームを結合するための係合構造と前記プローブの遠位端との間で前記プローブに結合された複数のセンサと、前記ロボットアームおよび前記複数のセンサに動作可能に結合されたプロセッサとを備え、前記プロセッサは、前記複数のセンサから検出されたユーザ入力に応答して前記ロボットアームを移動させるための命令で構成されている、システム。 (項目218) 前記プロセッサは、前記プローブを前記患者の中に挿入することに先立って、前記プローブが前記ロボットアーム上で自立型構成にある状態でゼロ重力モードを確立するための命令で構成され、前記ゼロ重力モードは、前記アーム上に結合された前記プローブを伴う前記ロボットアームの重量に実質的に対抗するための力を用いて、前記ロボットアームの継手を駆動するように構成されている、項目217に記載のシステム。 (項目219) 前記ユーザ入力は、前記複数のセンサを用いて検出される歪みを備え、前記歪みは、前記遠位端と前記係合構造との間の前記プローブの偏向に関連する歪みを備えている、項目217に記載のシステム。 (項目220) 前記プローブは、前記患者の中への挿入のためにサイズおよび形状を決定された伸長プローブを備えている、項目217に記載のシステム。 (項目221) 前記プローブは、前記ユーザが前記複数のセンサと前記プローブの前記遠位端との間で把持するための伸長部分を備え、前記プローブの挿入に対する組織の抵抗は、前記ユーザの手からの挿入力を反対側に押し、前記複数のセンサへの入力を減少させ、前記患者の中への前記プローブの前進を減少させる、項目220に記載のシステム。 (項目222) 挿入に対する前記組織の前記抵抗は、前記プローブの減少した前進を伴って前記ユーザによって感知される、項目221に記載のシステム。 (項目223) 前記複数のセンサおよび前記プローブは、前記プローブが移動に対する抵抗に遭遇すると、触覚フィードバックを前記ユーザに提供するように配置されている、項目217に記載のシステム。 (項目224) 前記ロボットアームは、複数の継手と、複数の内部継手センサとを備え、前記プロセッサは、前記プローブの受動モードを実装し、前記ユーザが前記プローブを前記患者の中に挿入することを可能にするように構成され、前記プロセッサは、反力を前記複数の内部継手に提供し、前記受動モードで前記アームを安定させるように構成されている、項目217に記載のシステム。 (項目225) 前記プローブまたは前記ロボットアームの前記遠位部分のうちの1つ以上は、前記プローブの移動を検出するための慣性測定ユニット(「IMU」)を備え、随意に、前記プロセッサは、前記IMUから出力を受信し、前記プローブの位置および向きを決定するように構成されている、項目217に記載のシステム。 (項目226) 前記プローブは、前記IMUの前記位置および向きに応答して前記プローブの位置および向きを決定するために、前記IMUに対して所定の位置および向きで前記アーム上に搭載されるように構成され、随意に、前記IMUは、前記アームの遠位端に関する所定の位置および向きで前記アームに結合されている、項目225に記載のシステム。 (項目227) 前記プロセッサは、前記IMUからの出力および前記複数のセンサからの出力を受信し、前記プローブを移動させるための位置または向きのうちの1つ以上を決定するように構成されている、項目225に記載のシステム。 (項目228) 前記プローブは、前記ユーザが前記プローブおよび前記センサを把持するために構成され、前記プロセッサは、前記ユーザが前記プローブを把持することに応答して前記ユーザ入力を決定するように構成されている、項目225に記載のシステム。 (項目229) 患者を治療するためのシステムであって、前記システムは、前記患者の中への挿入のためにサイズおよび形状を決定されたシースであって、前記シースは、伸長軸を備えている、シースと、前記シースに結合されたアームと、エネルギー源を備えている治療プローブであって、前記治療プローブは、伸長軸を備え、前記治療プローブは、前記シースの管腔の中への挿入のためにサイズおよび形状を決定されている、治療プローブと、前記治療プローブに結合されたロボットアームとを備え、前記ロボットアームは、前記治療プローブの前記伸長軸を前記シースの前記伸長軸と整列させ、前記治療プローブを前記シースの中に前進させるように構成されている、システム。 (項目230) 前記治療プローブに結合された前記ロボットアームは、前記治療プローブを前記シースの中に前進させることに先立って、前記治療プローブの前記軸を前記シースの前記軸と整列させるように構成されている、項目229に記載のシステム。 (項目231) 前記ロボットアームは、前記治療プローブの向きを決定するためのセンサを備え、随意に、前記センサは、加速度計、ジャイロスコープ、または慣性測定ユニットのうちの1つ以上を備えている、項目229に記載のシステム。 (項目232) シースに結合された前記アームは、前記シースの向きを決定するためのセンサを備え、随意に、前記センサは、加速度計、ジャイロスコープ、または慣性測定ユニットのうちの1つ以上を備えている、項目229に記載のシステム。 (項目233) 前記シースに結合された前記アームは、ロボットアームを備えている、項目229に記載のシステム。 (項目234) 前記シースは、前記治療プローブを受け取るための近位開口部と、遠位開口部とを備え、前記治療プローブは、少なくとも前記遠位開口部まで延びているために十分な長さを備えている、項目229に記載のシステム。 (項目235) 前記治療プローブは、前記治療プローブが前記シースの中に前進させられたとき、前記エネルギー源が少なくとも前記遠位開口部まで延びているために寸法を決定されている、項目234に記載のシステム。 (項目236) 前記エネルギー源は、前記ロボットアームの端部分と前記シースとの間に間隙を伴って少なくとも前記遠位開口部まで延びている、項目235に記載のシステム。 (項目237) 前記シースは、堅いシースを備えている、項目229に記載のシステム。 (項目238) 前記シースは、1つ以上の開口部を通して潅注流体を提供するために、前記1つ以上の開口部に結合された潅注管腔を備えている、項目229に記載のシステム。 (項目239) 前記シースは、切除された組織を前記管腔から吸引するために、前記管腔内の開口部まで延びている吸引チャネルを備えている、項目229に記載のシステム。 (項目240) 前記シースの前記管腔は、前記治療プローブ、内視鏡カメラおよび吸引管腔、および潅注管腔を受け取るようにサイズを決定されている、項目229に記載のシステム。 (項目241) 前記吸引管腔は、組織切除生成物を吸引するための開口部まで延びている、項目240に記載のシステム。 (項目242) 前記潅注管腔は、治療部位を洗浄するための開口部まで延びている、項目240に記載のシステム。 (項目243) 前記吸引管腔および前記潅注管腔は、二重管腔管の管腔を備えている、項目240に記載のシステム。 (項目244) 前記治療プローブは、前記シースの中に前進させるための堅い部分を備えている、項目229に記載のシステム。 (項目245) 前記治療プローブは、前記シースの中に前進させるための可撓性部分を備えている、項目229に記載のシステム。 (項目246) 前記治療プローブは、前記エネルギー源を回転および平行移動させるように構成されている、項目229に記載のシステム。 (項目247) 前記エネルギー源は、レーザビーム、水噴射、電極、または超音波トランスデューサのうちの1つ以上を備えている、項目246に記載のシステム。 (項目248) 前記ロボットアームは、前記エネルギー源を回転させるように構成されている、項目246に記載のシステム。 (項目249) 前記治療プローブは、前記治療プローブを回転させるための前記ロボットアーム上に設置された連鎖部に結合されている、項目246に記載のシステム。 (項目250) 前記連鎖部は、前記治療プローブを平行移動させるように構成されている、項目249に記載のシステム。 (項目251) 前記内視鏡カメラは、前記シースの中に前進させられたときに前記治療プローブを視認するように構成されたレンズとセンサアレイとを備えている、項目240に記載のシステム。 (項目252) 前記内視鏡カメラは、前記内視鏡カメラを前進および後退させるための連鎖部に結合されている、項目251に記載のシステム。 (項目253) 前記連鎖部は、前記ロボットアームに結合されている、項目252に記載のシステム。 (項目254) 前記内視鏡カメラは、前記管腔内で前記内視鏡カメラを前進および後退させるために十分な柱強度で前記連鎖部に結合するように構成された可撓性延長部を備えている、項目252に記載のシステム。 (項目255) 前記内視鏡カメラは、前記連鎖部に結合するように構成された堅い延長部を備えている、項目252に記載のシステム。 (項目256) 超音波プローブに結合されたアームをさらに備えている、項目229に記載のシステム。 (項目257) 前記超音波プローブに結合された前記アームは、ロボットアームを備えている、項目256に記載のシステム。 (項目258) 前記超音波プローブに結合された前記ロボットアームは、前記治療プローブを撮像するために、前記超音波プローブの視野を位置付けるように構成されている、項目257に記載のシステム。 (項目259) 前記超音波プローブに結合された前記ロボットアームは、前記治療プローブの位置に応答して前記超音波プローブを移動させるように構成されている、項目258に記載のシステム。 (項目260) 前記超音波プローブは、経直腸超音波(TRUS)プローブを備えている、項目256に記載のシステム。 (項目261) 前記超音波プローブは、連鎖部を備え、前記連鎖部は、前記超音波プローブを平行移動および回転させ、前記超音波プローブの視野内に前記治療プローブを位置付ける、項目256に記載のシステム。 (項目262) 前記ロボットアームの端部分に結合するように構成された結合アセンブリをさらに備え、前記結合アセンブリは、前記治療プローブを前記ロボットアームに結合するように構成されている、項目229に記載のシステム。 (項目263) 前記結合アセンブリは、前記ロボットアームの前記端部分に対する前記治療プローブの向きを確立するために、前記ロボットアームの端部分に関する向きで前記ロボットアームの端部分に結合するように構成され、随意に、前記端部分に関する前記結合アセンブリの前記向きは、事前決定された向きを備えている、項目262に記載のシステム。 (項目264) 前記結合アセンブリは、前記ロボットアームの前記端部に結合するための係合構造を備え、前記ロボットアームは、対応する係合構造を備えている、項目263に記載のシステム。 (項目265) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブを回転させるように構成されている、項目262に記載のシステム。 (項目266) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブを平行移動させるように構成されている、項目265に記載のシステム。 (項目267) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、内視鏡カメラを平行移動させるように構成されている、項目266に記載のシステム。 (項目268) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、潅注管腔の遠位開口部を平行移動させるように構成されている、項目266に記載のシステム。 (項目269) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、吸引管腔の遠位開口部を平行移動させるように構成されている、項目266に記載のシステム。 (項目270) 前記結合アセンブリは、前記治療プローブ、内視鏡カメラ、潅注管腔、および吸引管腔を一緒に平行移動させるように構成されている、項目262に記載のシステム。 (項目271) 前記結合アセンブリは、前記治療プローブ、内視鏡カメラ、潅注管腔、および吸引管腔を独立して平行移動させるように構成されている、項目262に記載のシステム。 (項目272) 前記ロボットアームに結合されたプロセッサをさらに備えている、項目229に記載のシステム。 (項目273) 前記プロセッサは、前記治療プローブを前記シースの中に前進させるための命令で構成されている、項目272に記載のシステム。 (項目274) 前記プロセッサは、前記治療プローブの前記伸長軸を前記シースの前記伸長軸と整列させるように構成されている、項目272に記載のシステム。 (項目275) 前記プロセッサは、前記治療プローブの前記伸長軸が前記シースの前記伸長軸と整列させられたことを示す入力を受信し、前記入力に応答して前記シースの前記伸長軸に沿って前記治療プローブを前進させるための命令で構成されている、項目274に記載のシステム。 (項目276) 前記プロセッサは、前記堅いシースの向きを決定するように構成され、前記プロセッサは、前記シースの前記向きで前記治療プローブを向けるための命令で構成されている、項目272に記載のシステム。 (項目277) 前記シースに結合された前記アームは、前記シースの向きを決定するためのセンサを備えている、項目276に記載のシステム。 (項目278) 前記プロセッサは、前記シースに結合された前記アームの継手状態から前記シースの前記向きを決定するように構成されている、項目276に記載のシステム。 (項目279) 前記ロボットアームは、前記治療プローブの向きを決定するためのセンサを備えている、項目276に記載のシステム。 (項目280) 前記ロボットアームの端部分に構成された結合アセンブリであって、前記結合アセンブリは、治療プローブを受け取るための構造と、ロボットアームの端部分に結合し、前記ロボットアームの前記端部分に対する前記治療プローブの向きを確立するための係合構造とを備えている、結合アセンブリ。 (項目281) 前記端部分に関する前記結合アセンブリの向きは、前記ロボットアームの前記端部分に対する前記プローブの事前決定された向きを確立するための事前決定された向きを備えている、項目280に記載の結合アセンブリ。 (項目282) 前記ロボットアームは、対応する係合構造を備えている、項目280に記載の結合アセンブリ。 (項目283) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブを回転させるように構成されている、項目280に記載の結合アセンブリ。 (項目284) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブを平行移動させるように構成されている、項目283に記載の結合アセンブリ。 (項目285) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、内視鏡カメラを平行移動させるように構成されている、項目280に記載の結合アセンブリ。 (項目286) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、潅注管腔の遠位開口部を平行移動させるように構成されている、項目280に記載の結合アセンブリ。 (項目287) 結合アセンブリは、前記ロボットアセンブリの前記端部分が静止したままで、吸引管腔の遠位開口部を平行移動させるように構成されている、項目280に記載の結合アセンブリ。 (項目288) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブ、内視鏡カメラ、潅注管腔、および吸引管腔を一緒に平行移動させるように構成されている、項目280に記載の結合アセンブリ。 (項目289) 前記結合アセンブリは、前記ロボットアアームの前記端部分が静止したままで、前記治療プローブ、内視鏡カメラ、潅注管腔、および吸引管腔を独立して平行移動させるように構成されている、項目280に記載の結合アセンブリ。 (項目290) 前記結合アセンブリは、前記ロボットアームの前記端部分が静止したままで、前記治療プローブ、内視鏡カメラ、潅注管腔、または吸引管腔を一緒に移動させるための1つ以上の連鎖部を備えている、項目280に記載の結合アセンブリ。 (項目291) 患者を治療する方法であって、前記方法は、治療プローブの伸長軸をシースの伸長軸と整列させることと、前記治療プローブの前記伸長軸が前記シースの前記伸長軸と整列させられたことを示す入力を受信することと、前記入力に応答して、前記シースの前記伸長軸に沿って前記治療プローブを前進させることとを含む、方法。 (項目292) 受動モードは、ゼロ重力モードを備えている、項目1-291のいずれか1項に記載のシステムまたは方法。 (項目293) クランプに結合されたセンサをさらに備え、前記クランプは、レールに結合するように構成され、前記センサは、前記クランプ、前記レール、またはロボットアームに結合された支持体のうちの1つ以上の荷重を測定するように構成されている、項目1-292のいずれか1項に記載のシステムまたは方法。 (参照による組み込み)

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Abstract

To provide favorable robotic arms and methods for tissue resection and imaging.SOLUTION: A system for treating a target tissue of a patient comprises a first robotic arm coupled to a treatment probe for treating the target tissue of the patient, and a second robotic arm coupled to an imaging probe for imaging the target tissue of the patient. The system further comprises one or more computing devices operably coupled with the first robotic arm and the second robotic arm, the one or more computing devices configured to execute instructions for controlling movement of one or more of the first robotic arm or the second robotic arm.SELECTED DRAWING: Figure 1

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Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims the benefit under 35 U.S.C.§119(e) of U.S. Provisional Application No. 62 / 933,793, filed on November 11, 2019, and U.S. Provisional Application No. 62 / 814,966, filed on March 7, 2019, the disclosures of which are incorporated herein by reference in their entireties.

[0002] The subject matter of this application is related to the following patents and patent applications, the entire contents of which are incorporated herein by reference: U.S. Patent Application No. 11 / 968,445, filed on January 2, 2008, now U.S. Patent No. 7,882,841; U.S. Patent Application No. 12 / 399,585, filed on March 6, 2009, now U.S. Patent No. 8,814,921; U.S. Patent Application No. 14 / 334,247, filed on July 17, 2014, now U.S. Patent No. 9,364,251; and International Application No. PCT / US2015 / 048695, filed on September 4, 2015.

Background Art

[0003] The field of the present disclosure relates to the treatment of tissues using energy, and more specifically, to the treatment of organs such as the prostate using fluid flow energy.

[0004] Previous methods and devices for treating subjects such as patients may, in at least some cases, result in near - ideal tissue removal. For example, previous methods of prostate surgery may, in at least some cases, result in a longer healing time and less desirable outcomes than would be ideal.

[0005] Previous methods and devices for imaging tissue may be sub-ideal for imaging treated tissue. For example, previous ultrasound methods and devices may not be suitable for visualizing the treatment site during treatment, and alignment of diagnostic images with treatment images may be sub-ideal. Also, at least some of the previous treatment methods and devices for treating tissue may not be suitable in combination with conventional imaging systems. In at least some cases, it would be helpful to provide improved imaging of tissue during surgery, for example, to provide real-time imaging of tissue, which would allow the user to adjust treatment based on real-time images of the tissue. At least some of the previous methods and devices for imaging tissue during surgery may be somewhat cumbersome to use and may result in delays in patient treatment.

[0006] Previous methods and devices for treating organs such as the prostate are somewhat cumbersome for the user and may provide a user interface that can offer a near-ideal surgical plan. Furthermore, at least some of the previous methods and devices for treating tissues such as prostate tissue may be slightly less accurate than ideal. In at least some cases, previous methods and devices may provide a near-ideal user experience. Also, at least some of the previous interfaces may provide a near-ideal connection between the treatment device and the tissue structure.

[0007] Previous methods and apparatus for treating tissue using robotic instrumentation may be sub-ideal during treatment. The robotic arms and surgical probes of a robotic surgical system may be aligned with each other and with the patient prior to treatment. In some cases, the robotic arms and surgical probes are initially moved and positioned manually before coupling with each other and locked in place for further controller-based adjustments. For example, a surgical probe or other tool coupled to a robotic arm may be manually guided through biostructure to reach a target site, such as through the anus and rectum in transrectal ultrasound ("TRUS"), or through the tortuous pathways of the urethra, prostate, and bladder neck with sharp curves through sensitive biostructures. In at least some cases, maintaining the desired alignment and the stability of the robotic arms after manual adjustment and during treatment may be sub-ideal. For example, previous robotic arms and end-surgery probes may be held excessively rigidly, potentially leading to tissue injury associated with patient movement, or they may be held with sub-ideal support strength, which could lead to sub-ideal alignment with the target site if the robotic arm and surgical probe are obstructed, for example, when struck or released from the user's grip following engagement.

[0008] The research related to this disclosure suggests that previous approaches to aligning probes with robotic arms may be sub-ideal in at least some cases.

[0009] While these aforementioned methods and apparatus may be highly effective and represent a significant advance over previous approaches to treating luminal tissue, it would be desirable to provide improvements to assist in more precise tissue removal, both in fully automated and physician-assisted operating modes. At least some of these objectives will be satisfied by the present invention described below. [Overview of the project] [Means for solving the problem]

[0010] Embodiments of this disclosure provide improved methods and apparatus for performing tissue therapy, such as tissue resection. In some embodiments, an image-guided therapy system comprises a therapy probe and an imaging probe. The imaging probe may be configured to provide images of a target site while the therapy probe performs resection of the target tissue. In some embodiments, each of the therapy probe and the imaging probe is coupled to a robotic arm under the control of one or more computing devices. The therapy probe may be coupled to a first robotic arm configured to provide computer-controlled movement of the therapy probe during tissue resection using the therapy probe. The imaging probe may be coupled to a second robotic arm configured to provide computer-controlled movement of the imaging probe before and / or during a tissue resection procedure using the therapy probe, during scanning of a target site using the imaging probe. One or more computing devices may be configured to execute commands to operate the robotic arm in a passive mode, configured to manually adjust and position the therapy and imaging probes in manually set positions for imaging and treatment from the same or different tissue sites, etc. One or more computing devices may be configured to execute commands to maintain the manually set positions of the probes after the robotic arm has been released from manual adjustment. The robotic arm may be configured to maintain a manually set position on one or more of the translation or rotation axes. In some embodiments, the rotation angle is maintained within 5°, and the translation position is maintained within 5mm or less. In some embodiments, the rotation angle and translation position are maintained for every three axes, which may improve the accuracy of imaging and treatment using the probe.

[0011] One or more computing devices operably coupled to the first and second robotic arms may be configured to automatically control the movement of the treatment probe and / or imaging probe, for example, based on a pre-planned or programmed scanning profile, or according to various pre-programmed parameters. Automatically controlled movement of the treatment probe along a treatment profile can, for example, perform treatment on a target site. Automatically controlled movement of the imaging probe along an imaging profile can, for example, generate a three-dimensional rendering of the target site. Automated, computer-controlled scanning of a target site using an imaging probe with a robotic arm can also be used to generate useful information about the target site for additional treatment. For example, the imaging probe may be configured to perform a color / Doppler scan of the target site after a resection procedure to identify bleeding sites within the target site requiring hemostasis. Three-dimensional scanning of a target site using an imaging probe can also be used to identify tissue abnormalities in the target site, such as tumors.

[0012] Alternatively, or in addition, one or more computing devices may be configured to control the movement of the therapeutic probe and / or imaging probe in response to user input, for example, through a graphical user interface of the therapeutic device. In some embodiments, one or more computing devices may be configured to limit the movement of the therapeutic probe and / or imaging probe within an allowable range of motion, which can be programmed into the first and / or second robotic arms prior to initiating the use of the first or second arm under computer control.

[0013] The first robotic arm and / or the second robotic arm may be configured to adjust the position and / or orientation of the first arm and / or the second arm to maintain the proper position or alignment of the treatment probe and imaging probe, and / or to prevent collision or interference between the treatment probe and imaging probe outside the patient's body.

[0014] The first robotic arm and / or the second robotic arm may be operably coupled with one or more feedback sensing mechanisms. For example, the first robotic arm and / or the second robotic arm may be operably coupled with a force sensor configured to detect compression of tissue in front of the treatment probe and / or imaging probe. One or more computing devices may include commands to control the movement of the robotic arm in response to the force detected by the sensor, for example, to prevent excessive compression of the anterior tissue and the resulting damage to the tissue and / or probe. Another exemplary feedback sensing mechanism may include position and / or motion sensors operably coupled with the first and / or second robotic arm. One or more computing devices may include commands to control the movement of the robotic arm in response to position and / or motion detected by the sensor, for example, to adjust the position of the treatment and / or imaging probe in response to patient movement during treatment and / or scanning procedures.

[0015] These and other embodiments will be described in further detail in the following description relating to the attached drawings. The present invention provides, for example, the following: (Item 1) A system for treating or imaging a patient's tissue, wherein the system is A probe whose size has been determined for insertion into the patient, A robotic arm configured to be coupled to the probe, One or more computing devices operably coupled to the robotic arm and Equipped with, The one or more computing devices are The objective is to establish an acceptable range of motion for the probe, wherein the acceptable range of motion is stored in the memory of one or more computing devices. Using the probe, to treat or image the target tissue of the patient, Moving the robot arm and influencing the movement of the probe within the allowable range of motion for the probe. A system consisting of instructions for performing a specific action. (Item 2) The system according to item 1, wherein the probe is configured to be coupled to the robot arm while the robot arm is in passive mode. (Item 3) The allowable range of motion for the probe is established while the robot arm is in passive mode, according to the system described in item 1. (Item 4) The system according to item 1, wherein establishing the allowable range of motion for the probe includes establishing the allowable range of motion for the probe in response to user input. (Item 5) The system according to item 1, wherein establishing the allowable range of motion for the probe includes establishing the allowable range of motion for the probe in response to the position of the probe. (Item 6) The system according to item 5, wherein the position of the probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue. (Item 7) The system according to item 1, further comprising updating the allowable range of motion for the probe in real time. (Item 8) The system according to item 1, further comprising a user input device operably coupled to one or more computing devices, wherein the user input device provides one or more user commands for controlling the movement of the robotic arm, and moving the robotic arm under the control of the one or more computing devices includes moving the robotic arm in response to the one or more user commands for controlling the movement of the robotic arm. (Item 9) The system according to item 8, wherein the user input device comprises one or more of a controller near an end of the robotic arm, a user interface on a display screen, a user interface on a console, or a controller that responds to a force on the end of the arm provided by the user to guide a probe on the robotic arm to a fixed position. (Item 10) The system according to item 1, further comprising the probe and one or more force sensors operably coupled to one or more computing devices, the one or more force sensors detecting compression of the patient's tissue using the probe. (Item 11) The system according to item 10, wherein the one or more computing devices comprise a processor configured with instructions to interrupt the treatment in response to detected compression of the tissue that exceeds a pre-determined threshold level of compression. (Item 12) The system according to item 10, wherein the one or more force sensors are operably coupled to the robotic arm. (Item 13) The system according to item 12, further comprising the probe and one or more motion sensors operably coupled to the one or more computing devices, the one or more motion sensors detecting movement of the patient, and the one or more computing devices being configured to adjust the position of the probe in response to the detected movement of the patient. (Item 14) The system according to item 1, wherein the robotic arm comprises a passive mode for manually adjusting the probe to a manually set position. (Item 15) The system according to item 14, wherein in the passive mode, the probe is supported by the robotic arm, the probe comprises a plurality of sensors at the interface between the robotic arm and the probe, and the plurality of sensors receive user input from a handle coupled to the plurality of sensors for the user to guide the probe. (Item 16) The system according to item 15, wherein a handle coupled to the plurality of sensors is configured to respond to user operation of the handle, and the plurality of sensors in the interface are coupled to a processor of one or more computing devices for operating the probe in response to user operation of the handle. (Item 17) The system according to item 16, wherein the plurality of sensors are configured to detect user operation of the handle with six degrees of freedom, the processor is configured to move the probe with six degrees of freedom, and the motion corresponding to the six degrees of freedom is in response to the user operation. (Item 18) The system according to item 14, wherein manually adjusting the robot arm in the passive mode includes manually adjusting the probe on one or more of at least one rotation axis or at least one translation axis. (Item 19) The system according to item 18, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 20) The system according to item 19, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 21) The manually set position of the probe is maintained after the robot arm is released from manual adjustment, as described in item 14. (Item 22) The robot arm is configured to maintain the manually set position with tolerances in one or more of the rotational or translational axes, optionally, the tolerances being within 5° for rotation around one or more of the three axes and within 5 mm for translation along one or more of the three axes, optionally, with respect to each of the one or more of the three axes, optionally, the rotational tolerance is within 3°, optionally, the translational tolerance is within 3 mm, optionally, 2 mm, as per item 21. (Item 23) The probe is the system described in item 21, comprising an imaging probe. (Item 24) The probe comprises a treatment probe, the robot arm comprises a first robot arm, and the system comprises An imaging probe whose size has been determined for insertion into the patient, A second robotic arm coupled to the imaging probe and Furthermore, The system according to item 21, wherein the one or more computing devices consist of instructions for establishing an allowable range of motion for the imaging probe. (Item 25) The system according to item 24, wherein the imaging probe is configured to image a target area of the patient using the imaging probe, and the second robotic arm is configured to move under the control of one or more computing devices and to influence the movement of the imaging probe within the allowable range of motion for the imaging probe. (Item 26) The system according to item 1, wherein one or more computing devices are equipped with instructions for imaging and treating the tissue. (Item 27) A method for treating target tissue at a target site in a patient, wherein the method is Manually inserting the probe into the patient, The probe is connected to the robot arm, The objective is to establish an acceptable range of motion for the probe, wherein the acceptable range of motion is stored in the memory of one or more computing devices operably coupled to the robot arm. Using the probe, to treat or image the target tissue of the patient, The robotic arm is moved under the control of one or more computing devices operably coupled to the probe, and the movement of the probe within the allowable range of motion for the probe is affected. Methods that include... (Item 28) The method according to item 27, wherein the probe is coupled to the robot arm while the robot arm is in passive mode. (Item 29) The allowable range of motion for the probe is established while the robot arm is in passive mode, as described in item 27. (Item 30) The method of item 27, wherein establishing the allowable range of motion for the probe includes establishing the allowable range of motion for the probe in response to user input. (Item 31) The method of item 27, wherein establishing the allowable range of motion for the probe includes establishing the allowable range of motion for the probe in response to the position of the probe. (Item 32) The method according to item 31, wherein the position of the probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue. (Item 33) The method according to item 27, further comprising updating the allowable range of motion for the probe in real time. (Item 34) The method of item 27, further comprising receiving one or more user commands for controlling the movement of the robotic arm from a user input device operably coupled with one or more computing devices, and moving the robotic arm under the control of the one or more computing devices, comprising moving the robotic arm in response to the one or more user commands for controlling the movement of the robotic arm. (Item 35) The method according to item 34, wherein the user input device comprises one or more of the following: a controller on the end of the robot arm, a user interface on a display screen, a user interface on a console, or a controller that responds to forces on the end of the arm provided by the user to guide a probe on the robot arm to a fixed position. (Item 36) The method of item 27, further comprising receiving sensor data from one or more force sensors operably coupled with the one or more computing devices, wherein the one or more force sensors are configured to detect compression of the patient's tissue using the probes. (Item 37) The method according to item 36, wherein the one or more computing devices comprises a processor comprising instructions for interrupting the treatment in response to detected compression of the tissue exceeding a predetermined threshold level of compression. (Item 38) The method according to item 36, wherein one or more force sensors are operably coupled to the robot arm. (Item 39) The method of item 38, further comprising receiving sensor data from one or more motion sensors operably coupled to one or more computing devices, the one or more motion sensors being configured to detect the patient's movement, and moving the robotic arm under the control of the one or more computing devices, which includes adjusting the position of the probe in response to the detected movement of the patient. (Item 40) The method according to item 27, further comprising manually adjusting the robot arm in passive mode and manually adjusting the probe to a manually set position. (Item 41) The method of item 40, wherein in the passive mode, the probe is supported by the robot arm, the probe comprises a plurality of sensors at the interface between the robot arm and the probe, and the plurality of sensors receive user input from a handle coupled to the plurality of sensors for the user to guide the probe. (Item 42) The method according to item 41, wherein a handle coupled to the plurality of sensors is configured to respond to user operation of the handle, and the plurality of sensors in the interface are coupled to a processor of one or more computing devices for operating the probe in response to user operation of the handle. (Item 43) The method according to item 42, wherein the plurality of sensors are configured to detect user operation of the handle with six degrees of freedom, the processor is configured to move the probe with six degrees of freedom, and the motion corresponding to the six degrees of freedom is in response to the user operation. (Item 44) The method according to item 40, wherein manually adjusting the robot arm in the passive mode and manually adjusting the probe includes manually adjusting the probe on one or more of at least one rotation axis or at least one translation axis. (Item 45) The method according to item 44, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 46) The method according to item 45, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 47) The manually set position of the probe is maintained after the robot arm is released from manual adjustment, as described in item 40. (Item 48) The robot arm is configured to maintain the manually set position with tolerances in one or more of the rotational or translational axes, optionally, the tolerances being within 5° for rotation around one or more of the three axes and within 5 mm for translation along one or more of the three axes, optionally, with respect to each of the one or more of the three axes, optionally, the rotational tolerance is within 3°, optionally, the translational tolerance is within 3 mm, optionally, 2 mm, as per item 47. (Item 49) The method according to item 27, wherein the probe comprises an imaging probe. (Item 50) The probe comprises a therapeutic probe, the robot arm comprises a first robot arm, and the method is Manually inserting the imaging probe into the patient, The imaging probe is coupled to the second robot arm, The objective is to establish an acceptable range of motion for the imaging probe, wherein the acceptable range of motion is stored in the memory of one or more computing devices operably coupled to the first robotic arm and the second robotic arm. The method described in item 47, further including the method described in item 47. (Item 51) The method according to item 50, wherein the imaging probe is coupled to the second robot arm while the second robot arm is in passive mode. (Item 52) The allowable range of motion for the imaging probe is established while the second robot arm is in passive mode, according to the method of item 50. (Item 53) The method according to item 50, wherein establishing the allowable range of motion for the imaging probe includes establishing the allowable range of motion in response to the distance or alignment between the treatment probe and the imaging probe. (Item 54) The method of item 50, wherein establishing the allowable range of motion for the imaging probe includes establishing the allowable range of motion for the imaging probe in response to user input. (Item 55) The method according to item 50, wherein establishing the allowable range of motion for the imaging probe includes establishing the allowable range of motion in response to the position of the imaging probe relative to the target tissue. (Item 56) The method according to item 55, wherein the position of the imaging probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue. (Item 57) The method according to item 50, further comprising updating the allowable range of motion for the imaging probe in real time. (Item 58) The method of item 50, further comprising receiving one or more user commands for controlling the movement of the second robotic arm from a user input device operably coupled with one or more computing devices, and moving the second robotic arm under the control of the one or more computing devices, which includes moving the second robotic arm in response to the one or more user commands for controlling the movement of the second robotic arm. (Item 59) The method according to item 58, further comprising establishing an allowable range of motion of the second robot arm in response to one or more user commands for controlling the movement of the second robot arm. (Item 60) The method of item 50, further comprising receiving sensor data from one or more force sensors operably coupled to one or more computing devices, the one or more force sensors being configured to detect compression of the patient's tissue using the imaging probe, and moving the second robotic arm under the control of the one or more computing devices, which includes moving the imaging probe away from the tissue in response to a determination that the detected compression of the tissue exceeds a predetermined threshold level of compression. (Item 61) The method according to item 60, wherein one or more force sensors are operably coupled to the second robot arm. (Item 62) The method according to item 50, further comprising receiving sensor data from one or more position sensors operably coupled with the one or more computing devices, wherein the one or more position sensors are configured to detect the position of one or more of the first robotic arm, the treatment probe, the second robotic arm, or the imaging probe. (Item 63) The method of item 50, further comprising receiving sensor data from one or more motion sensors operably coupled to one or more computing devices, wherein the one or more motion sensors are configured to detect the patient's movement, and moving the second robotic arm under the control of the one or more computing devices, which includes adjusting the position of the imaging probe in response to the detected movement of the patient. (Item 64) The method according to item 50, further comprising calibrating the first robot arm to identify its position relative to the second robot arm, and calibrating the second robot arm to identify its position relative to the first robot arm. (Item 65) The method according to item 50, wherein moving the first robotic arm or the second robotic arm under the control of one or more computing devices includes automatically adjusting the movement of the first robotic arm in response to the movement of the second robotic arm, or automatically adjusting the movement of the second robotic arm in response to the movement of the first robotic arm. (Item 66) The method according to item 50, wherein moving the first robotic arm or the second robotic arm under the control of one or more computing devices includes moving the first robotic arm or the second robotic arm to prevent contact between a portion of the treatment probe and a portion of the imaging probe that are positioned outside the patient. (Item 67) The method according to item 66, wherein moving the first robotic arm or the second robotic arm under the control of one or more computing devices includes moving the first robotic arm or the second robotic arm and maintaining alignment between the treatment probe and the imaging probe. (Item 68) The method according to item 67, wherein the alignment maintained between the treatment probe and the imaging probe includes parallel alignment between the treatment probe and the imaging probe, and the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe are parallel to each other. (Item 69) The method according to item 67, wherein the alignment maintained between the treatment probe and the imaging probe includes coplanar alignment between the treatment probe and the imaging probe, and the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe are coplanar with each other. (Item 70) The alignment maintained between the treatment probe and the imaging probe includes a non-parallel alignment between the treatment probe and the imaging probe, wherein the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe intersect each other, according to item 67. (Item 71) The method according to item 50, further comprising detecting one or more of the distance or alignment between the treatment probe and the imaging probe. (Item 72) The method according to item 50, wherein moving the first robotic arm or the second robotic arm under the control of one or more computing devices includes moving the first robotic arm or the second robotic arm and automatically moving the therapeutic probe or the imaging probe along a scanning profile stored on one or more computing devices. (Item 73) The method of item 72, wherein moving the first robotic arm under the control of one or more computing devices includes moving the first robotic arm and automatically moving the therapeutic probe over the scanning profile having a therapeutic profile. (Item 74) The method of item 72, wherein moving the second robotic arm under the control of one or more computing devices includes moving the second robotic arm and automatically moving the imaging probe across the scanning profile which has an imaging profile. (Item 75) The method according to item 74, wherein the imaging profile comprises multiple transverse scans or multiple sagittal scans of the target area, and the method further comprises generating a three-dimensional image of the target area. (Item 76) The method according to item 74, wherein the second robotic arm is moved to automatically move the imaging probe across the scanning profile having the imaging profile while the treatment probe is treating the target tissue. (Item 77) The method according to item 50, wherein imaging the target site using the imaging probe includes imaging the target site using the imaging probe operating in Doppler mode, and the method further includes identifying areas of high blood flow within the target site based on one or more images of the target site acquired using the imaging probe. (Item 78) The method according to item 77, further comprising applying hemostasis to an identified area of high blood flow within the target site. (Item 79) The method of item 77, further comprising performing a biopsy of tissue located in an identified high-blood-flow area within the target site. (Item 80) The method according to item 77, further comprising identifying the high-blood-flow area as cancerous tissue. (Item 81) The method according to item 77, wherein imaging the target area using the imaging probe includes rotating the imaging probe. (Item 82) The method according to item 50, wherein imaging the target site using the imaging probe includes generating an intraoperative image of the target site. (Item 83) The method according to item 82, further comprising mapping the intraoperative image with a preoperative image of the target site. (Item 84) The method according to item 83, wherein the preoperative image of the target site comprises one or more of the following: X-ray images, fluoroscopic images, computed tomography (CT) images, ultrasound images, or MRI images. (Item 85) The method according to item 83, wherein mapping the intraoperative image with the preoperative image includes mapping one or more anatomical regions in the intraoperative and preoperative images to each other. (Item 86) The method according to item 85, wherein the one or more anatomical regions comprise one or more of the bladder neck, external sphincter, or seminal cumulus. (Item 87) A method for operating a robotic arm to image or treat target tissue at a target site in a patient, wherein the method is: The requirement is to connect at least one probe to at least one robotic arm, The at least one robot arm is manually adjusted in passive mode, and the at least one probe is manually adjusted to a manually set position. To release the at least one robot arm from the passive mode and Includes, The at least one robotic arm maintains the manually set position of the at least one probe after being released from manual adjustment. A method comprising using the at least one probe to perform one or more imaging or treatment of the target tissue at the target site of the patient, from the maintained, manually set position. (Item 88) The method according to item 87, wherein the at least one probe is coupled to the at least one robotic arm prior to inserting the at least one probe into the patient. (Item 89) The method according to item 87, wherein the at least one probe is coupled to the at least one robotic arm after the at least one probe has been inserted into the patient. (Item 90) The method according to item 87, wherein the at least one robotic arm maintains the manually set position of the at least one probe using a locking configuration of the at least one robotic arm, and optionally, the sensor of the joint of the at least one robotic arm and the actuator coupled to the joint of the robotic arm maintain the manually set position of the at least one robotic arm with the locking configuration. (Item 91) The method according to item 87, wherein manually adjusting the at least one robot arm in the passive mode includes manually adjusting the at least one probe on one or more of the at least one rotation axis or at least one translation axis. (Item 92) The method according to item 91, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 93) The method according to item 92, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 94) The method according to item 87, wherein the at least one robotic arm maintains the manually set position within tolerances on one or more of the rotational or translational axes, optionally the tolerances are within 5° for rotation around one or more of the three axes and within 5 mm for translation along one or more of the three axes, optionally the rotational tolerance is within 3° for each of the one or more of the three axes, optionally the translational tolerance is within 3 mm, optionally 2 mm. (Item 95) The method according to item 87, wherein coupling the at least one probe to the at least one robotic arm includes coupling a therapeutic probe to a first robotic arm or coupling an imaging probe to a second robotic arm. (Item 96) The method according to item 95, wherein manually adjusting the at least one robotic arm in the passive mode includes aligning the treatment probe and the imaging probe with respect to each other. (Item 97) The method according to item 96, wherein the treatment probe and the imaging probe are aligned with each other so that they are parallel or in the same plane. (Item 98) The method according to item 96, wherein the at least one robotic arm maintains the alignment between the imaging probe and the treatment probe after being released from manual adjustment. (Item 99) The alignment between the imaging probe and the treatment probe is maintained within tolerances on one or more of the rotational or translational axes, optionally, the tolerances are within 5° with respect to rotation around one or more of the three axes and within 5 mm with respect to translation along one or more of the three axes, optionally, with respect to each of the one or more of the three axes, optionally, the rotational tolerance is within 3°, optionally, the translational tolerance is within 3 mm, optionally, 2 mm, as described in item 98. (Item 100) A system comprising a processor comprising instructions for performing the method described in any one of items 1-99. (Item 101) A system for operating a robotic arm to image or treat target tissue at a target site in a patient, wherein the system is At least one robotic arm coupled to at least one probe for one or more of the treatment or imaging of the target tissue of the patient, The at least one robotic arm and one or more computing devices operably coupled to it Equipped with, The one or more computing devices are The at least one probe is operated in passive mode so that the at least one robot arm can be manually adjusted to a manually set position, After the at least one probe has been manually adjusted to the manually set position, the at least one robot arm is released from the passive mode. After being released from the manual adjustment, the manually set position of the at least one probe is maintained. A system configured to execute instructions for performing a specific action. (Item 102) The system according to item 101, wherein the at least one probe is configured to be coupled to the at least one robotic arm prior to inserting the at least one probe into the patient. (Item 103) The system according to item 101, wherein the at least one probe is configured to be coupled to the at least one robotic arm after the at least one probe has been inserted into the patient. (Item 104) The system according to item 101, wherein the at least one robotic arm maintains the manually set position of the at least one probe using a locking configuration of the at least one robotic arm, and optionally, a sensor at the joint of the at least one robotic arm and an actuator coupled to the joint of the robotic arm maintain the manually set position of the at least one robotic arm with the locking configuration. (Item 105) The system according to item 101, wherein one or more computing devices are further configured to execute instructions for controlling the movement of the at least one robotic arm. (Item 106) The system according to item 101, wherein the at least one robotic arm is manually adjustable and configured to manually adjust the at least one probe on one or more of the at least one rotation axis or at least one translation axis. (Item 107) The system according to item 106, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 108) The system according to item 107, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 109) The system according to item 106, wherein the at least one robotic arm is configured to maintain the manually set position with tolerances in one or more of the rotational or translational axes, wherein the tolerances are optionally 5° with respect to rotation around one or more of the three axes and 5 mm or less with respect to translation along one or more of the three axes, wherein optionally, with respect to each of the one or more of the three axes, the rotational tolerance is optionally 3° or less, optionally, the translational tolerance is optionally 3 mm or less, optionally, 2 mm. (Item 110) The system according to item 101, wherein the at least one probe comprises one or more of a therapeutic probe or an imaging probe. (Item 111) The system according to item 110, wherein the at least one probe comprises the treatment probe and the imaging probe, and the at least one robotic arm comprises a first robotic arm coupled to the treatment probe and a second robotic arm coupled to the imaging probe. (Item 112) The system according to item 110, wherein the at least one probe comprises the treatment probe and the imaging probe, and the treatment probe and the imaging probe are manually adjusted and configured to align the treatment probe and the imaging probe with respect to each other. (Item 113) The system according to item 112, wherein the treatment probe and the imaging probe are aligned with each other so that they are parallel or in the same plane. (Item 114) The system according to item 113, wherein the at least one robotic arm maintains the alignment between the imaging probe and the treatment probe after being released from manual adjustment. (Item 115) The system according to item 114, wherein the alignment between the imaging probe and the treatment probe is maintained within tolerances in one or more of the rotational or translational axes. (Item 116) A system for treating target tissue at a target site in a patient, wherein the system is A first robotic arm coupled to a therapeutic probe for treating the target tissue of the patient, A second robotic arm coupled to an imaging probe for imaging the target tissue of the patient, One or more computing devices operably coupled to the first robotic arm and the second robotic arm Equipped with, A system in which one or more computing devices are configured to execute commands for controlling the movement of one or more of the first robotic arm or the second robotic arm. (Item 117) The system according to item 116, wherein one or more computing devices are configured to execute commands for controlling the movement of the first robotic arm or the second robotic arm to adjust one or more of the pitch, yaw, roll, or linear position of the treatment probe or the imaging probe along the entry axis of the treatment probe or the imaging probe into the patient. (Item 118) The system according to item 116, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm, respectively, to retract the therapeutic probe or the imaging probe along the entry axis. (Item 119) The system according to item 118, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm, respectively, to retract the therapeutic probe or the imaging probe along the entry axis but not to advance it. (Item 120) The system according to item 116, wherein one or more computing devices are configured to execute instructions that include controlling the movement of the first robotic arm or the second robotic arm in response to user instructions received using a user input device operably coupled with the one or more computing devices. (Item 121) The system according to item 116, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm, respectively, to move the therapeutic probe or the imaging probe within a permissible range of motion for the therapeutic probe or the imaging probe stored in the one or more computing devices. (Item 122) The system according to item 121, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to user input. (Item 123) The system according to item 121, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to the distance or alignment between the therapeutic probe and the imaging probe. (Item 124) The system according to item 121, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to the position of the therapeutic probe or the imaging probe relative to the target tissue. (Item 125) The system according to item 124, wherein the one or more computing devices are configured to execute instructions that include detecting the position of the therapeutic probe or the imaging probe relative to the target tissue based on one or more images of the target tissue, and the one or more images include one or more tissue markers. (Item 126) The system according to item 121, wherein one or more computing devices are configured to execute commands to update the permissible range of motion for the therapeutic probe or the imaging probe in real time. (Item 127) The system according to item 116, wherein one or more computing devices are configured to execute commands including controlling the movement of the first robotic arm or the second robotic arm to maintain alignment between the therapeutic probe and the imaging probe, and optionally the alignment keeps the therapeutic probe within the field of view of the imaging probe. (Item 128) The system according to item 127, wherein the alignment maintained between the treatment probe and the imaging probe includes a substantially parallel alignment between the treatment probe and the imaging probe, and the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe are substantially parallel to each other. (Item 129) The system according to item 127, wherein the alignment maintained between the treatment probe and the imaging probe includes coplanar alignment between the treatment probe and the imaging probe, and the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe are coplanar with each other. (Item 130) The alignment maintained between the treatment probe and the imaging probe includes a non-parallel alignment between the treatment probe and the imaging probe, wherein the longitudinal axis of the treatment probe and the longitudinal axis of the imaging probe intersect each other, as in the system described in item 127. (Item 131) The system according to item 116, wherein one or more computing devices are configured to execute instructions that include detecting one or more of the distance or alignment between the therapeutic probe and the imaging probe. (Item 132) The system according to item 116, wherein one or more computing devices are configured to execute instructions including controlling the movement of the first robotic arm or the second robotic arm to prevent contact between a portion of the treatment probe and a portion of the imaging probe that are positioned outside the patient. (Item 133) The system according to item 116, wherein one or more computing devices are configured to execute commands for automatically adjusting the movement of the first robotic arm in response to the movement of the second robotic arm. (Item 134) The system according to item 116, wherein one or more computing devices are configured to execute commands to automatically adjust the movement of the second robotic arm in response to the position of the first robotic arm, and optionally the second robotic arm moves the imaging probe in response to the position of the treatment probe and maintains the treatment probe within the field of view of the imaging probe. (Item 135) The system according to item 116, wherein one or more computing devices are configured to execute commands for controlling the movement of the first robotic arm or the second robotic arm to automatically move the therapeutic probe or the imaging probe along a scanning profile stored on the one or more computing devices. (Item 136) The system according to item 135, wherein one or more computing devices are configured to execute commands for controlling the movement of the first robotic arm to automatically move the therapeutic probe along the scanning profile having a therapeutic profile. (Item 137) The system according to item 135, wherein one or more computing devices are configured to execute commands for controlling the movement of the second robotic arm to automatically move the imaging probe along the scanning profile which has an imaging profile. (Item 138) The system according to item 137, wherein the imaging profile comprises multiple transverse or sagittal scans of the target area, and one or more computing devices are further configured to execute instructions that include generating a three-dimensional image of the target area. (Item 139) The system according to item 137, wherein one or more computing devices are configured to execute the instructions to automatically move the imaging probe along the scanning profile having the imaging profile while the therapeutic probe is treating the target tissue. (Item 140) The system according to item 116, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm in response to sensor data received from one or more sensors operably coupled with the one or more computing devices. (Item 141) The system according to item 140, wherein one or more of the sensors are operably coupled to one or more of the first or second robot arms. (Item 142) The system according to item 140, wherein the one or more sensors comprises one or more position sensors coupled to one or more of the first robotic arm, the treatment probe, the second robotic arm, or the imaging probe. (Item 143) The system according to item 140, wherein the one or more sensors comprises one or more force sensors configured to detect compression of the patient's tissue using the therapeutic probe or the imaging probe, and the one or more computing devices are configured to execute commands including moving the therapeutic probe or the imaging probe away from the tissue in response to a determination that the detected compression of the tissue exceeds a predetermined threshold level of compression. (Item 144) The system according to item 140, wherein the one or more sensors comprises one or more motion sensors configured to detect the movement of the patient, and the one or more computing devices are configured to execute commands including adjusting the position of the treatment probe or the imaging probe in response to the detected movement of the patient. (Item 145) The system according to item 116, wherein each of the first robotic arm and the second robotic arm comprises a plurality of couplings operably coupled to a plurality of actuators, the plurality of actuators operably coupled to one or more computing devices, and the commands for controlling the movement of the first robotic arm or the second robotic arm comprise commands for controlling the operation of one or more of the plurality of actuators. (Item 146) The system according to item 116, further comprising a mobile base coupled to the first robotic arm and the second robotic arm. (Item 147) The system according to item 146, wherein the mobile base comprises one or more user input devices operably coupled with the one or more computing devices, the one or more user input devices being configured to receive user commands for controlling the movement of one or more of the first robotic arms or the second robotic arms. (Item 148) The system according to item 146, wherein the mobile base comprises one or more computing devices configured to execute commands for controlling the movement of one or more of the first robotic arms or the second robotic arms. (Item 149) The system according to item 116, wherein one or more computing devices are operably coupled to one or more of the treatment probes or imaging probes, and the one or more computing devices are further configured to execute instructions for controlling one or more of the treatment using the treatment probes or imaging using the imaging probes. (Item 150) The system according to item 116, wherein the one or more computing devices are further configured to execute instructions including displaying one or more images of the target site acquired using an imaging probe on a display operably coupled with the one or more computing devices. (Item 151) The system according to item 116, wherein the first robotic arm or the second robotic arm each comprises a coupling structure configured to magnetically couple to the therapeutic probe or the imaging probe. (Item 152) The system according to item 116, wherein the first robotic arm or the second robotic arm each comprises a coupling structure configured to be removably coupled to the treatment probe or the imaging probe using a rapid release mechanism, the rapid release mechanism configured to discouple the first robotic arm or the second robotic arm from the treatment probe or the imaging probe, respectively, when an error is detected in the operation of the first robotic arm or the second robotic arm. (Item 153) The system according to item 116, further comprising a common arm, wherein the first robotic arm is operably coupled to the common arm in a first location, and the second robotic arm is operably coupled to the common arm in a second location. (Item 154) The system according to item 153, further comprising a movable base operably coupled to the common arm. (Item 155) The system according to item 116, wherein the imaging probe comprises an ultrasonic transducer configured to capture an ultrasonic image of the target tissue. (Item 156) The system according to item 155, wherein the ultrasonic transducer is configured to operate in Doppler mode so that areas of high blood flow within the target site can be identified. (Item 157) The system according to item 116, wherein one or more computing devices are configured to execute commands for operating the first robotic arm in a passive mode, and the first robotic arm is configured to be manually adjusted in the passive mode to position the therapeutic probe at a manually set position. (Item 158) The system according to item 157, wherein the therapeutic probe is configured to be manually adjustable on at least one axis of rotation or at least one axis of translation when the first robotic arm is in the passive mode. (Item 159) The system according to item 158, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 160) The system according to item 159, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 161) The system according to item 157, wherein one or more computing devices are configured to execute commands to maintain the manually set position of the therapeutic probe after the first robotic arm is released from manual adjustment. (Item 162) The system according to item 161, wherein the first robotic arm is configured to maintain the manually set position with tolerances in one or more of the rotational or translational axes. (Item 163) The system according to item 116, wherein one or more computing devices are configured to execute commands for operating the second robotic arm in a passive mode, and the second robotic arm is configured to be manually adjusted in the passive mode to position the imaging probe at a manually set position. (Item 164) The system according to item 163, wherein the imaging probe is configured to be manually adjustable on at least one rotation axis or at least one translation axis when the second robot arm is in the passive mode. (Item 165) The system according to item 164, wherein the at least one rotation axis comprises a first rotation axis, a second rotation axis perpendicular to the first rotation axis, and a third rotation axis perpendicular to the first and second rotation axes, and the at least one translation axis comprises a first translation axis, a second translation axis perpendicular to the first translation axis, and a third translation axis perpendicular to the first and second translation axes. (Item 166) The system according to item 165, wherein the first rotation axis comprises a pitch axis, the second rotation axis comprises a yaw axis, the third rotation axis comprises a roll axis, the first translation axis comprises an X axis, the second translation axis comprises a Y axis, and the third translation axis comprises a Z axis. (Item 167) The system according to item 163, wherein one or more computing devices are configured to execute commands to maintain the manually set position of the imaging probe after the second robotic arm is released from manual adjustment. (Item 168) The system according to item 167, wherein the second robotic arm is configured to maintain the manually set position with one or more tolerances in one or more of the rotational or translational axes. (Item 169) A system for treating patients, wherein the system is probe and, A coupling structure for receiving the aforementioned probe, A support for receiving the patient, An arm coupled to the support, A first slider is coupled to the arm so as to move in a first direction, A second slider coupled to the first slider, the arm, and the support so as to move in a second direction that traverses the first direction, The adjustable extension between the second slider and the coupling structure Equipped with, The adjustable extension includes an extension joint configured to expand and retract in a third direction that traverses the first and second directions, The coupling structure is supported by the arm, the first slider, the second slider, and the extension, to enable the coupling structure to move within a three-dimensional volume, in a system. (Item 170) The system according to item 169, further comprising the arm and a swivel portion coupled to the coupling structure and the expansion joint between the coupling structure and the expansion joint, wherein the swivel portion is configured to rotate the coupling structure up and down relative to the patient, and optionally the axis of rotation extends substantially horizontally, and optionally the substantially horizontal is at an angle of no more than about 10 degrees from horizontal. (Item 171) The system according to item 170, further comprising the arm and a turret coupled to the coupling structure between the coupling structure and the extension joint, wherein the turret is configured to allow the coupling structure to rotate about an axis of rotation, optionally the axis of rotation of the turret being within about 10 degrees of the vertical, and optionally the turret is coupled to the coupling structure and the arm between the coupling structure and the swivel. (Item 172) The system according to item 171, wherein each of the first slider, the second slider, the expansion joint, the turret, and the swivel is equipped with a brake, the brakes locking the positions of the first slider, the second slider, the expansion joint, the turret, and the swivel, and maintaining the position and orientation of the probe when the probe is inserted into the patient and coupled to the arm using a coupling structure. (Item 173) The system according to item 171, further comprising a processor-controlled actuator coupled to one or more of the first slider, the second slider, the expansion joint, the turret, or the swivel, wherein the processor-controlled actuator moves the coupling structure toward the coupling structure of the probe when the probe is inserted into the patient. (Item 174) The system according to item 173, further comprising a chain section coupled to a processor for controlling one or more of the position or orientation of the coupling structure, wherein the chain section comprises one or more of the first slider, the second slider, the expansion joint, the turret, and the swivel section coupled to the corresponding actuator. (Item 175) The system according to item 171, further comprising a second coupling structure for coupling to a second probe, wherein the second coupling structure is optionally configured to support the second probe above the probe. (Item 176) The system according to item 171, further comprising a second coupling structure for coupling to a second probe, the second coupling structure being coupled to a second expansion joint, a second turret, and a second swivel, the second coupling structure, the second expansion joint, the second turret, and the second swivel being supported by the arm to support the second probe. (Item 177) The system according to item 169, wherein the first direction is perpendicular to the second direction. (Item 178) The system according to any one of items 1-177, wherein the coupling structure of the probe comprises one or more projections or grooves on the lower surface of the probe, and the coupling structure supported by the arm comprises one or more projections or grooves on the upper surface of the coupling surface for coupling the coupling structure of the probe to the coupling structure supported by the arm. (Item 179) A mounting assembly for coupling to a patient support, wherein the mounting assembly is A first clamp for mounting to a first rail on the first side surface of the patient support, A first arm having a first end and a second end, wherein the first end is pivotably connected to the first clamp, A second clamp for mounting to a second rail on the second side surface of the patient support, A second arm having a first end and a second end, wherein the first end is pivotably connected to the second clamp, and Equipped with, A mounting assembly in which an extendable support extends between the first arm and the second arm to support a probe to be inserted into the patient. (Item 180) The mounting assembly according to item 179, wherein each of the first arm and the second arm is pivotably connected to the extendable support and adapts to variations in the distance between the first rail and the second rail. (Item 181) The mounting assembly according to item 180, wherein the first rail is substantially parallel to the second rail, and the first arm and the second arm are pivotably connected to the first clamp and the second clamp, respectively, enabling the first and second clamps to engage with the first rail and the second rail in a substantially parallel configuration. (Item 182) A first coupling for pivotably connecting to the first clamp and the first arm, wherein the first coupling is configured to be releasably coupled to the first end of the first arm, A second coupling for pivotably connecting to the second clamp and the second arm, wherein the second coupling is configured to be releasably coupled to the first end of the second arm. The mounting assembly described in item 179 further includes the following: (Item 183) The mounting assembly according to item 182, wherein each of the first and second couplings has a longitudinal axis for receiving the first end of the arm and a pivot axis traversing the longitudinal axis. (Item 184) The mounting assembly according to item 183, wherein the first coupling defines a first hollow cavity configured to receive the first end of the first arm, and the second coupling defines a second hollow cavity configured to receive the first end of the second arm. (Item 185) The mounting assembly described in item 179, wherein each of the first clamp and the second clamp comprises a first jaw and a second jaw, the first jaw and the second jaw being configured for relative movement between them to securely connect to the rail. (Item 186) The mounting assembly according to item 185, wherein the first jaw is movable toward the second jaw using a lever. (Item 187) The mounting assembly according to item 179, wherein the first rail and the second rail comprise a portion of one or more rails of the patient support, and optionally the patient support comprises a bed. (Item 188) The mounting assembly according to item 179, wherein the first arm is configured to pivot relative to the first clamp and the second arm is configured to pivot relative to the second clamp in order to adapt to a variable space between the first rail on the first side surface of the patient support and the second rail on the second side surface of the patient support. (Item 189) The mounting assembly according to item 179, configured to limit the movement of the extension support relative to the first and second rails to 5 mm or less in response to a 150 kg load on the extension support, and optionally, the movement to 3 mm or less in response to a 100 kg load on the extension support. (Item 190) The mounting assembly according to item 179, wherein the extension support, the first clamp, the first arm, the second clamp, and the second arm are configured to limit the movement of the extension support to 5 mm or less in response to a 150 kg load on the extension support, and optionally, the movement is 3 mm or less in response to a 100 kg load on the extension support. (Item 191) The mounting assembly according to item 190, wherein the probe to be inserted into the patient is located at a distance in the range of approximately 20 cm to approximately 60 cm, and the mounting assembly is configured to move the distal end of the probe by 6 mm or less in response to the load on the stretchable support. (Item 192) The mounting assembly according to item 179, further comprising a robotic arm attached to the extension support. (Item 193) The probe is connected to the robot arm in the mounting assembly described in item 192. (Item 194) The mounting assembly according to item 193, wherein the probe comprises one or more therapeutic probes or imaging probes. (Item 195) The mounting assembly according to item 194, wherein the robot arm comprises a first robot arm attached to the extension support and a second robot arm. (Item 196) The mounting assembly according to item 195, wherein the treatment probe is coupled to the first robotic arm and the imaging probe is coupled to the second robotic arm. (Item 197) The mounting assembly according to item 196, wherein the treatment probe and the imaging probe are aligned with each other so as to be substantially in the same plane. (Item 198) The mounting assembly according to item 179, further comprising one or more extendable legs connected to the extension support, the first arm, the second arm, the first clamp, or the second clamp, and extending downward therefrom and engaging with the floor surface. (Item 199) The mounting assembly according to item 179, further comprising extendable legs connected to the extension support and therefrom, extending downward and engaging with the floor surface. (Item 200) The mounting assembly according to item 179, further comprising a first extendable leg connected to the first clamp and extending downward therefrom to engage with the floor surface, and a second extendable leg connected to the second clamp and extending downward therefrom to engage with the floor surface. (Item 201) The mounting assembly according to item 179, further comprising a third clamp for engaging with the first rail and a fourth clamp for engaging with the second rail, wherein the first clamp is coupled to the third clamp using a first brace extending between them to distribute a first load along the first rail, and the second clamp is coupled to the fourth clamp using a second brace extending between them to distribute a first load along the second rail. (Item 202) The mounting assembly according to item 179, wherein the extension support comprises a crossbar extending between the first arm and the second arm. (Item 203) A system for treating target tissue at a target site in a patient, wherein the system is The mounting assembly described in any one of items 179-198, A first robot arm coupled to the extension support, A treatment probe attached to the first robotic arm, A second robot arm coupled to the extension support, The imaging probe attached to the second robotic arm and A system equipped with these features. (Item 204) The system according to item 203, wherein the treatment probe is connected to a chain section, and the chain section is configured to move the treatment probe in parallel along an extension axis and to rotate the treatment probe around the extension axis while the end of the first robot arm remains stationary, and the imaging probe is connected to a chain section, and the chain section moves the imaging probe in parallel along the extension axis of the imaging probe while the end of the second robot arm remains stationary. (Item 205) The system according to item 203, wherein the first robotic arm comprises a first set of joints for translating and rotating the treatment probe, and the second robotic arm comprises a second set of joints for translating and rotating the treatment probe. (Item 206) Each of the robotic arms has 5 to 7 degrees of freedom, as described in item 203. (Item 207) A system for treating patients, wherein the system is A robotic arm and A probe for coupling to the robot arm, wherein the probe is sized and shaped for insertion into the patient, A plurality of sensors coupled to the robot arm, wherein the plurality of sensors indicate the relative position and orientation of the probe with respect to the robot arm when the probe is separated from the robot arm, A processor operably coupled to the robot arm and the plurality of sensors Equipped with, The system comprises a processor comprising commands for moving the robot arm to an engagement position and orientation, and for engaging the probe with the robot arm. (Item 208) The system according to item 207, wherein the processor comprises instructions for using the robotic arm to search for the probe and for engaging the probe with the robotic arm. (Item 209) The processor comprises commands for using the robotic arm to explore the probe while the user stably holds the probe with the probe inserted into the patient, optionally, a gap extending between the probe and the robotic arm prior to exploring the probe, the distal end portion of the robotic arm contacting and engaging with the probe, as described in item 208. (Item 210) The system according to item 207, wherein the robot arm is provided with an engagement structure for engaging with the probe, and the probe is provided with an engagement structure for engaging with the robot arm in the engagement position and orientation. (Item 211) The system according to item 210, wherein the processor comprises instructions for moving the robot arm to a direction corresponding to the engagement direction and for moving the robot arm in parallel onto the probe in the engagement direction, prior to contacting the probe. (Item 212) The system according to item 207, wherein the plurality of sensors comprises a coarse sensor for the robot arm to sense the probe at a distance and a proximity sensor, and optionally the plurality of sensors are located on the robot arm. (Item 213) The system according to item 212, wherein the coarse sensor comprises an infrared transmitter and a beacon. (Item 214) The system according to item 212, wherein the coarse sensor comprises an infrared transmitter and a beacon. (Item 215) The system according to item 207, wherein the plurality of sensors comprises a sensor array coupled to the robot arm and one or more references on the probe for determining the position and orientation of the probe with respect to the robot arm. (Item 216) The system according to item 207, wherein the plurality of sensors are directed toward the probe when the probe engages with the robot arm. (Item 217) A system for treating patients, wherein the system is A robotic arm and A probe for coupling to the robot arm, wherein the probe is sized and shaped for insertion into the patient, Between the engagement structure for connecting the robot arm and the distal end of the probe, a plurality of sensors are coupled to the probe, A processor operably coupled to the robot arm and the plurality of sensors Equipped with, The system comprises a processor consisting of commands for moving the robot arm in response to user input detected by the plurality of sensors. (Item 218) The system according to item 217, wherein the processor comprises instructions for establishing a zero-gravity mode with the probe in an autonomous configuration on the robotic arm prior to inserting the probe into the patient, the zero-gravity mode being configured to drive the joints of the robotic arm using a force to substantially counteract the weight of the robotic arm with the probe coupled to the arm. (Item 219) The system according to item 217, wherein the user input comprises a strain detected using the plurality of sensors, and the strain comprises a strain related to the deflection of the probe between the distal end and the engagement structure. (Item 220) The system according to item 217, wherein the probe comprises an extendable probe whose size and shape are determined for insertion into the patient. (Item 221) The system according to item 220, wherein the probe comprises an extendable portion for the user to grasp between the plurality of sensors and the distal end of the probe, and tissue resistance to the insertion of the probe pushes the insertion force from the user's hand in the opposite direction, reducing the input to the plurality of sensors and reducing the advance of the probe into the patient. (Item 222) The system according to item 221, wherein the resistance of the tissue to insertion is sensed by the user with decreasing advancement of the probe. (Item 223) The system according to item 217, wherein the plurality of sensors and the probe are arranged to provide haptic feedback to the user when the probe encounters resistance to movement. (Item 224) The system according to item 217, wherein the robotic arm comprises a plurality of joints and a plurality of internal joint sensors, the processor is configured to implement a passive mode for the probe and to allow the user to insert the probe into the patient, and the processor is configured to provide reaction forces to the plurality of internal joints and to stabilize the arm in the passive mode. (Item 225) The system according to item 217, wherein one or more of the probe or the distal portion of the robot arm is equipped with an inertial measuring unit ("IMU") for detecting the movement of the probe, and optionally, the processor is configured to receive an output from the IMU and determine the position and orientation of the probe. (Item 226) The system according to item 225, wherein the probe is configured to be mounted on the arm in a predetermined position and orientation relative to the IMU in order to determine the position and orientation of the probe in response to the position and orientation of the IMU, and optionally the IMU is coupled to the arm in a predetermined position and orientation relative to the distal end of the arm. (Item 227) The system according to item 225, wherein the processor is configured to receive the output from the IMU and the outputs from the plurality of sensors and to determine one or more of the positions or orientations for moving the probe. (Item 228) The system according to item 225, wherein the probe is configured for the user to grasp the probe and the sensor, and the processor is configured to determine the user input in response to the user grasping the probe. (Item 229) A system for treating patients, wherein the system is A sheath whose size and shape are determined for insertion into the patient, wherein the sheath comprises an extension axis, The arm connected to the sheath, A therapeutic probe equipped with an energy source, wherein the therapeutic probe has an extension axis, and the therapeutic probe is sized and shaped for insertion into the lumen of the sheath, The robotic arm attached to the aforementioned treatment probe and Equipped with, The system is configured such that the robotic arm aligns the extension axis of the treatment probe with the extension axis of the sheath and advances the treatment probe into the sheath. (Item 230) The system according to item 229, wherein the robotic arm coupled to the treatment probe is configured to align the axis of the treatment probe with the axis of the sheath prior to advancing the treatment probe into the sheath. (Item 231) The system according to item 229, wherein the robotic arm is equipped with a sensor for determining the orientation of the treatment probe, and optionally the sensor comprises one or more of an accelerometer, a gyroscope, or an inertial measuring unit. (Item 232) The system according to item 229, wherein the arm coupled to the sheath is equipped with a sensor for determining the orientation of the sheath, and optionally the sensor comprises one or more of an accelerometer, a gyroscope, or an inertial measuring unit. (Item 233) The system according to item 229, wherein the arm coupled to the sheath comprises a robotic arm. (Item 234) The system according to item 229, wherein the sheath comprises a proximal opening for receiving the treatment probe and a distal opening, and the treatment probe is of sufficient length to extend at least to the distal opening. (Item 235) The treatment probe is sized such that the energy source extends at least to the distal opening when the treatment probe is advanced into the sheath, according to the system in item 234. (Item 236) The system according to item 235, wherein the energy source extends at least to the distal opening with a gap between the end portion of the robot arm and the sheath. (Item 237) The aforementioned sheath comprises a rigid sheath, as described in item 229. (Item 238) The system according to item 229, wherein the sheath comprises an irrigation lumen coupled to one or more openings for providing an irrigation fluid through one or more openings. (Item 239) The system according to item 229, wherein the sheath comprises a suction channel extending to an opening in the lumen for aspirating the excised tissue from the lumen. (Item 240) The system according to item 229, wherein the lumen of the sheath is sized to receive the treatment probe, endoscope camera and suction lumen, and irrigation lumen. (Item 241) The system according to item 240, wherein the suction lumen extends to an opening for aspirating tissue excision products. (Item 242) The system described in item 240, wherein the irrigation lumen extends to an opening for irrigating the treatment site. (Item 243) The system according to item 240, wherein the suction lumen and the irrigation lumen are provided with a double-lumen tube. (Item 244) The system according to item 229, wherein the therapeutic probe has a rigid portion for advancing into the sheath. (Item 245) The system according to item 229, wherein the therapeutic probe has a flexible portion for advancing into the sheath. (Item 246) The system according to item 229, wherein the therapeutic probe is configured to rotate and translate the energy source. (Item 247) The system according to item 246, wherein the energy source comprises one or more of a laser beam, a water jet, an electrode, or an ultrasonic transducer. (Item 248) The system according to item 246, wherein the robotic arm is configured to rotate the energy source. (Item 249) The system according to item 246, wherein the treatment probe is coupled to a chain mounted on the robotic arm for rotating the treatment probe. (Item 250) The system according to item 249, wherein the chain section is configured to move the treatment probe in parallel. (Item 251) The system according to item 240, wherein the endoscope camera comprises a lens and a sensor array configured to view the treatment probe when advanced into the sheath. (Item 252) The system according to item 251, wherein the endoscope camera is connected to a chain for advancing and retracting the endoscope camera. (Item 253) The system according to item 252, wherein the chain section is connected to the robot arm. (Item 254) The system according to item 252, wherein the endoscope camera comprises a flexible extension configured to be connected to the chain section with sufficient column strength to advance and retract the endoscope camera within the lumen. (Item 255) The system according to item 252, wherein the endoscope camera comprises a rigid extension configured to be coupled to the chain portion. (Item 256) The system described in item 229, further comprising an arm coupled to an ultrasonic probe. (Item 257) The system according to item 256, wherein the arm coupled to the ultrasonic probe comprises a robotic arm. (Item 258) The system according to item 257, wherein the robotic arm coupled to the ultrasound probe is configured to position the field of view of the ultrasound probe for imaging the treatment probe. (Item 259) The system according to item 258, wherein the robotic arm coupled to the ultrasound probe is configured to move the ultrasound probe in response to the position of the treatment probe. (Item 260) The system described in item 256 comprises a transrectal ultrasound (TRUS) probe. (Item 261) The system according to item 256, wherein the ultrasound probe comprises a chain section, the chain section translating and rotating the ultrasound probe to position the treatment probe within the field of view of the ultrasound probe. (Item 262) The system according to item 229, further comprising a coupling assembly configured to be coupled to the end portion of the robot arm, wherein the coupling assembly is configured to couple the therapeutic probe to the robot arm. (Item 263) The coupling assembly is configured to couple with respect to the end portion of the robot arm in order to establish the orientation of the treatment probe with respect to the end portion of the robot arm, and optionally the orientation of the coupling assembly with respect to the end portion has a predetermined orientation, as described in item 262. (Item 264) The system according to item 263, wherein the coupling assembly comprises an engagement structure for coupling to the end of the robot arm, and the robot arm comprises a corresponding engagement structure. (Item 265) The system according to item 262, wherein the coupling assembly is configured to rotate the treatment probe while the end portion of the robot arm remains stationary. (Item 266) The system according to item 265, wherein the coupling assembly is configured to move the treatment probe in parallel while the end portion of the robot arm remains stationary. (Item 267) The system according to item 266, wherein the coupling assembly is configured to move the endoscope camera in parallel while the end portion of the robot assembly remains stationary. (Item 268) The system according to item 266, wherein the coupling assembly is configured to move the distal opening of the irrigation lumen in parallel while the end portion of the robot assembly remains stationary. (Item 269) The system according to item 266, wherein the coupling assembly is configured to move the distal opening of the suction lumen in parallel while the end portion of the robot assembly remains stationary. (Item 270) The system according to item 262, wherein the coupling assembly is configured to move the treatment probe, endoscope camera, irrigation lumen, and suction lumen together in parallel. (Item 271) The system according to item 262, wherein the coupling assembly is configured to independently move the treatment probe, endoscope camera, irrigation lumen, and suction lumen. (Item 272) The system according to item 229, further comprising a processor coupled to the robotic arm. (Item 273) The system according to item 272, wherein the processor comprises instructions for advancing the therapeutic probe into the sheath. (Item 274) The system according to item 272, wherein the processor is configured to align the extension axis of the treatment probe with the extension axis of the sheath. (Item 275) The system according to item 274, wherein the processor receives an input indicating that the extension axis of the treatment probe is aligned with the extension axis of the sheath, and comprises instructions for advancing the treatment probe along the extension axis of the sheath in response to the input. (Item 276) The system according to item 272, wherein the processor is configured to determine the orientation of the rigid sheath, and the processor comprises instructions for orienting the therapeutic probe in the orientation of the sheath. (Item 277) The system according to item 276, wherein the arm coupled to the sheath is equipped with a sensor for determining the orientation of the sheath. (Item 278) The system according to item 276, wherein the processor is configured to determine the orientation of the sheath from the joint state of the arm coupled to the sheath. (Item 279) The system according to item 276, wherein the robotic arm is equipped with a sensor for determining the orientation of the treatment probe. (Item 280) A coupling assembly configured at the end portion of the robot arm, wherein the coupling assembly is A structure for receiving the treatment probe, An engagement structure that connects to the end portion of a robot arm and establishes the orientation of the treatment probe relative to the end portion of the robot arm, A coupling assembly equipped with this feature. (Item 281) The coupling assembly according to item 280, wherein the orientation of the coupling assembly with respect to the end portion has a predetermined orientation for establishing a predetermined orientation of the probe with respect to the end portion of the robot arm. (Item 282) The robot arm is a coupling assembly according to item 280, comprising a corresponding engagement structure. (Item 283) The coupling assembly according to item 280, wherein the coupling assembly is configured to rotate the treatment probe while the end portion of the robot arm remains stationary. (Item 284) The coupling assembly according to item 283, wherein the coupling assembly is configured to move the treatment probe in parallel while the end portion of the robot arm remains stationary. (Item 285) The coupling assembly according to item 280, wherein the coupling assembly is configured to move the endoscope camera in parallel while the end portion of the robot assembly remains stationary. (Item 286) The coupling assembly according to item 280, wherein the coupling assembly is configured to move the distal opening of the irrigation lumen in parallel while the end portion of the robot assembly remains stationary. (Item 287) The coupling assembly according to item 280, wherein the coupling assembly is configured to move the distal opening of the suction lumen in parallel while the end portion of the robot assembly remains stationary. (Item 288) The coupling assembly according to item 280, wherein the coupling assembly is configured to move the treatment probe, endoscope camera, irrigation lumen, and suction lumen together in parallel while the end portion of the robot arm remains stationary. (Item 289) The coupling assembly according to item 280, wherein the coupling assembly is configured to allow the treatment probe, endoscope camera, irrigation lumen, and suction lumen to move independently while the end portion of the robot arm remains stationary. (Item 290) The coupling assembly according to item 280, wherein the coupling assembly comprises one or more linkages for moving together the treatment probe, endoscope camera, irrigation lumen, or suction lumen while the end portion of the robot arm remains stationary. (Item 291) A method for treating a patient, wherein the method is Aligning the extension axis of the treatment probe with the extension axis of the sheath, The system receives an input indicating that the extension axis of the treatment probe is aligned with the extension axis of the sheath, In response to the input, the treatment probe is advanced along the extension axis of the sheath. Methods that include... (Item 292) The passive mode is a system or method described in any one of items 1-291, which includes a zero-gravity mode. (Item 293) A system or method according to any one of items 1-292, further comprising a sensor coupled to a clamp, wherein the clamp is configured to be coupled to a rail, and the sensor is configured to measure a load on one or more of the clamp, the rail, or a support bonded to a robotic arm. (Integrated by reference)

[0016] All publications, patents, and patent applications described herein are incorporated herein by reference to the same extent as each individual publication, patent, or patent application is specifically and individually indicated to be incorporated by reference. [Brief explanation of the drawing]

[0017] Novel features of the present invention are described in detail in the appended claims. A further understanding of the features and advantages of this disclosure will be obtained by referring to the following embodiments for carrying out the invention and accompanying drawings, which describe illustrative embodiments in which the principles of this disclosure are utilized.

[0018] [Figure 1] Figure 1 shows a front view of a system for performing tissue resection in a patient, according to several embodiments.

[0019] [Figure 2] Figure 2 schematically illustrates a system for performing tissue resection in a patient, according to several embodiments.

[0020] [Figure 3] Figures 3A and 3B show perspective views of a common base or mount for supporting one or more robot arms, according to several embodiments.

[0021] [Figure 4A] Figures 4A and 4B illustrate, respectively, perspective and side views of a system for performing tissue resection in a patient, equipped with a mobile base, according to several embodiments. [Figure 4B] Figures 4A and 4B illustrate, respectively, perspective and side views of a system for performing tissue resection in a patient, equipped with a mobile base, according to several embodiments.

[0022] [Figure 5] Figures 5A and 5B show top views of the coupling between the treatment probe and the first robot arm according to several embodiments, with Figure 5A showing the detached treatment probe and the first robot arm, and Figure 5B showing the coupled treatment probe and the first robot arm.

[0023] [Figure 6] Figure 6 shows flowcharts illustrating methods for operating a robotic arm coupled to a therapeutic probe, according to several embodiments.

[0024] [Figure 7] Figure 7 shows several embodiments of how to operate a robotic arm coupled to an imaging probe.

[0025] [Figure 8A] Figure 8A illustrates the configuration of a treatment probe and an imaging probe during patient treatment in several embodiments.

[0026] [Figure 8B] Figure 8B is a schematic diagram of a robot arm with a probe and force detection sensor according to several embodiments.

[0027] [Figure 9] Figures 9A, 9B, and 9C schematically illustrate the alignment of the imaging probe with the treatment probe axis in relation to the sagittal plane in several embodiments.

[0028] [Figure 10] Figure 10 shows intraoperative images of the surgical field, including identification of the bleeding site, according to several embodiments.

[0029] [Figure 11A] Figures 11A, 11B, and 11C show side, front, and perspective views, respectively, of systems for performing tissue resection in a patient according to several embodiments, each comprising a treatment table coupled with a slider and mount system for positioning imaging and treatment probes. [Figure 11B] Figures 11A, 11B, and 11C show side, front, and perspective views, respectively, of systems for performing tissue resection in a patient according to several embodiments, each comprising a treatment table coupled with a slider and mount system for positioning imaging and treatment probes. [Figure 11C] Figures 11A, 11B, and 11C show side, front, and perspective views, respectively, of systems for performing tissue resection in a patient according to several embodiments, each comprising a treatment table coupled with a slider and mount system for positioning imaging and treatment probes.

[0030] [Figure 12] Figure 12 illustrates a perspective view of a treatment system for performing tissue resection in a patient, according to several embodiments, which comprises a mobile cart with a display and a common robotic arm base for a robotic arm to operate imaging and treatment probes.

[0031] [Figure 13] Figure 13 illustrates perspective views of several embodiments of a treatment system for performing tissue resection.

[0032] [Figure 14] Figures 14A, 14B, and 14C illustrate perspective views of clamps for use with a treatment system according to several embodiments.

[0033] [Figure 15]Figures 15A, 15B, 15C, and 15D illustrate oblique internal views of clamps for use with treatment systems according to several embodiments.

[0034] [Figure 16] Figures 16A, 16B, 16C, and 16D illustrate side internal views of clamps for use with a treatment system according to several embodiments.

[0035] [Figure 17] Figures 17A, 17B, and 17C illustrate perspective, side, and angle views of the clamping system according to several embodiments, respectively.

[0036] [Figure 18] Figures 18A and 18B illustrate perspective views of a crossbar with a mount for use with a treatment system, according to several embodiments.

[0037] [Figure 19] Figures 19A and 19B illustrate perspective views of a crossbar with a mount for use with a treatment system, according to several embodiments.

[0038] [Figure 20] Figure 20 illustrates perspective views of a control handle according to several embodiments.

[0039] [Figure 21] Figure 21 illustrates plan views of imaging probes and treatment probes coupled to their respective control handles and exhibiting coplanarity, according to several embodiments.

[0040] [Figure 22] Figure 22 illustrates a perspective view of a system for positioning an imaging and treatment probe according to several embodiments, which includes a clamp, a brace, and a robotic arm.

[0041] [Figure 23] Figure 23 illustrates a side view of a system for positioning an imaging and treatment probe, according to some embodiments.

[0042] [Figure 24] Figure 24 illustrates a perspective view of a treatment system, according to some embodiments, that includes a wheeled probe-mounted and adjustment assembly.

[0043] [Figure 25] Figure 25 illustrates a system for positioning and calibrating one or more probes, according to some embodiments.

[0044] [Figure 26] Figure 26 illustrates an arm coupled to a sheath, a robotic arm coupled to a treatment probe, and an arm coupled to an ultrasound probe, according to some embodiments.

[0045] [Figure 27] Figure 27 illustrates a system that includes a robotic arm coupled to a treatment probe and an arm coupled to a sheath, as in Figure 26.

[0046] [Figure 28A] Figure 28A illustrates a coupling for coupling a robotic arm to a treatment probe.

[0047] [Figure 28B] Figure 28B illustrates the movement of a treatment probe, an endoscope, an irrigation lumen, and a suction lumen provided by a coupling as in Figure 28A.

[0048] [Figure 29] Figure 29 illustrates a method of treatment, according to some embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

[0049] Embodiments of this disclosure provide improved methods and apparatus for performing tissue resection, such as prostatectomy and other tissue therapies. The methods and apparatus disclosed herein are highly suitable for many types of surgical procedures and can be incorporated into many prior systems and methods. While some embodiments of this disclosure focus on transurethral treatment of the prostate, some aspects of this disclosure may also be used to treat and modify other tissues and associated organs such as the brain, heart, lungs, intestines, eyes, skin, kidneys, liver, pancreas, stomach, uterus, ovaries, testes, bladder, ears, nose, mouth, bone marrow, adipose tissue, muscle, glandular and mucous tissues, spinal cord and nerve tissue, soft tissues such as cartilage, hard biological tissues such as teeth and bones, and other tissues and associated organs such as body lumens and passages such as sinuses, ureters, colon, esophagus, pulmonary passages, blood vessels, and throat. The devices disclosed herein may be inserted through existing body lumens or through openings created in body tissues.

[0050] The methods and apparatus disclosed herein are very suitable for treating many types of tissue using an energy source. Tissues may include, for example, soft tissues such as glandular or capsular tissue, or hard tissues such as bone or obstructions such as kidney stones. Energy sources may include one or more of the following: laser beams, water jets, electrodes, ultrasound, high-intensity focused ultrasound, mechanical vibration, radio frequency (RF) energy, ultrasonic transducers, microwave energy, cavitation energy such as cavitation-forming water jets or ultrasonic cavitation, radiation such as ionizing radiation from radioisotopes, or ion energy from ionization electrodes, or plasma energy from plasma electrodes. The methods and apparatus disclosed herein are very suitable, for example, for performing lithotripsy and destroying kidney stones. The methods and apparatus disclosed herein are very suitable for treatment using radiation, such as radioisotopes on a treatment probe. Radiation therapy can be provided on a probe, removed using the probe, or implanted from a treatment probe, for example, for the treatment of cancer.

[0051] In some embodiments, the image-guided therapy system comprises a therapy probe and an imaging probe. The imaging probe may be configured to provide an image of the target site while the therapy probe performs the excision of the target tissue. Each of the therapy probe and the imaging probe may be coupled to a robotic arm under the control of one or more computing devices to enable more precisely controlled movement of one or both arms and to improve the safety and efficiency of therapies using the therapy system.

[0052] A robotic arm can be constructed in many ways. Research related to this disclosure suggests that a TRUS probe can exert force on a robotic arm. In some embodiments, the force is related to a force from the patient on the probe. In some embodiments, the force is related to a force caused by moving the probe against tissue and the tissue itself, for the purpose of improving imaging or tissue positioning for an intended treatment. The length of the probe can result in a corresponding torque on the robotic arm.

[0053] The inventors have conducted experiments to determine the amount of force that can be applied from a TRUS probe to a robotic arm. This force can be measured, for example, at an external motor mount on the patient. The force can range from 0 to about 5 kilograms, depending on the surgical placement of the probe and the patient. In some embodiments, the distance from the arm to the point of contact with the prostate corresponds to the amount of torque on the arm.

[0054] Instrument positioning can have three categories of motion control and capabilities, according to some embodiments disclosed herein. The three categories of motion generally include: 1) coarse movement capabilities for movement, storage, and preparation for surgical procedures; 2) intermediate movement capabilities for aligning the probe with the patient and inserting the probe into the patient; and 3) fine movement capabilities to accommodate positional tolerances for precise surgical procedures.

[0055] The coarse movement capability allows for storage, for example, under and adjacent to the table during patient positioning.

[0056] Intermediate motion allows for instrument positioning relative to the patient on a surgical support structure, e.g., an operating room ("OR") table, when the system is prepared and positioned for patient entry. A typical range of position for a TRUS probe or any suitable surgically invasive probe is one that has free motion for insertion into the patient, which can be described using an X, Y, Z coordinate system. With a suitable coordinate reference system, patient entry into the lumen may correspond to a value of 0, 0, 0 in the X, Y, Z coordinate system. The coordinate reference may also have an angular coordinate reference of X', Y', Z'. Entry into the lumen may involve the patient's anus. Using a probe that is collinear with the anal opening and patient axis at 0, 0, 0, intermediate motion may have an X motion tolerance of + / -2 to 15 cm, a Y motion tolerance of + / -2 to 15 cm, and a Z motion tolerance of + / -2 to 30 cm. In some embodiments, the X and Y motions correspond to the translation of the probe along the X and Y coordinate references. The Z-axis position corresponds to movement along the axis of the lumen and can correspond to the forward and backward movement of the probe along the body lumen, e.g., parallel movement in and out of the patient. Using angle adjustments of X', Y', and Z', the angular position capability can have X'+ / -0 to 30 degrees, Y'+ / -0 to 30 degrees, and Z'+ / -0 to 30 degrees relative to the patient's natural axis. Research related to this disclosure suggests that probes with these angular capabilities can be manipulated by the user for insertion into a patient.

[0057] In some embodiments, the micro-movement capability and tolerances correspond to the configuration of a robotic probe and arm, where the probe is positioned within the patient, for example, during tissue resection and imaging. When the system is used in conjunction with instruments positioned for diagnosis and treatment, the sensors and controls described herein can be configured to prevent tissue damage and to position the treatment and imaging probes to obtain reliable images, e.g., optimal images, and the treatment and imaging probes can be precisely positioned and held firmly in place against tissue pressure. The X, Y, and Z reference frames can be aligned at 0, 0, 0 on the lumen inlet (and the probe collinear with the patient axis). In some embodiments, the X motion tolerance is + / - 0 to 5 cm, the Y motion tolerance is + / - 0 to 5 cm, and the Z motion tolerance is + / - 0 to 15 cm. The X and Y motions generally correspond to the translation of the probe, and the Z axis corresponds to the forward and backward movement of the probe in and out of the patient. The corresponding angle adjustment ranges for X', Y', and Z' are, for example, X' + / - 0 to 10 degrees, Y' + / - 0 to 10 degrees, and Z' + / - 0 to 15 degrees relative to the patient's natural axis, with reference to the patient's midline, which has a Z-axis extending along the patient's midline. While the above values represent the range of motion, robotic arms and surgical probes may offer tighter tolerances with respect to the fixed position configuration of the probe. For example, when the probe is intended to be held in a fixed position, rotational tolerances can be maintained within or less than + / - 5° tolerance, e.g., + / - 3° for one or more of X', Y', and Z'. With respect to translation, manually set positions can be maintained to positional tolerances of, for example, 5 mm or less, 3 mm or less, or 2 mm or less with respect to one or more of the X, Y, and Z axes. In some embodiments, these tolerances are maintained for each of X, Y, Z and X', Y', Z'. In some embodiments, the probe is manually positioned, and translation and rotation tolerances are maintained within the above values, which can improve the accuracy of tissue treatment and associated imaging. These tolerances may correspond, for example, to the maximum structural slack or load on the arm with the probe mounted thereon.

[0058] The probe can be operated in many ways and inserted into a patient. For example, the probe can be operated manually, and a robotic arm can be moved to align with the probe and coupled to the probe, so that the probe maintains the above tolerance when released by the user, and the arm subsequently supports the full load of the patient and the probe. The arm can be aligned with the probe manually, or with at least some automation, such that sensors and induction circuits are used to align the arm with the probe held by the user. The arm may have coupling structures for engaging with the probe in six degrees of freedom so that coupling structures on the arm can be precisely aligned with coupling structures on the probe. The coupling structures can subsequently engage and couple with each other in response to the detection of alignment. In some embodiments, sensors are provided on one or more of the arm or probe to detect alignment between the arm and the probe, and the coupling structures engage in response to the detected alignment. The robotic arm may have a chain section coupled to a processor, the processor controlling the movement of the arm and aligning the arm with the probe held by the user.

[0059] In some embodiments, the urethral probe has dimensions, movement, and tolerance capabilities similar to those of a TRUS probe.

[0060] In some embodiments, the probe has a mass in the range of approximately 250 grams to 1,500 grams, and the arm maintains the tolerances described herein using a probe having a mass within this range.

[0061] A robotic arm as described herein can improve the alignment between a treatment probe and an imaging probe, which may include the sagittal plane of the imaging TRUS probe. For example, the treatment probe can be aligned substantially coplanar along the sagittal plane of the imaging probe. This coplanarity can provide imaging and alignment of the coordinates of the treatment probe and the imaging probe. In some embodiments, the tolerance of this coplanarity relates to a combination of the width of the treatment probe and the width of the imaging plane capability, e.g., the width of the image captured using ultrasonic beamforming. The relative position of TRUS to the treatment probe can be substantially parallel and aligned within an angular tolerance. The alignment may be in the range of + / - 0 (parallel) to about 30 degrees. In some embodiments, the extension axes of the treatment probe and the TRUS probe are aligned in a substantially coplanar configuration, and the separation distance between the probes varies along the lengths of the imaging and treatment probes. For example, the distal tip of the treatment probe may be furthest from the TRUS probe, and the proximal end may be closer to the TRUS probe, and the two probes are inclined relative to each other but substantially coplanar. The inclination between the two probes may be related to the tissue constraints of each unique human's natural mouth. The distance between the entrances to the naturally available mouths may vary, for example, within a range of approximately 5 cm to 25 cm.

[0062] In some embodiments, the imaging probe and the treatment probe are aligned so that the treatment probe is within the field of view of the imaging probe. In some embodiments, the alignment is configured to maintain the treatment probe within the field of view of the imaging probe. In some embodiments, the treatment probe is configured to move to a certain position, and the imaging probe is configured to maintain the treatment probe within the field of view.

[0063] Figure 1 shows an exemplary embodiment of a system 400 for performing tissue resection in a patient. The system 400 may comprise a therapeutic probe 450 and an imaging probe 460. The therapeutic probe 450 may be coupled to a first arm 442, and the imaging probe 460 may be coupled to a second arm 444. One or both of the first arm 442 and the second arm 444 may comprise a robotic arm whose movement may be controlled by one or more computing devices operably coupled to the arm. The therapeutic probe 450 may comprise a device for removing target tissue from a target site in the patient. The therapeutic probe 450 may be configured to deliver sufficient energy from the therapeutic probe 450 to the target tissue in order to remove it. For example, the therapeutic probe 450 may comprise an electrosurgical ablation device, a laser ablation device, a transurethral needle ablation device, a water jet ablation device, or any combination thereof. The imaging probe 460 may be configured to deliver sufficient energy from the imaging probe 460 to the target tissue in order to image the target tissue. The imaging probe 460 may include, for example, an ultrasound probe, a magnetic resonance probe, an endoscope, or a fluoroscopy probe. The first arm 442 and the second arm 444 may be configured to be independently adjustable, adjustable according to a fixed relationship, adjustable according to a user-selection relationship, independently lockable, or simultaneously lockable, or any combination thereof. The first arm 442 and the second arm 444 may each have multiple degrees of freedom, e.g., 6 degrees of freedom, for manipulating the treatment probe 450 and the imaging probe 460. The treatment system 400 may be used to perform tissue resection in the patient's organs, such as the patient's prostate. The patient may be positioned on a patient support 449, such as a bed, table, chair, or platform. The treatment probe 450 may be inserted into the patient's target site along an entry axis that coincides with the extension axis 451 of the treatment probe. For example, the treatment probe 450 may be configured for insertion into the patient's urethra to position the energy delivery area of the treatment probe within the patient's prostate.The imaging probe 460 can be inserted into the patient at a target site or an adjacent site, along an entry axis that coincides with the extension axis 461 of the imaging probe. For example, the imaging probe 460 may include a transrectal ultrasound (TRUS) probe configured for insertion into the patient's rectum to visualize the patient's prostate and surrounding tissues. As shown in Figure 1, the first arm 442 and the second arm 444 can be covered with sterile drapes to provide a sterile surgical environment, keep the robotic arms clean, and reduce the risk of damaging the robotic arms. Further details regarding various components of the system 400 suitable for incorporation with embodiments such as those disclosed herein can be found in U.S. Patents 7,882,841, 8,814,921, 9,364,251, and PCT Publication WO2013 / 130895 (the entire disclosure of which is incorporated herein by reference).

[0064] Figure 2 schematically illustrates an exemplary embodiment of a system 400 for performing tissue resection in a patient. The system 400 comprises a treatment probe 450 and optionally an imaging probe 460. The treatment probe 450 is coupled to a console 420 and a linkage unit 430. The linkage unit 430 may comprise one or more components of a robotic arm 442. The imaging probe 460 is coupled to an imaging console 490. The imaging probe may be coupled, for example, to a second robotic arm 444. The patient treatment probe 450 and the imaging probe 460 can be coupled to a common base 440. The patient is supported using a patient support 449. The treatment probe 450 is coupled to the base 440 using a first arm 442. The imaging probe 460 is coupled to the base 440 using a second arm 444. One or both of the first arm 442 and the second arm 444 may comprise a robotic arm whose movement can be controlled by one or more computing devices operably coupled to the arm, as will be described in more detail herein.

[0065] A common base is referenced, but the robot arm can be coupled to a bed rail, console, or any suitable support structure to support the base of the robot arm.

[0066] In some embodiments, the system 400 includes a user input device 496 coupled to a processor 423 for the user to operate surgical instruments on a robotic arm. The user input device 496 can be located in any preferred location, for example, on a console, on a robotic arm, or on a mobile base, and there may be one, two, three, four, or more user input devices used in conjunction with the system 400 to provide either redundant means of input, unique input commands, or a combination of them. In some embodiments, the user input device includes a controller for moving the end of a treatment probe or imaging probe in response to the mechanical movement of the user input device. The end of the probe may be shown on a display 425, and the user can operate the end of the probe. For example, the user input device may include a 6-degree-of-freedom input controller, in which the user can move the input device in 6 degrees of freedom, and the distal end of the probe moves in response to the movement of the controller. In some embodiments, the 6 degrees of freedom include 3 translational degrees of freedom and 3 rotational degrees of freedom. The processor may consist of instructions for switching between automated image-guided therapy using an energy source and therapy using an energy source, for example, by user movement of a user input device.

[0067] The patient is placed on the patient support 449 such that the treatment probe 450 and the ultrasound probe 460 can be inserted into the patient. The patient can be placed in one or more of many positions, such as prone, supine, upright, or inclined. In some embodiments, the patient is placed in the lithotomy position, and for example, a knee rest can be used. In some embodiments, the treatment probe 450 is inserted into the patient in a first direction on a first side of the patient, and the imaging probe is inserted into the patient in a second direction on a second side of the patient. For example, the treatment probe can be inserted into the patient's urethra from the front side of the patient, and the imaging probe can be inserted rectally into the patient's intestine from the rear side of the patient. The treatment probe and the imaging probe can be placed in the patient with one or more of urethral tissue, urethral wall tissue, prostate tissue, intestinal tissue, or intestinal wall tissue extending therebetween.

[0068] The treatment probe 450 and the imaging probe 460 can be inserted into the patient in one or more of many ways. During insertion, each of the first and second arms can be provided in a substantially unlocked configuration such that the treatment or imaging probe can be rotated and translated as desired to insert the probe into the patient. When the probe is inserted into the desired location, the arms can be locked. In the locked configuration, the probes can be oriented relative to each other in one or more of many ways, such as parallel, skewed, horizontal, angled, or non - parallel. To map the image data of the imaging probe to the treatment probe coordinate reference, it can be useful to determine the orientation of the probe using an angle sensor as described herein. Mapping the tissue image data to the treatment probe coordinate reference space can enable accurate targeting and treatment of the tissue identified for treatment by an operator such as a physician.

[0069] In some embodiments, the treatment probe 450 is coupled to the imaging probe 460 to align the treatment with the probe 450 based on images from the imaging probe 460. The coupling can be achieved using a common base 440 as shown. Alternatively, or in combination, the treatment probe and / or imaging probe may be equipped with magnets for holding the probes in alignment through the patient's tissue. In some embodiments, a first arm 442 is a movable and lockable arm so that the treatment probe 450 can be positioned at a desired location within the patient. When the probe 450 is positioned at a desired location in the patient, the first arm 442 can be locked using an arm lock 427. The imaging probe can be coupled to the base 440 using a second arm 444, which can be used to adjust the alignment of the imaging probe when the treatment probe is locked in place. The second arm 444 may be equipped with a lockable and movable probe, for example, under the control of an imaging system or console and user interface. The movable arm 444 may be finely adjustable so that the imaging probe 460 can be adjusted with a small movement of about 1 millimeter in relation to, for example, the treatment probe 450.

[0070] In some embodiments, the treatment probe 450 and the imaging probe 460 are coupled to angle sensors so that the treatment can be controlled based on the alignment of the imaging probe 460 and the treatment probe 450. A first angle sensor 495 may be coupled to the treatment probe 450 using a support 438. A second angle sensor 497 may be coupled to the imaging probe 460. The angle sensor may comprise one or more of many types of angle sensors. For example, the angle sensor may comprise a goniometer, an accelerometer, and a combination thereof. In some embodiments, the first angle sensor 495 comprises a three-dimensional accelerometer for determining the orientation of the treatment probe 450 in three dimensions. In many embodiments, the second angle sensor 497 comprises a three-dimensional accelerometer for determining the orientation of the imaging probe 460 in three dimensions. Alternatively, or in combination, the first angle sensor 495 may comprise a goniometer for determining the angle of the treatment probe 450 along the extension axis 451 of the treatment probe. The second angle sensor 497 may include a goniometer for determining the angle of the imaging probe 460 along the extension axis 461 of the imaging probe 460. The first angle sensor 495 is coupled to the controller 424 of the treatment console 420. The second angle sensor 497 of the imaging probe is coupled to the processor 492 of the imaging console 490. Alternatively, or in combination, the second angle sensor 497 may be coupled to the controller 424 of the treatment console 420.

[0071] Console 420 includes a display 425 coupled to a processor system in the components used to control the therapeutic probe 450. Console 420 includes a processor 423 having memory 421. A communication circuit 422 is coupled to the processor 423 and the controller 422. The communication circuit 422 is coupled to the imaging console 490 via the communication circuit 494 of the imaging console. An arm lock 427 of console 420 may be coupled to the first arm 442 to lock the first arm or to allow the first arm to move freely to insert the probe 450 into the patient.

[0072] Optionally, the console 420 may include components of an endoscope 426, which are coupled to an anchor 24 of a treatment probe 450. The endoscope 426 may comprise the components of the console 420 and an endoscope that can be inserted together with the treatment probe 450 to treat a patient.

[0073] Optionally, the console 420 may comprise one or more modules operably coupled with the treatment probe 450 to control aspects of treatment using the treatment probe. For example, the console 420 may comprise one or more of the following: an energy source 22 for supplying energy to the treatment probe; a balloon inflation control 26 for influencing the inflation of a balloon used to anchor the treatment probe at a target treatment site; an injection / wash control 28 for controlling the injection and washing of the probe; an injection control 30 for controlling suction by the probe; an injection control 32 for controlling blowing at a target treatment site (e.g., the prostate); or a light source 33 such as an infrared, visible light, or ultraviolet light source for supplying light energy to the treatment probe.

[0074] The processor, controller, and control electronics and circuits may include one or more of many preferred components, such as one or more processors, one or more field-programmable gate arrays (FPGAs), and one or more memory storage devices. In some embodiments, the control electronics control a control panel of a graphical user interface (hereinafter referred to as "GUI") to provide pre-procedure planning according to user-defined treatment parameters and to provide user control over the surgical procedure.

[0075] The treatment probe 450 may include an anchor 24. The anchor 24 can anchor the distal end of the probe 450 while energy is being delivered to the energy delivery area 20 using the probe 450. The probe 450 may include a nozzle 200.

[0076] The therapeutic probe 450 may be coupled to the first arm 442 using a linkage section 430. The linkage section 430 may include components for moving the energy delivery area 20 to a desired target location on the patient, for example, based on an image of the patient. The linkage section 430 may comprise a first portion 432, a second portion 434, and a third portion 436. The first portion 432 may include a substantially fixed anchoring portion. The substantially fixed anchoring portion 432 may be fixed to a support 438. The support 438 may comprise a reference frame for the linkage section 430. The support 438 may comprise a rigid chassis or frame or housing for rigidly or rigidly coupling the first arm 442 to the therapeutic probe 450. While the first portion 432 may remain substantially fixed, the second portion 434 and the third portion 436 can move and direct energy from the probe 450 to the patient. The first portion 432 can be fixed at a substantially constant distance 437 from the anchor 24. The substantially fixed distance 437 between the anchor 24 and the fixed first portion 432 of the chain allows the treatment to be precisely positioned. The first portion 432 may be equipped with a linear actuator for precisely positioning the high-pressure nozzle 200 within the energy delivery area 20 at a desired axial position along the extension axis 451 of the treatment probe 450.

[0077] The extension axis 451 of the probe 450 generally extends between a proximal portion of the probe 450 near the chain portion 430 and a distal end having an anchor 24 attached thereto. A third portion 436 can control the rotation angle 453 about the extension axis 451. During patient treatment, the distance 439 between the energy delivery area 20 and the first portion 432 of the chain portion may vary with reference to the anchor 24. The distance 439 may be adjusted in a manner 418 in response to computer control to set a target location along the extension axis 451 of the treatment probe referenced to the anchor 24. While the first portion of the chain portion remains fixed, the second portion 434 adjusts the position of the energy delivery area 20 along the axis 451. The third portion of the chain portion 436 adjusts the angle 453 about the axis in response to the controller 424 so that the distance along the axis at the treatment angle can be controlled very precisely with reference to the anchor 24. The probe 450 may include a rigid member, such as a spine, extending between the support 438 and the anchor 24, such that the distance from the chain section 430 to the anchor 24 remains substantially constant during treatment. The treatment probe 450 is coupled to a treatment component as described herein to enable treatment using one or more forms of energy, such as mechanical energy from a jet, electrical energy from an electrode, or optical energy from a light source such as a laser source. The light source may be infrared, visible light, or ultraviolet light. The energy delivery area 20 can be moved under the control of the chain section 430 to deliver the intended form of energy to the patient's target tissue, etc.

[0078] The imaging console 490 may include a memory 493, a communication circuit 494, and a processor 492. The processor 492 in the corresponding circuit is coupled to the imaging probe 460. An arm controller 491 is coupled to an arm 444 to precisely position the imaging probe 460. The imaging console may further include a display 425.

[0079] To facilitate precise control of the therapeutic probe and / or imaging probe during patient treatment, each of the therapeutic probe and imaging probe may be coupled to a computer-controllable arm of a robot. For example, referring to system 400 shown in Figure 2, one or both of the first arm 442 coupled to the therapeutic probe 450 and the second arm 444 coupled to the imaging probe 460 may comprise a computer-controllable arm of a robot. The robot arm may be operably coupled to one or more computing devices configured to control the movement of the robot arm. For example, the first robot arm 442 may be operably coupled to the processor 423 of the console 420, or the second robot arm 444 may be operably coupled to the processor 492 of the imaging console 490 and / or to the processor 423 of the console 420. One or more computing devices such as processors 423 and 492 may provide computer-executable instructions for controlling the movement of one or more robot arms. The first and second robotic arms may be substantially similar in structure and function, or they may differ to adapt to specific functional requirements for controlling the movement of the therapeutic probe versus the imaging probe.

[0080] A robotic arm may have six, seven, or more joints to enable the arm to move under computer control. Suitable robotic arms are commercially available from several manufacturers, including RoboDK Inc., Kinova Inc., and other manufacturers.

[0081] One or more computing devices operably coupled to the first and second robotic arms may be configured to automatically control the movement of the treatment probe and / or imaging probe. For example, the robotic arms may be configured to automatically adjust the position and / or orientation of the treatment probe and / or imaging probe during patient treatment according to one or more pre-programmed parameters. The robotic arms may be configured to automatically move the treatment probe and / or imaging probe along a pre-planned or programmed treatment or scanning profile, which may be stored in the memory of one or more computing devices. As an alternative to, or in addition to, automatic adjustment of the robotic arms, one or more computing devices may be configured to control the movement of the treatment probe and / or imaging probe in response to user input, for example, through a graphical user interface of the treatment device. As an alternative to, or in addition to, automatic adjustment of the robotic arm, one or more computing devices may be configured to control the movement of the therapeutic probe and / or imaging probe in response to real-time positioning information, for example, biological structures recognized in one or more images captured by the imaging probe or other imaging source (from which the permissible range of motion of the therapeutic probe and / or imaging probe may be established), and / or positional information of the therapeutic probe and / or imaging probe from one or more sensors coupled to the probe and / or robotic arm.

[0082] Figures 3A and 3B illustrate exemplary embodiments of a common base or mount 440 for supporting one or more robotic arms in an image-guided therapeutic system as disclosed herein. Figure 3A shows a patient support 449 comprising one or more rails 452. The patient support 449 may comprise an operating table or platform. One or more robotic arms, associated with one or more therapeutic probes or imaging probes, may be mounted on the rails 452 such that the rails function as a common base 440. Figure 3B shows a common base 440 comprising a floor stand 454 configured to couple with a first robotic arm connected to a therapeutic probe and / or a second robotic arm connected to an imaging probe. The floor stand 454 may be positioned between the patient's legs during a therapeutic procedure.

[0083] Figures 4A and 4B illustrate exemplary embodiments of a treatment system 400 as described herein, comprising a mobile base 470. Figure 4A is a front view of the treatment system 400, and Figure 4B is a side view. The treatment system 400 comprises a treatment probe 450 coupled to a first robotic arm 442 and an imaging probe 460 coupled to a second robotic arm 444. Each of the first robotic arm 442 and the second robotic arm 444 has a proximal end and a distal end, the distal ends of which are coupled to the treatment probe 450 and the imaging probe 460, respectively, and the proximal end is coupled to a common base 440, which comprises a mobile base 470. The first robotic arm 442 may comprise a first arm coupling structure 504 for coupling to the treatment probe 450, and the second robotic arm 444 may comprise a second arm coupling structure 505 for coupling to the imaging probe 460. The treatment probe 450 may be coupled to the distal end of the first robotic arm 442 via a mounting device 500, which may include a chain section configured to influence the movement of the treatment probe as described herein (e.g., rotation, translation, pitch, etc.). The coupling of the treatment probe 450 to the first robotic arm 442 may be fixed, detachable, or user-adjustable. Similarly, the coupling of the imaging probe 460 to the second robotic arm 444 may be fixed, detachable, or user-adjustable.

[0084] The first robotic arm 442 may articulate in one or more first arm joints 443. The imaging arm 444 may articulate in one or more second arm joints 445. Each arm joint 443 or 445 may be operably coupled to a computer-controllable actuator, such as a stepping motor, to influence movement in the joint. Each arm joint 443 or 445 may comprise one of various kinematic joints, including, but not limited to, prism, rotary, parallel cylinder, cylinder, spherical, planar, edge slider, cylindrical slider, point slider, spherical slider, or cross-cylinder joints, or any combination thereof. Furthermore, each arm joint 443 or 445 may comprise a linear, orthogonal, rotary, torsional, or rotary joint, or any combination thereof.

[0085] The system 400 may further comprise a console 420, as described herein, which may be supported by a mobile base 470 and a separate mobile support 480. The console 420 may be operably coupled to the mobile base 470 via power and communication cables 475 to enable control of a treatment probe 450 which is coupled to the mobile base via a first robotic arm. The treatment console 420 comprises a processor and a memory storing computer executable instructions for execution by the processor to control various modules or functions of the treatment console, such as energy sources, infusion / washing controls, suction controls, and other components, as described herein with reference to Figure 2. The treatment console 420 may further comprise a display 425 that communicates with the processor. The display 425 may be configured to display one or more of the following: target vital signs such as heart rate, respiratory rate, temperature, blood pressure, oxygen saturation, or any physiological parameters, or any combination thereof; procedure status; one or more pre-captured images or a series of images of the treatment site from one or more views; one or more real-time images or a series of images of the treatment site from one or more views obtained by the imaging probe 460; a set of treatment parameters, including, but not limited to, treatment mode such as cutting or coagulation; treatment intensity; time elapsed during treatment; time remaining during treatment; treatment depth; area or volume of the treated treatment site; area of the treatment site to be treated; area or volume of the treatment site not to be treated; location information of the treatment probe 450 or the imaging probe 460 or both; treatment adjustment controls such as means for adjusting treatment depth, treatment intensity, location and / or orientation of the treatment probe 450, imaging depth, or location and / or orientation of the imaging probe 460, or any combination thereof; or system configuration parameters.

[0086] The mobile base 470 may further include one or more computing devices for controlling the movement of one or more robot arms. For example, the mobile base may include a processor and a memory that stores computer-executable instructions for execution by one or more processors. The memory may also store instructions for operating one or more robot arms coupled to the mobile base. The processor may be operably coupled to the robot arms via suitable electromechanical components to influence the movement of the robot arms. For example, each of one or more joints of the robot arms may include a stepper motor, and the processor may be operably coupled to the stepper motor at each joint to actuate the motor by a predetermined increment in a predetermined direction. Alternatively, one or more robotic arms may be operably coupled to one or more processors in console 420 or a separate imaging console (such as imaging console 490 shown in Figure 2), and one or more console processors may be configured to execute commands to control the movement of one or more robotic arms, and the commands may be communicated to the robotic arms via communication circuits (communication circuit 422 of console 420 or communication circuit 494 of console 490 shown in Figure 2). Computer-executable commands for controlling the movement of the robotic arms may be pre-programmed and stored in memory, or may be provided by a user via one or more user inputs during or between treatments of a patient using the treatment system.

[0087] One or more computing devices operably coupled to the first and / or second robotic arms may be configured to control the movement of the arms to adjust the pitch, yaw, roll, and / or linear position of the therapeutic probe and / or imaging probe along the target site.

[0088] The mobile base 470 may include one or more user input devices to enable a user to control the movement of the robotic arm under computer commands. For example, as shown in Figures 4A and 4B, the mobile base may include a keyboard 474 and / or a foot switch 471, the foot switch being operably coupled to the mobile base via a foot switch cable 472. The keyboard 474 and the foot switch 471 may be configured, independently or in combination, to control the movement of a first robotic arm 442 and / or a second robotic arm 444, for example, through the joint movement of one or both robotic arms in one or more joints. The keyboard and foot switch may communicate with one or more processors configured to control the movement of the robotic arm. When a user enters a command into the keyboard and / or foot switch, the user command may be received by one or more processors and converted into an electrical signal, which may be transmitted to one or more computer-controllable actuators operably coupled to one or more robotic arms. The keyboard and / or footswitches may control the movement of one or both arms toward or away from a treatment position, focus position, predetermined location, or user-defined location, or any combination thereof.

[0089] Optionally, the keyboard 474 and foot switch 471 may be configured to control the operation of the treatment probe 450 and / or the imaging probe 460, either independently or in combination. For example, the keyboard 474 and / or foot switch 471 may be configured to start, stop, pause, or resume treatment using the treatment probe. The keyboard 474 and / or foot switch 471 may be configured to start acquiring images or a series of images previously acquired or currently acquired by the imaging probe, or to freeze, save, or display them on the display 425.

[0090] The mobile base 470 and mobile support 480 of the console 420 may be independently positioned around the patient, who is supported by a patient support 449 such as a platform. For example, the mobile base 470, which supports the first and second robotic arms and the treatment and imaging probes, may be positioned between the patient's legs, while the mobile support 480, which carries the console 420 and the display 425, may be positioned to the side of the patient, such as near the patient's torso. The mobile base 470 or mobile support 480 may have one or more movable elements, such as multiple wheels, that allow the base or support to move. The mobile base 470 may be covered with sterile draping throughout the treatment procedure to prevent contamination and fluid ingress.

[0091] Figures 5A–5B show exemplary couplings between a therapeutic probe 450 and a first robotic arm 442. Figure 5A shows the therapeutic probe detached from the robotic arm. Figure 5B shows the therapeutic probe coupled to the robotic arm. As shown, the therapeutic probe 450 may be coupled to the robotic arm 442 with a mounting device 500, which may include a reusable motor pack. The therapeutic probe 450 may be detachably coupled to the mounting device 500. The mounting device may further include a connector 502, which is coupled to the robotic arm and configured to lock the mounting device in place. The robotic arm 442 may include a coupling structure 504 located at the distal end of the arm, which is configured to lock and receive the connector 502 of the mounting device 500. When the therapeutic probe and the robotic arm are coupled together, the movement of the therapeutic probe may be controlled by moving the robotic arm (for example, by articulating one or more joints of the robotic arm under computer control).

[0092] In some embodiments, the therapeutic probe is coupled to the robot arm via a quick release mechanism so that the coupling between the probe and the robot arm can be quickly disconnected to prevent injury to the patient if the robot arm loses position or is otherwise unable to function correctly. The therapeutic probe and the robot arm can be coupled to each other in many ways, such as mechanically (e.g., by a broom clip) and / or magnetically. For example, in the embodiments shown in Figures 5A and 5B, the coupling structure 504 may comprise a slot 506 having a magnet 508 disposed therein, and the connector 502 may comprise a ferromagnetic fixture configured to fit into the slot 506 and engage with the magnet 508. The coupling structure 504 may further comprise a latching mechanism 510 for selectively engaging or disengaging the connector 502 with the magnet 508. For example, as shown in Figures 5A and 5B, the latching mechanism 510 may comprise a rotatable knob that can be rotated to affect the engagement of the magnet 508 of the coupling structure 504 with the connector 502 of the mounting device 500. The latching mechanism can be automatically or manually engaged or disengaged by the user to connect or disconnect the mounting device 500, and therefore the treatment probe 450 coupled thereto, to the robot arm 442, respectively. In some embodiments, the coupling structure 504 may be operably coupled to one or more computing devices configured to control the robot arm, and one or more computing devices may have commands to release the coupling structure from the probe when an error is detected in the operation of the robot arm.

[0093] In some embodiments, the first robotic arm 442 may be configured to automatically locate a therapeutic probe 450 in response to sensor location data from one or more of the mounting devices 500 or coupling structures 504. The first robotic arm 442 may be operated in “exploration” mode to locate, for example, the mounting device 500. In some embodiments, the probe comprises one or more reference targets, and the robotic arm comprises corresponding sensors with sufficient resolution and positioning to identify the relative position of the probe in 3D space. In some embodiments, the processor comprises commands for exploring a therapeutic probe or imaging probe with a mounting structure on the robotic arm, for example, when the probe is positioned within a patient, while the user holds the probe stably.

[0094] Sensors on robot arms such as the first robot arm 442 and sensors on probes such as therapeutic probes can be arranged in many ways, for example, as shown in Figure 8B.

[0095] The processor may be coupled to a sensor near the end of the robot arm or on the probe to dynamically update its relative position during the movement of the robot arm while attempting to engage with the probe on the arm. The sensors on the robot arm may comprise multiple sensors, each comprising one or more of the following: capacitive, capacitive displacement, Doppler, induction, magnetic, optical, radar, sonar, ultrasonic, or Hall effect sensors, to determine the relative distance between the robot arm and the probe. In some embodiments, the probe comprises multiple targets, and the sensors are configured to generate signals in response to the distance from the multiple targets. Alternatively, or in combination, the sensors may be positioned on the probe and targets on the robot arm. In some embodiments, the sensors may comprise close-contact mechanical sensors for confirming the docking of the probe on or near the robot arm to sense the position of the probe relative to the robot arm, for example, when the probe and arm are within a few millimeters of docking with each other. The close-contact mechanical sensors may comprise one or more of the following: micromotion switches, whisker touch sensors, or pin-in-Hall contact switches. In some embodiments, the probe and robotic arm are equipped with an integrated locking mechanism for providing a non-moving locking engagement at the final position of contact. The integrated locking mechanism may comprise one or more of the following mechanical means of reversible mounting: magnetic, electromagnetic, latch, screws such as multi-swivel latch screws or quarter-swivel lock screws, vacuum, or as understood by those skilled in the art.

[0096] In some embodiments, multiple sensors are used, such as one or more sensors for close separation distances between the probe and the robot arm, one or more sensors for intermediate separation distances, and one or more sensors for far separation distances. Coarse location sensors, such as beacons, can be used to determine the approximate location of the probe. One or more sensors, such as proximity sensors, can be used for fine location positioning of the probe relative to the robot arm. In some embodiments, one or more markers on the probe are used in conjunction with machine vision detection of a camera and one or more markers.

[0097] In some embodiments, a coarse spatial sensor may be provided, which may be an infrared (IR) beacon, enabling coarse spatial location for homing detection of a robotic arm to a probe. In some cases, a homing beacon, such as an IR beacon, enables homing over longer distances compared to a sensor that may rely on reference visual recognition.

[0098] In some embodiments, a docking detection sensor confirms that the robot arm is engaged with or in close proximity to the probe. In some embodiments, a Hall effect sensor may be used in conjunction with a permanent magnet to influence the sensor output. In some embodiments, the Hall effect sensor is noise-resistant, non-contact, and has a consistent detection range. Any of several different types of Hall sensors may be utilized, often the sensor functioning as a simple switch and linear range measurement and detection, where the overall output voltage is set by the supply voltage and varies proportionally to the magnetic field strength. This results in distance measurement between the sensor and the positioning magnet, which can be used to measure the distance between the robot arm and the probe and assist in docking. The sensor and beacon may be located within the respective housings of the robot arm and probe.

[0099] In some embodiments, the position sensing of the robot arm is performed by an inertial measuring unit (IMU) which may include detection of up to nine axes. In some cases, a six-axis IMU, which may be located within the joint of the robot arm, may be used for motion detection, vibration detection, position and orientation information, redundancy, and backup of the primary encoder signal. The IMU may perform dual functions, including docking with the robot arm and exploring probes for force detection and motion compensation as described herein. The sensors described may be used in combination with any robot arm or probe described herein.

[0100] According to some embodiments, the procedure for docking a robotic arm with a probe may include an IR beacon for providing coarse position and spatial location for homing detection, a reference on either the arm or the probe, and an optical sensor for visualizing the reference which may be used to enable fine alignment of the position in the XY plane, and a Hall effect sensor for detecting Z-direction proximity for docking. The IR beacon allows for longer-distance exploration of the robotic arm's home position relative to the probe. The reference and optical sensor may enable fast, low-latency detection of the probe's 2D location and 2D orientation by the robotic arm. A user interface, which may be located on the robotic arm, on the probe, or on the robotic arm control unit, may indicate distance, position, docked status, or other information. In some embodiments, the user interface may include one or more visual cues, such as LED indicators, to indicate the relative position and / or docking status of the arm and probe.

[0101] The coupling mechanisms shown in Figures 5A and 5B are described in relation to coupling a therapeutic probe to a first robotic arm, but substantially similar mechanisms can also be used to couple an imaging probe to a second robotic arm 444. For example, the coupling structure of the second robotic arm 444 may include a similar coupling mechanism for engaging with an attachment device connected to the imaging probe.

[0102] Figure 6 shows a method 600 for operating a robotic arm coupled to a therapeutic probe, according to several embodiments.

[0103] In step 605, the therapeutic probe is inserted into the patient manually, semi-automatically, or automatically, with a robotic arm on standby on one side of the patient. For example, with respect to a prostatectomy system, the therapeutic probe may be manually inserted into the patient's urethra toward the prostate. The therapeutic probe may be manipulated as it is advanced to follow the tortuous pathways of the urethra, prostate, and bladder neck. After entering the urethra, the therapeutic probe may be rotated (e.g., 90 degrees) before further advancement through the urethral bulb. Commands may be provided to the user to perform such a rotation, or, if the insertion is automatic or semi-automatic, the robotic arm may be commanded to perform such a rotation in response to image, position, and / or force feedback data. In some embodiments, the therapeutic probe is inserted into the patient in parallel with or after an imaging probe, and in some cases, the insertion of the therapeutic probe may be guided by image data from the inserted imaging probe.

[0104] In step 610, the robotic arm is coupled to the therapeutic probe. The user can manually align the robotic arm coupling structure to the attachment device of the therapeutic probe as described herein while the robotic arm remains in passive or "zero gravity" mode. The attachment device and the robotic arm coupling structure can then be used to mount the robotic arm to the therapeutic probe together.

[0105] In step 615, the permissible range of motion for the robotic arm is programmed. For example, the user can manually move, rotate, and angle the therapeutic probe while the probe is attached to the robotic arm and the robotic arm is still in passive mode, thereby setting boundaries for the permissible range of motion of the therapeutic probe. The user may set boundaries based on a combination of cystoscope, ultrasound, and tactile feedback. Alternatively, the boundaries may be based on biological structures such as anatomical models or tissue states. A processor operably coupled to the robotic arm can detect and store the boundaries for the permissible range of motion so that when the robotic arm is switched to active mode, it can use these boundaries to avoid movement outside the permissible range of motion.

[0106] In some embodiments, the therapeutic probe is manually inserted into the penile urethra and positioned with its distal end approximately 1 cm beyond the middle lobe and within the patient's bladder. The probe can be imaged using ultrasound, such as a TRUS probe. The image of the probe may show, for example, the probe manually positioned near its final location within the patient's biostructure, approximately 1 cm beyond the middle lobe in the bladder. In some embodiments, the range of motion is manually calibrated by the physician manipulating the probe parallel to the initial insertion angle at which the therapeutic probe docks upward within the pubic bone or urethral arch, and limiting its movement to a range of approximately 3 mm to 5 mm laterally in the X-plane and approximately 0 mm to 10 mm downward in the Y-plane. The trained movement with respect to the Z-plane (in and out of the patient) would be set to 0 cm inward toward the patient and full withdrawal outward from the patient. For example, a 30 cm probe may be retracted to 30+ cm to remove it from the patient, and much less to adjust the effective area for clinical treatment. Angularly, when measured from the physician's complete insertion position, the safe range of motion within the patient depends on tissue elasticity and anatomical structures such as bone structure. As an example of angular positioning with a fulcrum in the pelvic notch bone structure, the permissible angular range of movement can be set, for example, within a range of approximately 0 to + / - 5 degrees in the lateral X direction, within a range of approximately 0 to + / - 25 degrees vertically along the Y plane, or a combination of movements within these ranges depending on the patient's biomechanism.

[0107] Alternatively, or in addition, the boundary for the permissible range of motion of the treatment probe may be automatically or semi-automatically determined using one or more system processors in response to automatic analysis of image data of the target site from an imaging probe or other imaging source (e.g., cystoscope, external ultrasound source, CT scanner, MRI system, fluoroscopy system, etc.). Image data may be generated in real time. For example, one or more system processors may be instructed to recognize biological structures in the image data (e.g., prostate, external sphincter, seminal cumulus, bladder neck, etc.), if applicable, the treatment and / or imaging probe, and in response determine the boundary for the permissible range of motion. Alternatively, or in addition, the boundary for the permissible range of motion of the treatment probe may be automatically or semi-automatically determined using one or more system processors in response to position and / or force feedback data of the treatment probe from one or more position and / or force sensors on the treatment probe and / or the treatment probe robotic arm. For example, one or more force sensors on the treatment probe and / or the treatment probe robotic arm may provide tissue pressure data that can indicate an area where probe advancement is more restricted and presents a risk of tissue damage.

[0108] In some embodiments, the joint sensor within the robotic arm includes a force feedback sensor for detecting the force on the probe inserted into the patient. Alternatively, or in combination, sensors coupled to the processor may be located on one or more of the probes or at the interface between the probe and the robotic arm. For example, a probe sensor within the probe may sense the pressure near the distal end of the probe. The processor may consist of commands to adjust the distal end of the probe by translating or rotating in response to the sensed distal pressure. The sensor may include one or more multi-plane strain gauge elements positioned along the probe to sense the pressure of the probe against tissue. The processor may consist of commands to implement threshold limits and avoid undesirable tissue damage. The multi-plane strain gauge elements may include one or more of the following: an electrically conductive thin-film sensor, a semiconductor sensor, a piezoresistive sensor, a nanoparticle-based strain sensor, a capacitive sensor, an optical ring resonator, an optical fiber sensor, or a conductive fluid in an elastomer. In some embodiments, the probe shaft includes a spring constant and embedded strain gauges at periodic locations along the shaft for measuring axial pressure at specific points along the shaft and during bending. These sensor measurements can be combined with arm joint sensors. In some embodiments, the processor consists of commands to identify pressure resistance sources, such as bone constraints related to proximity to bone, robust tissue entry points, or the distal tip of the probe being pushed against internal bio-structural tissue. Alternatively, or in combination, the probe on the probe may comprise an elastomer tubular sheath having an exposed "touch area" coupled with a pressure sensor that reports information from elements such as a ring around the probe, a linear lateral structure, or a button sensor element near the distal end of the probe.

[0109] In step 620, the robotic arm is operated under computer control through user input. The user can control the movement of the robotic arm through inputs provided to the graphic user interface of the image-guided therapy system (e.g., user interface software provided through a therapy console as described herein). For example, the user can influence the rotation, translation, and / or pitch angle adjustment of the therapy probe. While in active mode, the robotic arm may be configured to move only within the boundaries of an allowable range of motion, such as set in step 615. While in active mode, the robotic arm may be configured to retract the therapy probe from the patient but not advance it into the patient, ensuring patient safety, and any advancement of the probe into the patient can be performed manually by the user. During probe retraction, the robotic arm may be programmed to maintain the probe on a linear track such that the z-axis position of the probe remains substantially constant. The robotic arm and therapy probe may be operated under computer control to perform a therapy protocol, which may be automated. In some embodiments, a tissue resection procedure is automatically planned based on image data from the imaging probe or other imaging source. For example, one or more system processors may recognize the prostate or other relevant biological structure and, in response to the location of the biological structure and probe, generate a treatment protocol, which may then be instructed to allow the user to modify and / or accept the treatment protocol before it is implemented by manipulating the robotic arm and / or treatment probe.

[0110] In step 625, the robotic arm is automatically operated under computer control to adjust the position of the treatment probe. The position of the treatment probe may be adjusted according to pre-programmed parameters, user commands, real-time feedback (e.g., from imaging, position, and / or force feedback data), or a combination thereof. For example, the imaging system may be configured to detect the location of the treatment probe during treatment using smart image recognition based on ultrasound images of the target site acquired, for example, using an ultrasound imaging probe. Based on the detected location of the treatment probe, the robotic arm may be operated to automatically adjust the position and / or orientation of the treatment probe to align it with the patient's target tissue and / or the imaging probe and / or to compensate for patient movement.

[0111] In step 630, the treatment probe is detached from the robotic arm. When the treatment procedure is complete, the user can detach the treatment probe from the robotic arm, manually move the robotic arm to the side, and then remove the treatment probe from the patient.

[0112] One or more steps of Method 600 may be carried out using a circuit as described herein, for example, one or more of the processors or logic circuits of the systems described herein. The circuit may be programmed to provide one or more steps of Method 600, and the program may include program instructions stored in computer-readable memory, or programmed steps of a logic circuit, such as one involving a programmable array logic or a field-programmable gate array.

[0113] The steps described above illustrate a method 600 for operating a robotic arm coupled to a therapeutic probe, according to several embodiments. Those skilled in the art will recognize many variations based on the teachings described herein. For example, the steps may be completed in a different order. One or more steps may be added or omitted. Some of the steps may include substeps. Many of the steps may be repeated as frequently as necessary or desired.

[0114] Figure 7 shows a method 700 for operating a robotic arm coupled to an imaging probe, according to several embodiments.

[0115] In step 705, the imaging probe is inserted into the patient manually, semi-automatically, or automatically, with a robotic arm on standby on one side of the patient. For example, in relation to an image-guided prostatectomy system, the imaging probe may comprise a TRUS probe and may be manually inserted into the patient's rectum. In some embodiments, the imaging probe is inserted in parallel with or before the treatment probe. The imaging probe may provide one or more images along the transverse plane. The imaging probe may provide one or more images along the sagittal plane, which may be generated as the imaging probe (and / or imaging transducer within the imaging probe) is advanced and / or retracted. The transverse and / or sagittal images may be combined to generate a three-dimensional image.

[0116] In step 710, the robotic arm is coupled to the imaging probe. For example, the robotic arm and the imaging probe may be coupled together using a coupling mechanism substantially similar to those described herein with reference to the therapeutic probe.

[0117] In step 715, the allowable range of motion for the robot arm is programmed. For example, the user can manually move, rotate, and angle the imaging probe while the probe is attached to the robot arm, with the robot arm still in passive mode, to set a boundary for the allowable range of motion of the imaging probe. The user may set the boundary based on a combination of cystoscope, ultrasound, and tactile feedback.

[0118] In some embodiments, the probe is manually positioned near its final location within the biological structure of the patient's rectum. The range of motion is manually calibrated by the physician, for example, by manipulating the probe approximately parallel to the initial insertion angle. The physician moves the inserted probe within the permissible range of motion, for example, with a boundary ranging from approximately 3 cm to approximately 5 cm along one or more of the lateral X-plane or the vertical Y-plane. In some embodiments, the physician moves the probe along the Z-plane (in and out of the patient). In some embodiments, the range of motion along the Z-plane may range from 0 cm inward toward the patient (0 to avoid rectal injury caused by accidental robotic movement) to complete withdrawal outward from the patient. For example, a 10 cm probe may be retracted 10+ cm to remove it from the patient. Angularly, measured from the physician's complete insertion position, the safe range of motion within the patient depends on anatomical structures such as tissue elasticity and bone structure. As an embodiment of angular positioning of a probe with a pivot point on a tissue surface (or alternatively, on a plane defined by bone structure), the allowable range of motion can be set to, for example, 0 degrees to approximately + / -15 degrees, or, for example, approximately 0 to approximately + / -30 degrees, in one or more of the X or Y planes. In some embodiments, the angular boundaries may have a combination of motions corresponding to traversing a cone within these boundaries.

[0119] A processor operably coupled to the robotic arm can detect and store boundaries for the permissible range of motion so that the robotic arm can use these boundaries to avoid movement outside the permissible range of motion when switched to active mode. Alternatively, or in addition, the boundaries for the permissible range of motion of the imaging probe may be determined automatically or semi-automatically using one or more system processors in response to automatic analysis of image data of the target site from the imaging probe or other imaging sources (e.g., cystoscope, external ultrasound source, CT scanner, MRI system, fluoroscopy system, etc.). Image data may be generated in real time. For example, one or more system processors may be instructed to recognize biological structures in the image data (e.g., prostate, external sphincter, seminal cumulus, bladder neck, etc.), if applicable, the treatment and / or imaging probe, and in response determine the boundaries for the permissible range of motion. Alternatively, or in addition, the boundaries for the permissible range of motion of the imaging probe may be automatically or semi-automatically determined using one or more system processors in response to position and / or force feedback data of the imaging probe from one or more position and / or force sensors on the imaging probe and / or the treatment probe robot arm. For example, one or more force sensors on the imaging probe and / or the imaging probe robot arm may provide tissue pressure data that indicates an area where probe advancement is more restricted and presents a risk of tissue damage.

[0120] In step 720, the robotic arm is automatically operated under computer control to scan the tissue. For example, during the planning of a treatment procedure, the robotic arm can be pre-programmed to automatically scan the target area and render a three-dimensional image of the target area. While in active mode, the robotic arm may be configured to move only within the boundaries of an allowable range of motion, such as set in step 715. While in active mode, the robotic arm may be configured to retract the treatment probe from the patient but not advance it into the patient, ensuring patient safety, and any advancement of the probe into the patient can be performed manually by the user. During probe retraction, the robotic arm may be programmed to maintain the probe on a linear track such that the z-axis position of the probe remains substantially constant.

[0121] In step 725, the robotic arm is operated under computer control through user input. The user can manipulate the robotic arm's movement through inputs provided to the graphical user interface of the image-guided therapy system (e.g., user interface software provided through a therapy or imaging console as described herein). For example, the user can influence the rotation, translation, and / or adjustment of the pitch angle of the imaging probe. While in active mode, the robotic arm may be configured to move only within the boundaries of an allowable range of motion, such as that set in step 715. While in active mode, the robotic arm may be configured to retract the therapy probe from the patient but not advance it into the patient, ensuring patient safety, and any advancement of the probe into the patient can be performed manually by the user.

[0122] In step 730, the robotic arm is automatically operated under computer control to adjust the position of the imaging probe. The position of the imaging probe may be adjusted according to pre-programmed parameters, user commands, real-time feedback (e.g., from imaging, position, and / or force feedback data), or a combination thereof. For example, the imaging system may be configured to detect the location of the treatment probe during treatment using smart image recognition based on ultrasound images of the target site acquired, for example, using an ultrasound imaging probe. Based on the detected location of the treatment probe, the robotic arm may be operated to automatically adjust the position and / or orientation of the imaging probe to align it with the treatment probe and / or to compensate for patient movement.

[0123] In step 735, the imaging probe is detached from the robotic arm. When the treatment procedure is complete, the user can detach the imaging probe from the robotic arm, manually move the robotic arm to the side, and then remove the imaging probe from the patient.

[0124] One or more steps of Method 700 may be carried out using a circuit as described herein, for example, one or more of the processors or logic circuits of the systems described herein. The circuit may be programmed to provide one or more steps of Method 700, and the program may include program instructions stored in computer-readable memory, or programmed steps of a logic circuit, such as programmable array logic or field-programmable gate array logic.

[0125] The steps described above illustrate a method 700 for operating a robotic arm coupled to an imaging probe, according to several embodiments. Those skilled in the art will recognize many variations based on the teachings described herein. For example, the steps may be completed in a different order. One or more steps may be added or omitted. Some of the steps may include substeps. Many of the steps may be repeated as needed or desired.

[0126] Figure 8A illustrates the configuration of a treatment probe 450 and an imaging probe 460 during treatment of a patient using a treatment system as described herein. In some embodiments, it is desirable to ensure that the treatment probe and imaging probe, outside the patient's body, do not collide with or otherwise interfere with each other during use of the system, thereby maintaining the precision of probe movement and the sterility of the system. Robotic arms, as described herein, coupled to the treatment probe and imaging probe and configured to control their movement, may be configured to maintain boundaries and prevent collisions or interference between the two probes. For example, one or both of the first robotic arm coupled to the treatment probe and the second robotic arm 444 coupled to the imaging probe may sense the distance 520 between the two probes and be configured to maintain the distance substantially constant or above a minimum threshold to prevent collisions. Alternatively, or in addition, as described with reference to the methods shown in Figures 6 and 7, the user may program an allowable range of motion for one or both of the treatment probe and imaging probe to set a boundary for the range of motion that would prevent collisions or interference between the probes.

[0127] For example, before the robot arm is switched to active mode, the user can program the allowable range of motion of the probes by rotating one or both probes within a range of a permissible pitch angle of 525, such that the two probes do not come into contact with each other within that range.

[0128] Referring to Figure 8B, the robotic arm 442 is coupled to a motor pack 802 as described herein. The motor pack 802 may be coupled to the handpiece of the probe 450. In some embodiments, one or both of the robotic arms coupled to the therapeutic probe and the imaging probe may be equipped with one or more feedback sensing mechanisms. For example, the first robotic arm 442 and / or the second robotic arm 444 may be operably coupled to a force sensor configured to detect compression of tissue in front of the therapeutic probe and / or the imaging probe. In some embodiments, the force exerted by the imaging probe is in the range of 0-4 kg exerted upward to compress tissue and achieve visualization of the therapeutic probe and the target tissue area. In some embodiments, the force exerted by the therapeutic probe is related to the position of the probe in a lumen such as the urethra. In some embodiments, the force is related to a fulcrum at the urethral notch and pivoting to lift the target biostructure. These forces may be in the range of 0-10 kg for bone structures and in the range of 0-2 kg for target biostructures such as the prostate.

[0129] According to some embodiments, one or more X-direction force sensors 810, one or more Y-direction force sensors 812, and / or one or more Z-direction force sensors 814 may be provided on a robotic arm 442, a handpiece 804, and / or a probe 450. One or more force sensors may comprise, for example, strain gauges, pressure sensors, or piezoelectric transducers. In some embodiments, the strain gauge comprises one of several configurations of a Wheatstone bridge. The Wheatstone bridge circuit converts small changes in resistance into a measurable voltage difference that may be equal to the applied force. The force sensors may be coupled to a handpiece such as any handpiece embodiment described herein. In some cases, one or more force sensors are operably coupled to an imaging probe, a therapeutic probe, or both.

[0130] In some embodiments, the circuitry for operating the force sensor is insulated and isolated from the imaging probe and the treatment probe. This allows the probe to meet any patient leakage current requirements, reduces any noise that may be picked up by the probe, and thus improves the signal-to-noise ratio (S / N) of the force sensor. In some embodiments, the signal wires from the force sensor may be twisted together and optionally shielded to maintain signal integrity, improve tolerance, and maintain a suitable S / N ratio. The force sensor may be formed from any suitable material, and in some cases, from a biocompatible material for any portion of the sensor that may come into contact with the patient before, during, or after treatment.

[0131] In some embodiments, one or more force sensors are sized to fit on or inside a probe shaft, such as an imaging probe or a treatment probe shaft. The force sensor may be configured with an arbitrary preferred strain sensitivity "k", which is a proportional factor between relative changes in resistance. The strain sensitivity is dimensionless and is a number called the gauge factor ("GF"). Linear pattern strain gauges may be used to measure strain in a single direction on a handpiece. Conductive signal wires may be bonded to the sensor's pads, which carry the signal to an input amplifier. One or more sensors may be bonded to one or more probes on a carrier substrate, which can insulate the sensors from any metal of the probe, such as a metal probe shaft.

[0132] The displacement of the handpiece in the Z direction can be detected by a spring and sensor 814. Using this configuration, the entire probe assembly may be able to slide a suitable distance and provide protection from the probe being driven into the tissue wall. The probe assembly may be arranged on a sliding trolley 820, which can be repelled by a simple spring to provide a constant and known force "K" spring constant. Accurate distance measurement of the handpiece, such as any displacement of the trolley, is possible over short distances with a suitable arrangement, such as less than 2 inches. Other position encoder linear sensors may be used in combination or as alternatives. For example, a linear variable differential transformer (LVDT), an electromechanical sensor used to convert mechanical motion into a variable current, can be used to measure resistance to the insertion force of the probe. This could be an optical encoder or one of several suitable inductive linear encoders. The sensor can measure force based on the inductive linear encoder 824 and may be arranged for non-contact to ensure high reliability. High-resolution encoders 824 may be provided for linear resolutions of about 15 micrometers with respect to digital encoders and about 54 micrometers with respect to analog encoders, etc.

[0133] One or more sensors may be provided on one or more robotic arms to measure position, orientation, force, or some other parameter. In some cases, two sensors may be part of the robotic arm assembly and may be used to determine unintentional movement. These sensors may be located in one or more joints of the robotic arm and may be internal encoders, which may be inertial measuring units (IMUs) 822. An IMU is an electronic sensor device that measures and orients one or more parameters such as force, angular factor, and / or orientation of a sensor and may use a combination of accelerometers, gyroscopes, and / or magnetometers. Some IMUs, suitable for integration into one or more robotic arms, may have a full acceleration range of ±2 / ±4 / ±8 / ±16g ("g" values related to acceleration due to gravity) and a wide angular factor range of ±125 / ±250 / ±500 / ±1,000 / ±2,000 / ±4,000 degrees / second ("dps"). The IMU can detect forces on a robotic arm and communicate the magnitude and / or direction of the external force to a computing device such as a robotic control system. One or more IMUs 822 can control one or more robotic arms and provide feedback which can be used to compensate for vibration, position recognition, and stabilization.

[0134] As described herein, the robotic arm 442 can be docked with the probe 450 by the use of sensors to assist in one or more of coarse alignment, intermediate alignment, and fine alignment. For example, the probe may be associated with a beacon 830, such as an IR beacon, and the robotic arm 442 may carry an IR receiver 832 that can detect emissions from the IR beacon 830 for coarse alignment. One or more alignment references 834 may be associated with the probe 450, and one or more alignment sensors 836 may be associated with the robotic arm 442. The alignment sensors 836 can detect the position of the alignment reference and thus determine the position of the robotic arm 442 relative to the probe 450, as described herein. In some embodiments, proximity sensors or proximity switches, such as Hall effect sensors, are used to detect alignment between the probe and the arm in order to engage the probe and the arm, for example, to lock the probe onto the arm when the arm is suitably operated to a fixed position.

[0135] In some embodiments, when treatment is complete, the arm can be detached from the probe while the user is holding the probe, and the arm can be withdrawn from the probe, for example, automatically withdrawn from the probe.

[0136] One or more computing devices operably coupled to the robotic arm (such as the processor of console 420 or console 490 as described herein) may include commands to control the movement of the robotic arm in response to forces detected by sensors, for example, to prevent excessive compression of the anterior tissue and the resulting damage to the tissue and / or probe. In an exemplary use case of a treatment system for prostate tissue resection, the treatment probe is ideally positioned anteriorly centered in the patient's prostatic cavity, but without excessive compression of the anterior prostate, preventing accidental injury to the urethra / prostate (e.g., excessive bleeding, necrosis, tissue perforation) and / or damage to one or both the imaging probe and / or the treatment probe. Similarly, the imaging probe, which may be a TRUS probe, is ideally positioned within the patient's rectum with sufficient anterior compression to visualize the prostate and / or the treatment probe, but without excessive compression of the tissue, so as to avoid accidental injury to the rectum (e.g., bleeding or tissue perforation) and / or damage to one or both the imaging probe and / or the treatment probe. A therapeutic probe, a first robotic arm coupled thereto, an imaging probe, and / or a second robotic arm 444 coupled thereto may be equipped with force sensors configured to detect anterior tissue compression using the probes. The detected force level is communicated to a processor operably coupled to the robotic arm and can be compared to a force threshold pre-programmed or stored in the memory of the computing system. If the detected force exceeds the threshold, the movement of the robotic arm may be adjusted to move the probe away from the anterior tissue, thereby at least partially relieving the compression of the anterior tissue.

[0137] Another exemplary feedback sensing mechanism may include position and / or motion sensors operably coupled to a first and / or second robotic arm 444. One or more computing devices operably coupled to the robotic arm may include commands to control the movement of the robotic arm in response to position and / or motion detected by the sensors, for example, to adjust the position of a therapeutic and / or imaging probe in response to patient movement during a therapeutic and / or scanning procedure. Patient movement while a rigid element such as a therapeutic or imaging probe is positioned inside the patient's body may potentially cause injury to the patient and may necessitate the removal of the probe during probe movement and subsequent repositioning. A robotic arm that automatically adjusts the probe position in response to sensed patient movement can improve the safety and efficiency of the procedure. One or more position or motion sensors, such as coils and / or accelerometers, may be attached to the patient, and the sensors may be operably coupled to a computing device that controls the robotic arm. The sensors may generate small local electromagnetic fields or other signals to help determine, for example, the patient's location and / or movement. The processor receives detected patient movement data and can adjust the movement of the robotic arm to substantially match the patient movement so that the probe attached to the robotic arm remains within an acceptable range of position relative to the tissue or patient organ. In some embodiments, the processor is configured to interrupt treatment if the force applied to the sensor exceeds a threshold amount.

[0138] Optionally, in some embodiments, the robotic arms may be configured to move automatically in a chain reaction. For example, if the user of the system moves the first robotic arm, the second robotic arm 444 may be configured to automatically adjust its position accordingly. In an exemplary use case of a treatment system for prostate tissue resection, the patient's prostate may be asymmetrical in its biological structure, and the user may need to adjust the position or orientation of the treatment probe accordingly (e.g., pushing the probe aside, adjusting the pitch angle of the probe, etc.). A robotic arm coupled to the imaging probe may be configured to automatically detect adjustments made to the robotic arm coupled to the treatment probe and to make corresponding adjustments to the position and / or orientation of the imaging probe. Such chained movement of the two robotic arms may be useful, for example, to maintain the treatment and imaging probes in a desired positional relationship relative to each other, with the extension axis of the treatment probe substantially aligned with the extension axis of the imaging probe.

[0139] Figures 9A–9C schematically illustrate the alignment of the treatment probe axis 451 of the imaging probe 460 with respect to the sagittal plane 950. Figure 9A is a side view of the treatment probe 450 inclined with respect to the imaging probe 460. The treatment probe 450 has an extension axis 451, and the imaging probe 460 has an extension axis 461 that provides a reference for the image generated by the imaging probe. The extension axis 461 can define the sagittal image plane 950 at least partially. Figure 9B is a top view of the treatment probe 450 substantially aligned with the sagittal image plane 950. When the treatment probe axis 451 is substantially aligned with the sagittal image plane 950, a substantial portion of the treatment probe is within the field of view of the ultrasound probe and is visible in the sagittal image. In some embodiments, two probes are substantially aligned when their extension axes are aligned within approximately 5 degrees of each other with respect to a plane perpendicular to the sagittal image plane. If there is a larger inclination angle between the probes, the treatment probe will extend across the field of view of the ultrasound probe, and only a portion of the probe within the field of view of the ultrasound probe will be visible in the ultrasound image.

[0140] When the probe is substantially aligned in the sagittal image plane but is tilted at an angle as shown in Figure 9A, the treatment probe and tissue may appear rotated in the sagittal image, and an acceptable amount of rotation may be greater than, for example, 5 degrees. Figure 9C is a top view of the treatment probe 450 crossing the sagittal image plane 950. When the imaging probe is not sufficiently aligned with the treatment probe, the treatment probe may appear distorted in the sagittal image, with only a portion of the treatment probe extending through the sagittal field in the image. In some embodiments, the treatment and imaging probes may be equipped with one or more sensors to confirm the desired alignment (parallel and / or coplanar) of the probes relative to each other. For example, the system may be equipped with a first orientation sensor 473 and a second orientation sensor 476 on the treatment probe 450 and imaging probe 460, respectively. In some embodiments, the first and second orientation sensors 476 comprise magnetic elements, Hall effect sensors, dials, variable resistors, potentiometers, accelerometers, or any combination thereof that can indicate the relative position and orientation of the probes to each other. In some embodiments, the sagittal plane angle of the ultrasound imaging probe can be rotated by rotating the ultrasound imaging probe around its extension axis. For example, in some patients, the prostate may be asymmetrical or the urethral notch may be deformed, and the imaging probe and treatment probe may be positioned opposite the patient or at least offset from each other with respect to the patient's midline, and rotation of the imaging probe around its extension axis can rotate the sagittal plane of the ultrasound probe, bringing the treatment probe and tissue treatment area into the field of view of the ultrasound imaging probe. The alignment, orientation, and relative positioning of the treatment and imaging probes may be continuously monitored during the treatment procedure.

[0141] When the treatment probe and imaging probe are sufficiently aligned, the user can align the treatment probe with the imaging probe by using the image of the treatment probe acquired with the imaging probe and providing user input in the GUI to control, for example, a robotic arm coupled to the treatment probe or imaging probe. Alternatively, or in addition, the robotic arm may be programmed to automatically adjust its movement and maintain the probe in sufficient alignment, as described herein. For example, when the user adjusts the position or orientation of the treatment probe by controlling a first robotic arm coupled to the treatment probe, a second robotic arm 444 coupled to the imaging probe may automatically detect the adjustment made to the first robotic arm and make corresponding adjustments to substantially match the pitch, roll, yaw, and / or linear position of the treatment probe along the treatment probe axis.

[0142] To provide automatic, synchronous movement of two robotic arms, a calibration step may be added to the treatment procedure, in which each arm identifies its position relative to the other arm. For example, each robotic arm may have a “target” on the arm at a known location, and during the calibration procedure, the user may operate the first arm and touch the target located on the second arm using the first arm coupling structure, and then operate the second arm and touch the target located on the first arm using the second arm coupling structure. Automatically synchronously moving the two robotic arms can thus facilitate the treatment procedure by eliminating the need for the user to separately adjust the movement of the second arm after moving the first arm. In addition, synchronous movement of the two arms can help improve the safety and efficiency of the treatment procedure when the patient moves while the probe is inserted into the patient's body, as described herein.

[0143] Optionally, in some embodiments, a robotic arm coupled to a treatment probe may be configured to move the treatment probe along a pre-programmed treatment profile for performing treatment on a target site. For example, the treatment profile may comprise a tissue excision profile of the target site, which is programmed by a user of the treatment system and stored in the memory of one or more computing devices operably coupled to the robotic arm. Further details regarding automated treatment using programmed treatment profiles can be found in PCT Publication WO2013 / 130895, which is incorporated herein by reference above.

[0144] Optionally, in some embodiments, a robotic arm coupled to an imaging probe may be configured to move the imaging probe along a pre-programmed imaging profile to generate a three-dimensional rendering of the target site before and / or during treatment with the treatment probe. A three-dimensional image of the target site may be derived from a two-plane imaging probe by 1) rotating the imaging probe in a fixed position with the imaging probe capturing a sagittal image of the target site, and then interpolating the sagittal image, or 2) translating the imaging probe across the target site (along the z-axis of the probe) with the imaging probe capturing a cross-sectional image of the target site, and then interpolating the cross-sectional image. To improve the efficiency of 3D image rendering and the resolution of the resulting 3D image, the robotic arm may be configured to rapidly scan the target site along a pre-programmed imaging profile, and the 3D image may be generated using software for rendering 3D images of the treatment site in substantially real time. A pre-programmed imaging profile may be stored in the memory of one or more computing devices and may comprise a series of sagittal scans taken at predetermined time intervals while the imaging probe rotates in a fixed position, and / or a series of transverse scans taken at predetermined time intervals while the imaging probe is translated across the target area (along the z-axis or extension axis of the imaging probe).

[0145] Automated computer-controlled scanning of a target site using an imaging probe with a robotic arm can also be used to generate useful information about the target site for additional treatment. For example, the imaging probe may be configured to perform a color / Doppler scan of the target site after a resection procedure to identify bleeding sites within the target site where hemostasis is required.

[0146] In some embodiments, the Doppler ultrasound image shows blood moving away from the ultrasound probe as blue and blood moving towards the ultrasound probe as red. In some embodiments, the tissue excision profile can be adjusted prior to tissue excision to reduce, and in some cases avoid, the excision of blood vessels present in the Doppler ultrasound image. For example, the ultrasound image may comprise a 3D ultrasound image and a 3D excision profile adjusted to reduce or avoid blood vessels.

[0147] Figure 10 illustrates the identification of a highly vascularized area 810 from an ultrasound image 800 of patient tissue 805. As described herein, a robotic arm coupled to the imaging probe may be automatically moved to acquire scans from the imaging probe while the imaging probe is operating in Doppler imaging mode. Highly vascularized areas 810 can be identified from the resulting Doppler scan image based on the detection of blood flowing closer to or further from the imaging plane of the imaging probe. In some cases, a highly vascularized area 810 may include a bleeding area, and based on the Doppler information, the user can efficiently identify and treat the bleeding by, for example, using a focus ablation device or hemostatic agents such as gels and substrates, thereby reducing bleeding, ablation time, and heat or other effects on the tissue. Highly vascularized areas 810 may also include, in some cases, abnormal or cancerous tissue growth. These areas may be flagged or identified for subsequent treatment. For example, normal tissue may be excised around abnormal tissue so that it leaves islands of abnormal tissue to be treated later using local drug delivery, etc.

[0148] Three-dimensional scanning of a target site using an imaging probe can also be used to identify tissue abnormalities in the target site, such as tumors. For example, a tumor may be identified from images of the target site acquired by automated scanning of the target site using an imaging probe, based on the difference between the hyperechoic and hypoechoic areas of the scanned tissue. Robotically controlled scanning of the target site can improve the speed of image analysis and, therefore, the accurate detection of tissue abnormalities. In addition, the imaging probe may be operated in Doppler imaging mode during automated scanning to identify areas of higher blood flow that may correspond to the location of potential cancer. Biopsies may be performed in identified areas of tissue to improve cancer detection.

[0149] Figures 11A, 11B, and 11C illustrate exemplary embodiments of a treatment system 1100, which includes a treatment table. System 1100 may comprise one or more components of system 400 and may include a probe mount and coupling structure on a swivel for coupling an arm to one or more of the imaging probes 460 and treatment probes 450 to the patient after one or more of the probes have been inserted into the patient. Figure 11A is a side view, Figure 11B is a front view of the treatment system 1100, and Figure 11C is a perspective view of the treatment system showing the positioning of patient P. Figures 11A-11C also show a three-dimensional coordinate system legend comprising the X, Y, and Z axes, each of which is perpendicular to the other, the X and Z axes are orthogonal horizontal axes, and the Y axis is a vertical axis, which aids in the visualization and explanation of system 1100. The treatment system 1100 may comprise a treatment probe 450, an imaging probe 460, a platform 1113, and a probe mounting and adjustment assembly 1120.The probe mounting and adjustment assembly 1120 includes a probe mount 1104, a swivel section 1105, a vertical turret 1106, a first horizontal slider 1107 for translating the vertical turret 1106 along a first Z translation direction 1133 (i.e., along the Z axis or an axis parallel thereto), a pair of first horizontal arms 1108 oriented along the Z direction, a pair of vertical arms 1111 oriented along the Y direction (i.e., along the Y axis or an axis parallel thereto), a pair of first locking mechanisms 1110 for the pair of vertical arms 1111, and for translating the pair of vertical arms 1111 along a second Z translation direction 1131 (i.e., along the Z axis or an axis parallel thereto). The patient support, such as a platform 1113, may include a pair of second horizontal sliders 1112 and a pair of second horizontal sliders 1112 coupled thereto; a pair of second horizontal arms 1114 oriented along the X direction, each second horizontal arm 1114 coupled to a first horizontal arm 1108; a pair of second locking mechanisms 1115 for the pair of first horizontal arms 1108; a horizontal adjuster 1116 for a vertical turret 1106; a third locking mechanism 1117 for the vertical turret 1106; and a third horizontal slider 1118 for translating the first horizontal slider 1107 in a first X translation direction 1136 (i.e., along the X axis or an axis parallel thereto). These arms, sliders, and locking mechanisms may be operated or repositioned by robotic control or manually, or one or more of them. The treatment probe 450 and the imaging probe 460 may be aligned so as to be parallel to each other or in one or more planes, as described herein. The treatment probe 450, the imaging probe 460, one or more of the various arms, various sliders, or various mechanisms may be covered with one or more protective drapes to facilitate the provision of a sterile surgical environment or to minimize subsequent cleaning for the various components of the system 1100.

[0150] The treatment probe 450 and the imaging probe 460 may be aligned substantially vertically and rigidly (e.g., rigidly) and adjustable to one or more probe-binding mounts 1104, the probe-binding mounts 1104 may rotate about an axis defined by the swivel section 1105 in a first rotational direction 1135 (i.e., about the X-axis or an axis parallel thereto) relative to the vertical turret 1106, such as in the YZ plane (or a plane parallel thereto) as shown in Figures 11A-11C. In some embodiments, the position of the extension axis 451 of the treatment probe 450 relative to the extension axis 461 of the imaging probe 460 may be set by adjusting the position of the treatment probe 450 relative to the probe mount 1104 and by adjusting the position of the imaging probe 460 relative to the probe mount 1104. In some embodiments, each of the therapeutic probe 450 and the imaging probe 460 is detachably mounted on the probe coupling mount 1104 by fasteners comprising screws, nuts, washers, bolts, pins, swivels, hinges, bearings, clamps, straps, thumb screws, latches, collets, dovetails, channels, springs, magnets, threads, keys, slots, gears, pulleys, racks, pinions, or any combination thereof. In some embodiments, the therapeutic probe 450 is detachably mounted on the first probe coupling mount 1104, and the imaging probe 460 is detachably mounted on the second probe coupling mount 1104. In some embodiments, the probe coupling mount 1104 comprises electrical connectors for transmitting power and / or data to or from the therapeutic probe 450 and / or the imaging probe 460 to a computer or processor. In some embodiments, the probe coupling mount 1104 comprises hose connectors for transmitting liquid and / or gas to the therapeutic probe 450. In some embodiments, the fasteners, electrical connectors, and hose connectors comprise a single component. In some embodiments, the fasteners and electrical connectors comprise multiple components.In some embodiments, the position of the therapeutic probe 450 relative to the probe mounting mount 1104 and the position of the imaging probe 460 relative to the probe mounting mount 1104 are adjusted manually, by a driven actuator, or both. In some embodiments, the position of the therapeutic probe 450 relative to the probe mounting mount 1104 and the position of the imaging probe 460 relative to the probe mounting mount 1104 are adjusted by thumb screws, swivels, hinges, pins, slots, bearings, pulleys, racks, pinions, linear actuators, motors, solenoids, or any combination thereof.

[0151] In some embodiments, the probe coupling mount 1104 further includes a manual operating feature that allows a user to manually manipulate its position. In some embodiments, the manual operating feature comprises a handle, knob, hilt, bar, grip, or any combination thereof.

[0152] In some embodiments, the probe coupling mount 1104 can rotate at least about 315 degrees, at least about 300 degrees, at least about 280 degrees, at least about 260 degrees, at least about 240 degrees, at least about 220 degrees, at least about 200 degrees, at least about 180 degrees, at least about 160 degrees, at least about 140 degrees, at least about 120 degrees, at least about 100 degrees, or at least about 80 degrees around a first rotation direction 1135.

[0153] In some embodiments, the probe coupling mount 1104 further includes cable guides, cable relief members, slip rings, or any combination thereof for restraining and protecting any cables exiting from the treatment probe 450 or imaging probe 460.

[0154] In some embodiments, the substantially vertical turret 1106 can also extend and retract in a first Y translation direction 1132 (i.e., along the Y axis or a parallel axis) to set the height of the probe mount 1104 relative to a first horizontal slider 1107. The turret may be equipped with extension joints to enable extension and retraction, such as telescopic sliding tubes or threaded assemblies, and combinations thereof. In some embodiments, the position of the vertical turret 1106 is adjusted manually, by a driven actuator, or both. The rotation of the probe mount 1104 relative to the vertical turret 1106 can be controlled by robotic control or set manually. In some embodiments, the rotation of the vertical turret 1106 about its vertical axis of symmetry to a second rotation direction 1134 (i.e., about the Y axis or a parallel axis) can be set and locked by a third locking mechanism 1117. In some embodiments, a pair of first horizontal sliders 1107 are capable of translating the treatment probe 450 and imaging probe 460 toward or away from the patient P. In some embodiments, the first horizontal sliders 1107 include a manual actuator, a driven actuator, or both. In some embodiments, the position of the vertical turret 1106 toward or away from the patient is modified by the horizontal sliders 1107. A horizontal adjuster 1116 is capable of translating the robotic arm in the X direction across the patient support. The horizontal adjuster 1116 can be operated by a manual actuator, a driven actuator, or both.

[0155] In some embodiments, a third horizontal slider 1118 allows for the parallel movement of the first horizontal slider 1107, and thus the treatment probe 450 and imaging probe 460, horizontally (i.e., along the X-axis) toward the left or right side of the patient, and one or more third locking mechanisms 1117 can engage and disengage the ability of a vertical turret 1106 to parallel move horizontally along the third horizontal slider 1118. In some embodiments, each end of the third horizontal slider 1118 is attached to a second horizontal arm 1114, each second horizontal arm 1114 may be attached perpendicularly to a first horizontal arm 1108, and each first horizontal arm 1108 may be attached perpendicularly to a vertical arm 1111. In some embodiments, each vertical arm 1111 is attached to a second horizontal slider 1112 on a platform 1113, the second horizontal slider 1112 is capable of translating one or more vertical arms 1111 horizontally (i.e., along the Z-axis) toward or away from the patient, and one or more first locking mechanisms 1110 set the position of one or more vertical arms 1111 relative to the platform 1113.

[0156] In some embodiments, one or more exemplary embodiments of the components of the treatment system 1100 consist of metal, plastic, textile, cloth, foam, wood, carbon fiber, fiberglass, glass, or any combination thereof.

[0157] In some embodiments, the vertical turret 1106, the first horizontal slider 1107, the second horizontal slider 1112, and the third horizontal slider 1118 comprise actuators, bearings, shafts, worm drives, racks, pinions, gears, belts, chains, pulleys, slides, collars, shafts, or any combination thereof. In some embodiments, at least one of the vertical turret 1106, the first horizontal slider 1107, the second horizontal slider 1112, and the third horizontal slider 1118 further comprises an encoder, the encoder measuring translational or rotational displacement.

[0158] In some embodiments, the first locking mechanism 1110, the second locking mechanism 1115, and the third locking mechanism 1117 include a cam, a screw, a handle, a knob, a shaft, a clamp, or any combination thereof.

[0159] In some embodiments, each of the sliders, turrets, and vertical extension couplings is equipped with an actuator coupled to a processor to control the position and angle of the coupling structure. In some embodiments, the coupling between the horizontal arm 1108 and the second horizontal arm 1114 is equipped with an electric coupling. In some cases, the electric coupling is under the robotic control of the processor and can be operated to move hardware out of the way, assist in patient extraction from a patient support, etc.

[0160] In some embodiments, the system comprises a chain connected to a processor, the chain comprising one or more of a slider, a turret, and a vertical extension coupling. Each of these one or more components may include an actuator, which is connected to the processor to control the position and angle of the coupling structure on the arm in response to a control signal from the processor.

[0161] The arm may, for example, comprise multiple arms and sliders.

[0162] In some embodiments, one or more of the exemplary embodiments of the treatment system 1100 components may be disassembled, portable, or both. In some embodiments, the treatment system 1100 further comprises cable management members, wheels, footrests, power supplies, mounting members, or any combination thereof.

[0163] One or more image sensors 1145 may be provided at one or more locations around the treatment system 1100, and may be provided on the first and / or second horizontal arms. One or more image sensors may be used to obtain images of reference markers on the imaging probe 460 or the treatment probe 450 or both, to assist in the alignment and / or docking of the robot arm with the probe, or to detect the position, orientation, or alignment of the probe. A user interface 1140 may be provided on the robot arm, the probe, or both to indicate the docked status of the robot arm with the probe. In some cases, the user interface is one or more visual indicators, such as LED indicators. One or more visual indicators may convey additional operational or status information of the robot arm or probe.

[0164] Figure 12 illustrates an exemplary embodiment of a treatment system 1200, which includes a treatment platform. System 1200 may comprise one or more components of system 400 or system 1100 as described herein. Figure 12 is a perspective view of the treatment system 1200. The treatment system 1200 may comprise a treatment cart 1210. The cart 1210 may comprise a housing 1213, a common robot arm 1214 capable of one or more rotations or translations relative to the housing 1213, a fluid container hanger 1215, a fluid container 1216 for saline solution or the like, a push handle 1217, one or more wheels 1218, a support 1219, one or more display screens 1220, a treatment probe robot arm 442 capable of one or more rotations or translations relative to the common robot arm 1214, a treatment probe 450 coupled to the treatment probe robot arm 442, an imaging probe robot arm 444 capable of one or more rotations or translations relative to the common robot arm 1214, and an imaging probe 460 coupled to the imaging probe arm 444.

[0165] In some embodiments, the treatment probe robot arm 442 and the imaging probe robot arm 444 work in conjunction with the common robot arm 1214 to position the treatment probe 450 and the imaging probe 460, respectively, in alignment with each other (i.e., parallel and / or coplane alignment). In some embodiments, the housing 1213 contains a power supply, a pressure source, communication components, power cables, medications, or any combination thereof. In some embodiments, the common robot arm 1214 can pivot or translate with about one or more degrees of freedom relative to the housing 1213. In one embodiment, the common robot arm 1214 can pivot about a vertical axis perpendicular to the floor at an angle of about 220 degrees. In some embodiments, the common robot arm 1214 can extend and retract. In some embodiments, the cart 1210 is portable and may include a push handle 1217, one or more wheels 1218, and a support 1219 for maintaining the stability of the cart 1210 during patient treatment. In some embodiments, the cart 1210 further includes a fluid container hanger 1215 capable of supporting a saline or fluid container 1216 for storing a certain amount of fluid or saline for use with a treatment probe 450, which can provide a pressurized fluid jet for tissue excision. In some embodiments, the cart 1210 further includes one or more screens 1220 capable of displaying information to the physician or patient from an imaging probe 1202 or other source. In some embodiments, the treatment system 1200 further includes containers for storing the removed tissue and used saline.

[0166] Figure 13 illustrates an exemplary embodiment of the probe mounting and adjustment assembly 1600. The probe mounting and adjustment assembly 1600 is attached to a patient support by a plurality of clamps 1302. According to some embodiments, the patient support is a bed, table, or platform, and the clamps are attached to the patient support by mechanical fastening to the patient support, etc. The probe mounting and adjustment assembly 1600 may include two, three, four, six, or more clamps 1302 for attachment to the patient support. In some embodiments, the mounting assembly 1600 supports the first robotic arm 442 using the mounted first probe 460 and the second robotic arm 444 using the mounted second probe 450, in a substantially "collision-proof" configuration, such that a collision between the mounting assembly 1600, the first robotic arm 442, the first probe 460, the second robotic arm 444, or the second probe 450 by a medical professional results in a clinically acceptable amount of movement to the probe inserted into the patient, e.g., movement of about 5 mm or less.

[0167] The mounting assembly 1600 can be configured in many ways, but in some embodiments, the mounting assembly is configured to limit the movement of the extension support 1310 relative to the first and second rails to 5 mm or less in response to a 150 kg load on the extension support 1310, for example, the crossbar 1310.

[0168] As used herein, the terms “extension support” and “crossbar” are used synonymously. In some embodiments, the movement is 3 mm or less in response to a 100 kg load on the extension support 1310. In some embodiments, the extension support 1310, the first clamp 1302, the first arm 442, the second clamp 1304, and the second arm 444 may be configured to limit the movement of the extension support 1310 to 5 mm or less in response to a 150 kg load on the extension support 1310, and the movement may be 3 mm or less in response to a 100 kg load on the extension support 1310. In some embodiments, the probe to be inserted into the patient has a distance in the range of about 20 cm to about 60 cm, and the mounting assembly 1600 is configured to move the distal end of the probe to 6 mm or less in response to a load on the extension support 1310.

[0169] The probe mounting and adjustment assembly 1600 may be a modular system comprising a collapsible universal operating table mounting system and a pair of lockable positioning arms disposed on the universal mount. The universal mount is easy and intuitive to adjust and fits most commonly used operating tables, including tables with different sized mounting rails, variable table widths, and removable and foldable leg supports. This provides a rigid platform in which the mounting arms 1312, 1314 are optimized for weight, stiffness, fluid movement, and range of motion, offering superior surgical planning capabilities.

[0170] The two mechanical arms 442 and 444 enable smooth fluid motion within a defined surgical planning field. They assist in probe alignment, streamline surgical planning, provide tactile feedback of the patient's biostructure, and minimize the risk of injury. When locked, the mechanical arms 442 and 444 provide a rigid interface that allows the operator to hold both imaging and therapeutic probes to which they wish to be positioned. Between procedure setup and disassembly, the probe mounting and adjustment assembly 1600 can be disassembled into compact, easily manageable components that can be deployed by a single person and mounted in / on top of the console for storage.

[0171] According to several embodiments, the probe mounting and adjustment assembly 1600 comprises two similar, for example, substantially identical rail clamps 1302, 1304 and a crossbar 1310. The rail clamps 1302, 1304 can be adjusted and set to fit all commonly used table rail sizes and to be deployed / removed by a simple throw of a lever 1406. The lever 1406 is the primary touch point of the rail clamps, allowing them to be deployed with one hand in a single motion. The crossbar 1310 docks into the two receptacles 1316 of the rail clamps 1302, 1304 to complete the table mounting system and folds flat for storage. This is deployed by squeezing two control triggers, one in each hand. The control triggers release the angle swivel, which allows for folding for storage as well as fine width adjustment for mounting on a patient support. The control triggers also release the mechanism that secures the crossbar 1310 to the rail clamps. According to some embodiments, the mechanism on the crossbar 1310 self-engages and self-locks when pushed into a fixed position, minimizing the possibility of improper assembly. The crossbar 1310 may also have a width adjustment mechanism for coarse adjustment to different operating table widths. The components can be positioned symmetrically to produce an isosceles trapezoidal geometric shape relative to the OR table. In some embodiments, the rail clamps 1302, 1304 may be positioned at different Z positions, and the patient may be positioned at different X positions, angled on the table at a Z' angle, producing multiple asymmetries. The design of the mounting assembly 1600, including the rail clamps 1302, 1304, the rail clamp receptacle 1316, the lockable crossbar mounting arms 1312, 1314, and the crossbar 1310 (including arm rotation around the Y axis), provides adjustment of the arm structure, enabling precise positioning of the imaging probe 460 and the treatment probe 450 to adapt to all variables of equipment setup, patient biomechanism, and patient position.

[0172] According to some embodiments, the mechanical arms 442, 444 comprise two similar arms (e.g., substantially identical arms) and a lateral adjustment mechanism. Each arm may comprise three rotatable / locking joints connected together by arm segments, a bottom-top interface for secure mounting to the crossbar 1310, and a top-top control handle 1318 and stepper mount 1320. The joints may be configured to rotate about the X-axis. The control handle 1318 is the primary touch point for operation, enabling one-handed positioning and adjustment of each probe 450, 460. The stepper mount 1320 provides a drape-safe interface for mounting steppers, used for fine control of the imaging probe 460 and the therapeutic probe 450. Each mechanical arm 442, 444 may be covered with surgical draping to minimize contamination and simplify post-procedure cleaning. The control handle 1318 may have a two-stage operating mechanism, namely a first stage for simultaneously disengaging all couplings and holding them in the disengaged state, and a second stage for re-engaging the system when in the desired position. This can reduce the need to hold each arm in a tight grip during operation for improved feel and more precise control. In some embodiments, the control handle 1318 includes a handle for operating the robot arm, and a button or switch engages or disengages the locking mechanism in the coupling, enabling or disabling manual operation of the robot arm.

[0173] Clamps 1302 and 1304 are connected to the receptacle 1316 by a clamp coupling 1324. The clamp coupling 1324 allows for degrees of freedom between the clamp 1302 and the receptacle 1316, thereby allowing adjustment of the orientation or position of the clamp 1302 and facilitating tightening to the patient support. The receptacle 1316 is connected to the mounting arm 1312. In some embodiments, the receptacle 1316 is coupled to the receptacle 1316 by defining a recess and the mounting arm 1312 fitting inside the recess, and can be secured through any preferred mechanical interaction such as a ball stopper, friction fit, positioning screw, thumb screw, keyway, projection and pocket, pin, interference structure, or some other preferred connection structure. In some embodiments, the mounting arm 1312 is equipped with a lever that pivots a locking pin, enabling a secure connection between the mounting arm 1312 and the receptacle 1316. In exemplary use, according to some embodiments, the mounting arm 1312 may be inserted into a recess of the receptacle 1316, and the locking pin may retract as the mounting arm 1312 engages with the inner surface of the receptacle 1316. In response to full insertion, the locking pin or other projection structure may be biased to extend away from the mounting arm 1312, snap outward from the mounting arm into a recess, cavity, hole, or pocket formed in the receptacle 1316, thereby securely connecting the mounting arm 1312 to the receptacle 1316. A lever on the mounting arm 1312 may be coupled to the projection structure so that when the lever is pressed down, the projection structure is pulled into the mounting arm 1312, thereby facilitating the withdrawal of the mounting arm 1312 from the receptacle 1316.

[0174] The mounting arm 1312 is connected to the crossbar 1310 by a crossbar coupling 1326, etc. The crossbar coupling 1326 may allow pivoting movement between the mounting arm 1312 and the crossbar 1310. As shown in the figure, a pair of mounting arms 1312, 1314 may be connected to the crossbar 1310 at either end of the crossbar 1310. The pair of mounting arms 1312, 1314 may rotate or pivot about the crossbar coupling 1326 to vary the distance between clamps 1302, 1304. In this way, the distance between clamps 1302, 1304 can be adjusted to fit onto patient supports of various different sizes.

[0175] The crossbar 1310 supports the mechanical arm base 1328. The mechanical arm base 1328 may be slidably connected to the crossbar 1310, allowing it to slide along the X-axis and move horizontally from side to side relative to the patient. The mechanical arm base 1328 may be fixed to the crossbar 1310 in any preferred way, such as by screws, thumb screws, cams, levers, locks, twist locks, or any preferred structure for fixing the mechanical arm base 1328 to the crossbar 1310.

[0176] The mechanical arm base 1328 provides mounting points for one, two, or more mechanical arms 442, 444. As shown, in some embodiments, two mechanical arms are connected to the mechanical arm base 1328. The mechanical arms 442, 444 can be connected by any type of secure connection, such as screws, slide locks, clips, or other suitable connectors. The components of the probe mounting and adjustment assembly 1600 can be formed from any suitable material, and in some embodiments, one or more components are formed from a metal such as stainless steel, titanium, tantalum, platinum, palladium, or any suitable alloy. The components of the probe mounting and adjustment assembly 1600 may be formed from any suitable polymer, such as, or in addition to, polyvinyl chloride (PVC), polypropylene (PP), polyethylene (PE), polystyrene (PS), and one or more of nylon, polyethylene terephthalate (PET), polyimide (PA), polycarbonate (PC), acrylonitrile butadiene (ABS), polyetheretherketone (PEEK), or polyurethane (PU).

[0177] In some embodiments, the clamp 1302, clamp coupling 1324, receptacle 1316, mounting arm 1312, crossbar coupling 1326, crossbar 1310, mechanical arm base 1328, or mechanical arm 444 comprises actuators, bearings, shafts, worm drives, racks, pinions, gears, belts, chains, pulleys, slides, collars, shafts, or any combination thereof. In some embodiments, at least one of the clamp 1302, clamp coupling 1324, receptacle 1316, mounting arm 1312, crossbar coupling 1326, crossbar 1310, mechanical arm base 1328, or mechanical arm 444 comprises an encoder, the encoder measures translational or rotational displacement or position.

[0178] The mechanical arm 442, 442 may comprise one or more segments separated by joints that provide degrees of freedom between the segments. For example, the mechanical arm may have two, three, four, or more segments 1330, each connected to one another by joints 1332 that allow relative pivoting or rotational movement between adjacent segments 1330. The mechanical arm itself may be connected to the mechanical arm base 1328 by joints that allow rotation of the mechanical arm about one or more axes.

[0179] A mechanical arm 442 carries a probe mount 1334 on which a probe 450 can be mounted. As shown in the figure, the first mechanical arm 442 carries an imaging probe 460, and the second mechanical arm 444 carries a treatment probe 450. In some embodiments, the probe mount 1334 includes a riser 1336 configured to raise probes such as the treatment probe 450 in the Y direction so that the treatment probe 450 is higher than the imaging probe 460. Thus, when the treatment probe 450 and the imaging probe 460 are aligned perpendicularly to each other, the riser 1336 facilitates the treatment probe 450 avoiding contact with the imaging probe 460 as they are separated perpendicularly from each other.

[0180] The treatment probe 450 has an extension axis along its shaft, and similarly, the imaging probe 460 has an extension axis along its shaft. In some configurations, the treatment probe axis and the imaging probe axis are aligned in a plane; that is, the axes are parallel to each other and therefore coplane. In some embodiments, the configuration of the mechanical arms 442, 444 and the probe mount 1334 allows the treatment probe axis and the imaging probe axis to be positioned coplane with each other in a vertical plane. In other words, the two axes can be aligned vertically such that one probe is directly above the other probe.

[0181] According to some embodiments, the probe is movable within the surgical planning field in the X, Y, and Z directions and rotates about any of these axes. In some cases, the imaging probe 460 and the treatment probe 450 are independently positionable in the YZ plane, and in other cases, there is limited relative movement along the X axis. According to some embodiments, the imaging probe 460 has a limited range of translational movement, which in some cases is about ±2 inches from the center position in the X direction, -3 to +4 inches in the Y direction, -9 to +2 inches in the Z direction (and a further 100 mm in the Z direction with fine control of the stepping motor). The imaging probe 460 may have a limited range of rotational movement, which in some embodiments can be rotated any of 0° to about 45° around the X axis, ±15° around the Y axis, and ±32° around the Z axis.

[0182] According to some embodiments, the treatment probe 450 may have a limited range of motion, which may be approximately ±2 inches from the center along the X-axis, 3 to 12 inches from the top of the patient support, and -9 to 2 inches in the Z-direction (and approximately 100 mm further under stepping motor control). In some embodiments, the treatment probe 450 may be rotated approximately ±30° around the X-axis, approximately ±15° around the Y-axis, and with very slight adjustments around the Z-axis, etc.

[0183] The mechanical arm may also be equipped with a control handle 1318. According to some embodiments, the control handle 1318 is coupled to one or more of the mechanical arms, allowing an operator to manually position the mechanical arms 442, 444 and, consequently, the probe carried by the mechanical arms. The control handle 1318 may be any preferred configuration that provides a method for manually adjusting or moving the mechanical arm. In some embodiments, the control handle 1318 includes a lever that disengages a clutch in one or more of the couplings that separate segments of the mechanical arm. In some cases, the lever of the control handle 1318, when pressed, disengages one, two, three, or more couplings, allowing the couplings to swivel, rotate, or perform some combination that enables the operator to manually position the mechanical arm. The control handle 1318 may be connected to or formed integrally with the probe slider 1340. The probe slider 1340 allows the imaging probe 460 or the treatment probe 450, or both, to move substantially in and out of the patient in the Z-direction. The probe slider 1340 may be manually operated, robotically controlled, or a combination of both.

[0184] During use, clamps 1302 and 1304 are coupled to a patient support. In some cases, the patient support is a bed, and there may be two, four, six, or more clamps coupled to it. The clamps may include clamp adjusters 1342 that allow the jaws within the clamp to separate. A handle 1408 on each clamp is operated by the operator, and the jaws of the clamp firmly grip the patient support. The receptacle 1316 can be operated to position it in an orientation configured to couple with the mounting arm 1312 of the probe mounting and adjustment assembly 1600. The mounting arms 1312 and 1314 are then coupled to the receptacle 1316 and secured to the mounting arm in any preferred manner.

[0185] The crossbar 1310 can be connected to the mounting arm 1312; however, in some embodiments, the crossbar 1310 and the mounting arms 1312, 1314 are not detachable from each other, and the coupling of the mounting arms to the receptacle 1316 positions the crossbar 1310 in the appropriate position for patient treatment. Once the crossbar 1310 is in position, the mechanical arms 442, 444 can be fixed to the mechanical arm base 1328 of the crossbar 1310. The imaging probe 460, the treatment probe 450, or both are then coupled to the probe mount 1334. The operator can then manually operate the mechanical arms 442, 444, for example, by using the control handle 1318, to position the imaging probe 460 and the treatment probe 450.

[0186] The mechanical arms 442, 444 can then be controlled by robotic control or manually during part or all of the procedure. In some embodiments, the mechanical arms 442, 444 are placed in a starting position. The modular nature of the probe mounting and adjustment assembly 1600 allows the components to be isolated, easily managed, and individually configured. The illustrated configuration further enables treatment planning and smooth tactile positioning and adjustment of the probes by automatically aligning the imaging probe 460 and the treatment probe 450 in the same plane. Furthermore, in some embodiments, the mechanical arms enable positioning and compression adjustment of the probes, while stepping motors in the joints enable computer-controlled Z-direction positioning and angle adjustment of the probes. In some embodiments, the description refers only to the mechanical arm 442, mounting arm 1312, and associated hardware components, but it should be understood that additional mechanical arms may have the same or similar hardware.

[0187] Figures 14A, 14B, and 14C illustrate exemplary embodiments of a clamp 1302 that can be used in conjunction with a probe mounting and adjustment assembly 1600. The clamp 1302 has a fixed jaw 1402, a movable jaw 1404, and a lever 1406 that varies the distance between the fixed jaw 1402 and the movable jaw 1404. The lever 1406 includes a handle 1408 configured for gripping and operating the clamp. The lever 1406 is mechanically coupled to the movable jaw 1404, and when the handle 1408 is in an upward position relative to the clamp 1302, the jaws are separated, and as the lever 1406 is moved downward relative to the clamp 1302, the movable jaw 1404 is brought closer to the fixed jaw 1402 from a first position 1410 to a second position 1412. In some cases, both the upper jaw 1402 and the lower jaw 1404 are movable relative to each other, but in the illustrated embodiment, the upper jaw 1402 is shown as fixed and the lower jaw 1404 is movable.

[0188] The clamp 1302 includes a clamp coupling 1324 that attaches the clamp to the receptacle 1316. In some embodiments, the receptacle 1316 has a recess 1420 configured to receive a portion of the mounting arm 1312 and to facilitate secure attachment between the receptacle 1316 and the mounting arm 1312. The clamp coupling 1324 provides rotational movement of the receptacle 1316 relative to the clamp 1302. This allows the clamp 1302 to be coupled to the patient support at any angle or configuration, and allows the receptacle 1316 to orient in a preferred direction and receive the mounting arm 1312. The illustrated embodiment shows a rotational coupling between the receptacle 1316 and the clamp 1302, but other forms of attachment, such as ball socket joints, hinges, swivels, or other structures that allow the receptacle to move relative to the clamp 1302, may also be considered.

[0189] A clamp adjuster 1342 is provided to provide initial adjustment of the clamp 1302. For example, the clamp adjuster 1342 can be used to move the movable jaw 1404 to a first position 1410. A handle 1408 can then be used to move the movable jaw 1404 to a second position 1412, so that the patient support is gripped between the fixed jaw 1402 and the movable jaw 1404. If the grip on the patient support is not sufficiently tight, the clamp 1302 can be disengaged from the patient support, and the clamp adjuster 1342 can be used to reposition the movable jaw 1404 to the first position 1410. A lever 1406 can then be used to move the movable jaw 1404 to a second position 1412, so that the fixed jaw 1402 and the movable jaw 1404 are tightly engaged on the patient support. As used herein, the first position 1410 of the movable jaw 1404 is associated with the clamp in the disengaged configuration, and the second position 1412 of the movable jaw 1404 is associated with the clamp in the engaged configuration. The clamp adjuster 1342 can be used to vary the first position 1410, which has the effect of varying the clamping force when the movable jaw 1404 is moved to the second position 1412.

[0190] Figures 15A, 15B, 15C, and 15D illustrate the internal structure of an exemplary clamp 1302, which can be used in conjunction with embodiments of the probe mounting and adjustment assembly 1600 described herein. Figures 15A and 15B illustrate the clamp in the disengaged configuration, and Figures 15C and 15D illustrate the clamp in the engaged configuration. The clamp 1302 includes a lever 1406 with a handle 1408 formed therein. The lever 1406 is pivotably coupled to the fixed jaw 1402 by a lever shaft 1502 and is configured to pivot between an upper disengaged position and a lower engaged position. The lever shaft 1502 is coupled to a lever arm 1504, which in turn is coupled to an adjuster block 1506. The adjuster block 1506 is connected to the adjuster column 1508 by forming internal threads on the adjuster block 1506 that cooperate with threads formed on the adjuster column 1508.

[0191] In some embodiments, the lever shaft 1502 is pivotably connected to the lever arm 1504 at the upper lever arm coupling 1510 and pivotably connected to the adjuster block 1506 at the lower lever arm coupling 1518, so that movement of the lever 1406 around the lever shaft 1502 causes movement of the upper lever arm coupling 1510 around the lever shaft 1502. The lever arm 1504 is pivotably connected to the adjuster block 1506, so that pivotal movement of the lever arm 1504 around the lever shaft 1502 causes translation of the adjuster block 1506, and consequently translation of the adjuster support 1508.

[0192] The movable jaw 1404 has a through-hole that captures a pair of jaw supports 1512, allowing the movable jaw 1404 to slide across the jaw supports 1512. The jaw supports 1512 extend between the clamp base 1514 and the fixed jaw 1402. The adjuster block 1506 includes a jaw mover 1516 projection configured to contact the movable jaw 1404, and as the adjuster block 1506 moves upward, the jaw mover 1516 contacts the movable jaw 1404, moving the movable jaw 1404 between a first position and a second position. The adjuster support 1508 can be rotated by a thumbscrew or knob on the clamp adjuster 1342 to vary the first position of the adjuster block 1506 depending on the size of the patient support to which the clamp will be attached. In some embodiments, the clamp 1302 may have markings corresponding to a first position of the movable jaw 1404 so that the adjustment of the adjuster column 1508 and adjuster block 1506 can be repeated for subsequent clamps or procedures. For example, once the first clamp 1302 is dialed in to apply an appropriate amount of clamping force to the patient support, the markings may visually indicate the position or setting of the clamp adjuster 1342, which can be used to adjust subsequent clamps such as the second clamp 1304, third clamp, fourth clamp, etc., so that all clamps have similar clamping forces on the patient support. This clamping method relies on a chain section subjected to high stress across the center to achieve high clamping force and release prevention (although a latch locking feature (not shown) may be used to prevent release). In some embodiments, when tightening onto the bed rail, as the lever 1406 is lowered and the jaw gap (the distance between the fixed jaw 1402 and the movable jaw 1404) is closed, the jaws contact the rail before the lever 1406 reaches its home position. At this point, the chain and jaws (both fixed and movable) are subjected to a force that moves them within the elastic deformation of the material. This elastic deformation increases the "sense" of the force on the closing lever 1406, but the point is that the design of the chain provides significant lever arm mechanical efficiency.All metals are subjected to stress as the clamp is closed, and the chain moves across the maximum distance of deformation to a position of less deformation (but still significant). This smaller distance requires a force to move it back across the maximum distance in order to release the clamp 1302. Relevant to the performance of this clamping are considerations of the material properties of the fixed and movable jaws (linear springs), lever arm 1504 (C or S spring), and lever shaft 1502, including the spring constant (k), material coefficient, and design considerations to prevent reaching the elastic yield of the material which would cause permanent deformation of the components. In addition, if the above components were a fully rigid system, this may require a spring element designed within the adjuster block 1506.

[0193] Figures 16A, 16B, 16C, and 16D illustrate side views of a clamp that can be used with a probe mounting and adjustment assembly 1600, according to several embodiments, as the handle 1408 is moved through its range of motion from the disengaged position to the intermediate, three-quarter, and fully engaged positions, respectively. When in use, the clamp adjuster 1342 is used to establish the initial first position of the lower jaw 1404 by pivoting the clamp adjuster 1342 and advancing the adjuster block 1506 along the threaded portion of the adjuster support 1508. This allows the initial first position of the movable jaw 1404 to be established while the lever 1406 remains in the disengaged position.

[0194] The upper joint 1510 of the lever arm is offset from the lever shaft 1502 by a distance M, and the upper joint 1510 of the lever arm rotates about the lever shaft 1502. Note that, as shown in Figure 16A, the movable jaw 1404 comes into contact with the adjuster block 1506, which allows it to move freely downward away from the fixed jaw 1402 until this contact limits the movement of the movable jaw 1404 away from the fixed jaw 1402. As the lever 1406 is moved from the position shown in Figure 16A to the position shown in Figure 16D, the upper joint 1510 of the lever arm rotates about the lever shaft 1502, moving from a position approximately below the lever shaft 1502 to a position approximately directly above the lever shaft 1502. This motion results in a linear translation of the adjuster block 1506 over a distance of 2M. Correspondingly, the adjuster block 1506 and the movable jaw 1404 also move a linear distance equal to 2M. For example, in Figure 16D, the upper pin is A (upper joint 1510 of the lever arm), the middle pin is B (lever shaft 1502), and the bottom pin is C (lower joint 1518 of the lever arm). B is located in space and is immovable relative to the fixed jaw 1402. A rotates about B, causing the lever arm 1504 to rotate about C. The movement of the lever arm 1504 causes C to translate along the Y axis (causing the movement of the movable jaw). Points B and C remain collinear along the Y axis (an axis called BCY), and it can be imagined that A traverses arcs of different radii centered on B and C. Each of A, B, and C has imaginary parallel X-rays Ax, Bx, and Cx through them, and the distances between them change as handle 1408 is moved. Furthermore, the distance between Ax and Cx is D rotate (Many positions), D max (A is the best) (This is the greatest power that can be obtained), and D locked (A crosses the BCY axis) (This is the sustained clamping force). The locking mechanism of this design ensures that the distance between Ax and Cx is at its maximum distance D during the closing of handle 1408. maxDepending on the locking position of A reached when it is reached, and in accordance with further closing of lever 1406, the distance between Ax and Cx is D locked Reaching D max It is less than [value]. This position depends on A, which crosses axis BCY.

[0195] The components of the clamp 1302 can be formed from any suitable material, and in some embodiments, the fixed jaws 1402 and movable jaws 1404 are formed from a suitable metal such as various steels or steel alloys, aluminum, or any other type of metal or metal alloy. The lever 1406 and handle 1408 can be formed from any suitable material, which may be a polymer material, and in some cases a reinforced polymer. The fixed jaws 1402 and movable jaws 1404 can be of any suitable shape, and in some embodiments, one or more of the fixed jaws 1402 and movable jaws 1404 are wedge-shaped, U-shaped, L-shaped, or some other suitable cross-sectional shape for clamping onto various patient supports. In some cases, the fixed jaws 1402 and movable jaws 1404 are configured to clamp onto a rail which is formed as a tube, a flat bar, an oval tube, or a rail having some other geometric shape. When in use, the clamp can be attached to the patient support as a first step in preparation for the procedure. The crossbar 1310 can then be mounted on the clamp by the mounting arm and receptacle 1316.

[0196] Figures 17A, 18B, and 17C illustrate a clamp 1302 attached to a rail 1702 in a rear perspective view, a side view, and a front perspective view, respectively. The illustrated clamp 1302 is substantially as described elsewhere in this specification with respect to Figures 16A–16D, etc. The patient support 1113 is provided with a rail 1702 along its side. The rail 1702 may be spaced apart from the patient support 1113 at a distance that allows persons and objects to grip the rail 1702 and / or mount on it. The clamp 1302 may be mounted on the rail with sufficient clamping force to produce a secure engagement with the rail 1702 and the patient support 1113. In some embodiments, the clamp 1302 has a low profile and does not extend above the upper surface of the patient support 1113. As used herein, the term “low profile” is used to describe a clamp 1302 that does not extend upward above the upper surface of the patient support 1113. This facilitates the attachment of the clamp 1302 to the patient support 1113 before the patient is placed on the patient support 1113. The low profile clamp does not interfere with the patient when placed on the patient support.

[0197] In some embodiments, the sensor 1399 is coupled to one or more clamps, such as clamps described herein, configured to be coupled to a rail. In some embodiments, the sensor 1399 comprises multiple sensors coupled to clamps on each side of the rail. The sensors can be configured to measure the load of one or more of the clamps, rails, or supports coupled to a robotic arm, such as those described herein.

[0198] Figures 18A and 18B illustrate perspective views of exemplary embodiments of a crossbar 1310 with mounted mounting arms 1312, 1314, which may be used in conjunction with a probe mounting and adjustment assembly 1600 as described herein. The crossbar 1310 has a first end and a second end, both of which can be connected to the mounting arms 1312. A crossbar coupling 1326 connects the mounting arms 1312 to the crossbar 1310 and provides pivotal movement of the mounting arms 1312 relative to the crossbar 1310. The crossbar coupling 1326 allows pivotal movement of the mounting arms 1312 during the setup of the probe mounting and adjustment assembly 1600 and allows the clamp 1302 to be properly positioned on the patient support 1113 for tightening and, in some embodiments, can be tightened to resist pivotal movement of the mounting arms 1312 relative to the crossbar 1310. The crossbar coupling 1326 can be any preferred coupling that allows for the adjustability of the mounting arm 1312 and may comprise an actuator, bearing, shaft, worm drive, rack, pinion, gear, belt, chain, pulley, slide, collar, shaft, or any combination thereof. The crossbar coupling 1326 may further include a locking mechanism for selectively fixing the relative position of the mounting arm 1312 and the crossbar coupling 1326. In some embodiments, the locking mechanism comprises a cam, screw, handle, knob, shaft, clamp, or any combination thereof.

[0199] The mechanical arm base 1328 may be slidably positioned on the crossbar 1310 and configured to selectively slide along the length of the crossbar 1310. The mechanical arm base 1328 may be selectively fixed to the crossbar 1310 at a desired location by any mounting mechanism such as screws, cams, handles, knobs, clamps, or any combination thereof. In some embodiments, the mechanical arm base 1328 is rigidly fixed to the crossbar 1310 and is not movable along the crossbar 1310. The mechanical arm base 1328 includes one, two, three, or more arm mounts 1802 configured to receive and hold a mechanical arm 442, which may be a robotic arm, a manually operated arm, or a combination of mechanical and robotic.

[0200] In some embodiments, the mechanical arm base 1328 includes a first arm mount 1802 and a second arm mount 1804, the first and second arm mounts configured to couple with the first and second mechanical arms. The first and second mechanical arms may each carry a therapeutic probe 450 and an imaging probe 460, respectively. The first and second arm mounts may be spaced a fixed distance from each other along a crossbar 1310. In some cases, a fixed, known distance between the arm mounts, and thus between the mechanical arms, can be used by the controller to align the therapeutic probe 450 and the imaging probe 460 relative to each other. For example, by using the fixed positions of the arm mounts 1802 and 1804, the controller can determine the home positions of the probes relative to each other, which can also facilitate proper alignment of the therapeutic probe axis with respect to the imaging probe axis.

[0201] The mechanical arm is secured to the arm mount by any suitable mechanism such as screws, knobs, cams, clips, retainers, clamps, or any combination thereof. In some embodiments, the mechanical arm base 1328 provides a mount to which two mechanical arms are attached, and the arm mounts 1802, 1804 can be separated by a fixed distance. This facilitates the orientation and alignment of the probe mounted on the mechanical arm and further assists in the calibration of the probe's position.

[0202] With reference to Figures 19A and 19B, exemplary embodiments of the crossbar 1310 are shown, along with the range of motion of the mounting arms and mounting configurations on patient supports of various sizes. The mounting arms are attached to the crossbar 1310 by a crossbar coupling 1326 that allows the mounting arms to pivot relative to the crossbar 1310. The mounting arms are selectively movable between a first position 1902, which can be used for storing the probe mounting and adjustment assembly 1600 or during transport, and a second position 1904, in which the mounting arms are rotated away from the crossbar 1310 and spread apart from each other to facilitate mounting on patient supports. The mounting arms 1312 and 1314 are selectively movable through an angle α and can be fixed in any orientation. In some embodiments, the range of motion α is at least 90°, and in some embodiments, the range of motion of the mounting arm is 100°, 110°, 120°, 130°, 140°, 150°, 160°, 170°, or 180°. In some embodiments, the mounting arms 1312, 1314 are not positioned symmetrically, and therefore the angle α is not consistent between the mounting arms. For example, the first mounting arm 1312 may be positioned at an angle α of 100°, and the second mounting arm 1314 may be positioned at an angle α of 125°.

[0203] As shown in Figure 19B, mounting arms 1312 and 1314 are illustrated with clamps 1302 attached thereto, and the mounting arms can be spread to accommodate patient supports having varying widths. For example, if a first patient support 1906 has a first width, the mounting arms can be spread to a first distance to position the clamps coupled to the mounting arms to be mounted on the patient support. As the mounting arms are rotated through their range of motion to accommodate the width of the patient support, the clamps can be rotated so that the jaws of the clamps are aligned with the patient support. When mounting on a second patient support 1908 having a greater width than the first patient support, the mounting arms can be spread further to accommodate this larger, more sized patient support. As shown, the further the mounting arms are spread, the closer the crossbar 1310 is to the patient support. By providing the mounting arm with a range of pivotal motion relative to the crossbar 1310 and allowing the clamp 1302 to pivot relative to the mounting arm, the probe mounting and adjustment assembly 1600 can be fitted onto a patient support of many different sizes. In some embodiments, the clamp 1302 may be fixed to a longer mounting arm, which can be used in conjunction with the crossbar 1310 for further adjustability to accommodate a wider range of patient support sizes.

[0204] Figure 20 illustrates an exemplary embodiment of a mechanical arm 442 with a control handle 1318. The mechanical arm 442 is a robotic arm and may be under the control of one or more computing devices to enable precise movement of the robotic arm and probes attached thereto. The robotic arm may be articulated using two, three, or more segments 2002, which are joined by a coupling 2004. The segments 2002 may be joined by a coupling 2004 that allows rotation between adjacent segments 2002. The coupling 2004 may be any suitable coupling and may include a locking mechanism to enable selective movement and locking of the mechanical arm 442. The coupling 2004 may include a conical clutch locking coupling and may include hydraulics to facilitate movement of the mechanical arm. Other suitable couplings include single-plate clutches, multi-plate clutches, locking cam interfaces, interlocking gear teeth, hydraulic actuation, pushrod actuation, electric actuation, and cable actuation. Each joint 2004 may comprise one of various kinematic joints, including, but is not limited to, prism, rotation, parallel cylinder, cylinder, spherical, planar, edge slider, cylindrical slider, point slider, spherical slider, or intersecting cylindrical joint, or any combination thereof. Furthermore, each joint 2004 may comprise a linear, orthogonal, rotational, torsional, or rotary joint, or any combination thereof. In some embodiments, the joint 2004 has a limited range of motion to reduce the potential risk of pinching.

[0205] The mechanical arm 442 includes a mounting cleat 2006 to facilitate the attachment of the mechanical arm 442 to a mechanical arm base 1328 which is coupled to a crossbar 1310 (Figure 13). The mechanical arm 442 further includes a mount 2008 configured to receive a probe slider 1340. The probe slider 1340 may include a motor that enables the probe mounted thereon to be moved forward or backward in the Z direction under computer control. In some embodiments, the probe slider 1340 may include a stepping motor and may be configured to provide fine control of the probe mounted thereon. In some embodiments, the probe mounting and adjustment assembly 1600 comprises two mechanical arms, each with a probe mounted thereon, and each probe can be moved forward in the controlled Z direction by commands to a computing device and to actuate the stepping motor of the probe slider 1340.

[0206] The control handle 1318 is attached to the mechanical arm 442 and can be used to manually operate the mechanical arm 442. A control lever 2010 is coupled to each coupling 2004 in the mechanical arm. The control lever 2010 may be mechanically coupled to the coupling by a pull wire, belt, chain, or equivalent. Alternatively, the control lever 2010 may be electronically coupled to the coupling 2004. As described herein, the coupling 2004 may include actuators for enabling robotic operation of the mechanical arm 442. In some embodiments, the control lever 2010 is operable to disengage an actuator, enabling manual operation of the mechanical arm 442. For example, the coupling 2004 may include a clutch mechanism that selectively disengages the actuator within the coupling 2004. Thus, when the operator pulls the control lever 2010, the clutch within the coupling disengages the actuator, allowing the operator to move the mechanical arm 442 by applying force on the handle 1318. The mechanical arm 442 can provide movement around the axis of each joint 2004, and can also enable rotational movement around the mechanical arm base 1328. Manual operation of the mechanical arm 442 allows the operator to position the mechanical arm 442 and the attached probe in the Y direction (e.g., vertical) and the Z direction (e.g., closer to or further away from the patient). The operator can manually position the probe attached to the mechanical arm, calibrate the position of the probe tip, and instruct one or more computing devices to operate the mechanical arm according to the treatment plan.

[0207] In some embodiments, the geometry of the mechanical arm 442 includes three rotary joints 2004, enabling fluid motion within a constrained surgical design area. In some embodiments, the mechanical arm 442 includes three rotary joints 2004 that enable the movement of all segments of the mechanical arm 2002 around the X axis. As a result, the mechanical arm 442 can be freely moved in the YZ plane, while its ability to be manipulated in the XY plane is limited. In some cases, the joints 2004 can be unlocked to allow fluid motion with low resistance, which enables precise positioning and tactile feedback of patient biomolecules.

[0208] Figure 21 illustrates two mechanical arms with mounted probes, where the two probes are aligned in a vertical plane. The first arm 442 and the second arm 444 are coupled to a common base, such as a mechanical arm base 1328, which is supported on a crossbar 1310 of the probe mounting and adjustment assembly 1600. The first and second arms are mounted and separated by a distance that may be a fixed distance determined by the mechanical arm base 1328. The first arm carries an imaging probe 460, which has an imaging probe axis 2102. The second arm 444 carries a treatment probe 450, which has a treatment probe axis. The mechanical arms are adjusted as necessary to orient the imaging probe axis 2102 so that it is parallel to the treatment probe axis. In some embodiments, the imaging probe axis 2102 and the treatment probe axis are coplanar in a vertical plane, which can facilitate proper positioning of the imaging probe 460 and the treatment probe 450 relative to the biostructure of the patient undergoing the procedure. As illustrated with reference to Figure 13, the second arm 444 may incorporate a riser 1336 into the probe mount to raise the treatment probe 450 above the imaging probe 460 so that the first arm and the second arm 444 do not interfere with each other when the imaging probe axis 2102 and the treatment probe axis are aligned in a vertical plane. The imaging probe axis 2102 and the treatment probe axis may be coplanar in a plane that is not vertical but substantially vertical, and they may be aligned under computer control of the first arm and the second arm 444.

[0209] Figure 22 illustrates an exemplary embodiment of a probe mounting and adjustment assembly 1600 attached to a patient support 1113. The crossbar 1310 carries two mechanical arms 442, 444 that are independently attached to the crossbar 1310 and therefore can move independently along the crossbar 1310. The crossbar 1310 may also include additional support structures such as legs 2202, braces 2204, stretchers 2206, cross braces 2208, and feet 2210. In some embodiments, the crossbar 1310 is coupled to one or more legs 2202 that extend from the crossbar 1310 to the floor. The legs 2202 may be adjustable and configured to bear a large proportion of the weight of the probe mounting and adjustment assembly 1600. One or more legs 2202 may include a foot 2210 for spreading the load on the ground and may include anti-slip material to reduce the tendency of the legs 2202 to slide on the floor. One or more stretchers 2206 may be provided between two or more legs 2202 to reduce the tendency of the legs to tilt in response to an inclined force.

[0210] One or more cross braces 2208 may be mounted between the legs 2202 to provide rigidity to the support structure. One or more braces 2204 may be provided to increase the stiffness of the clamp connection 1324, for example, by connecting one or more braces from the top of the legs to a position near where the clamp connects to the mounting arm. The use of legs, cross brace material, stretcher, braces, and any combination thereof may be selected to increase the rigidity and stiffness of the probe mounting and adjustment assembly 1600 compared to a probe mounting and adjustment assembly without the extra support structure. In some embodiments, the support structure reduces relative motion between the probe mounting and adjustment assembly and the patient support.

[0211] In addition, or alternatively, one or more additional clamps 1302 may be connected to the leg, stretcher, crossbar 1310, or cross brace material at a preferred location. Additional clamps may be used in addition to the clamps already shown and described as being connected to the end of the crossbar 1310, and may provide additional mounting points between the probe mounting and adjustment assembly 1600 and the patient support.

[0212] Figure 23 illustrates a probe mounting and adjustment assembly 1600 that utilizes a second clamp on one side of a patient support. The clamp assembly may comprise a first clamp 1302 and a second clamp 1304, which are joined together using a bracing material and spaced apart by a fixed distance. The clamp assembly is configured to allow the first clamp 1302 and the second clamp 1304 to be clamped to a rail 1702 on the same side of the patient support 1113, for example, by clamping them on the same rail of the patient support. The first clamp 1302 and the second clamp 1304 may be rigidly spaced apart or may have adjustable relative spacing to adapt to clamping to different patient support structures. In embodiments where the spacing between the first and second clamps is adjustable, the spacing between the clamps may be rigidly fixed once a relative spacing is selected. For example, the spacing may be rigidly fixed by a screw, cam, lock, knob, or some other fixing structure.

[0213] A similar clamp assembly may be provided for the opposite side of the patient support and coupled to the crossbar 1310. In this configuration, there may be four clamps for coupling the probe mounting and adjustment assembly 1600 to the patient support. Multiple mounting points to the patient support may reduce relative movement between the patient support and the probe mounting and adjustment assembly 1600 compared to using fewer clamps. It should be understood that the clamp assembly illustrated in Figure 23 may be used in conjunction with any of the other structures shown or described, such as the structure shown in Figure 22, which comprises one or more of the following: legs, stretchers, braces, cross braces, and equivalents.

[0214] In some embodiments, the sensor 1399 is coupled to one or more clamps configured to be coupled to a rail. In some embodiments, the sensor 1399 comprises multiple sensors coupled to clamps on each side of the rail. The sensors can be configured to measure the load on one or more of the clamps, rails, or supports coupled to the robotic arm. One or more sensors can be positioned in any preferred location to measure the load on the clamps, extensions coupled to the clamps, or supports to which one or more robotic arms are coupled, such as a crossbar. In some embodiments, the clamps are operably coupled to one or more computing devices as described herein. In some embodiments, the processor is configured to alert the user when the load exceeds a threshold amount. In some embodiments, the sensors are located, for example, on the jaws of the clamp or on another locking structure of the clamp. In some embodiments, for example, these are pressure sensors, piezoelectric sensors, or strain gauges as described herein.

[0215] Figure 24 illustrates an exemplary embodiment of a treatment system 2400 as described herein, comprising a mobile base 2402. The treatment system comprises a treatment probe 450 coupled to a first robotic arm 442 and an imaging probe 460 coupled to a second robotic arm 444. In some cases, the treatment probe 450 and the imaging probe 460 may have probe mounts that are coupled to the same robotic arm and provide relative movement and alignment between the two probes.

[0216] Each of the first robotic arm 442 and the second robotic arm 444 has a proximal end and a distal end, the distal end of which is coupled to a treatment probe 450 and an imaging probe 460, respectively, and the proximal end is coupled to a common base which has a movable base 2402. The first robotic arm 442 may have a first arm coupling structure for coupling to the treatment probe 450, and the second robotic arm 444 may have a second arm coupling structure for coupling to the imaging probe 460. The treatment probe 450 may be coupled to the distal end of the first robotic arm 442 by a probe mount which may have a chain section configured to allow movement of the treatment probe 450 (e.g., rotation, translation, pitch, etc.) as described herein. The coupling of the treatment probe 450 to the first robotic arm 442 may be fixed, detachable, or user-adjustable. Similarly, the coupling of the imaging probe 460 to the second robotic arm 444 may be fixed, detachable, or user-adjustable.

[0217] The first robotic arm 442 may articulate in one or more arm joints 2004. The imaging arm may articulate in one or more second arm joints. Each arm joint may be operably coupled to a computer-controllable actuator, such as a stepping motor, to affect movement in the joint. Each arm joint may comprise one of various kinematic joints, including, but not limited to, prism, rotation, parallel cylinder, cylinder, spherical, planar, edge slider, cylindrical slider, point slider, spherical slider, or cross-cylinder joints, or any combination thereof. Furthermore, each arm joint may comprise a linear, orthogonal, rotational, torsional, or rotary joint, or any combination thereof. In some embodiments, the first robotic arm 442 and the second robotic arm 444 provide arm joints 2004 that allow the therapeutic probe 450 and the imaging probe 460 to move with six degrees of freedom, and, if any, with additional degrees of freedom. The imaging probe 460 and the treatment probe 450 can be moved manually, under computer-controlled robotic control, or a combination of both.

[0218] The treatment system may further include a console (not shown) as described herein. The console may be operably coupled to a mobile base 2402 via power and communication cables to enable control of a treatment probe 450 which is coupled to a mobile base via a first robotic arm 442. The treatment console includes a processor and a memory storing computer-executable instructions for execution by the processor to control various modules or functions of the treatment console, such as energy sources, injection / washing controls, suction controls, and other components as described elsewhere herein. The treatment console may further include a display that communicates with the processor. The display may be configured to show, for example, one or more of the following: target vital signs such as heart rate, respiratory rate, temperature, blood pressure, oxygen saturation, or any physiological parameters, or any combination thereof; the status of the procedure; one or more pre-captured images or a series of images of the treatment site from one or more views; one or more real-time images or a series of images of the treatment site from one or more views obtained by the imaging probe 460; a set of treatment parameters, including, but not limited to, treatment mode such as cutting or coagulation; treatment intensity; time elapsed during treatment; time remaining during treatment; treatment depth; area or volume of the treated treatment site; area of the treatment site to be treated; area or volume of the treatment site not to be treated; location information of the treatment probe 450 or the imaging probe 460 or both; treatment adjustment controls, such as means for adjusting the treatment depth, treatment intensity, location and / or orientation of the treatment probe 450, imaging depth, or location and / or orientation of the imaging probe 460, or any combination thereof; or system configuration parameters.

[0219] The mobile base 2402 may further include one or more computing devices for controlling the movement of one or more robot arms. For example, the mobile base may include a processor and a memory that stores computer-executable instructions for execution by one or more processors. The memory may also store instructions for operating one or more robot arms coupled to the mobile base. The processor may be operably coupled to the robot arms via suitable electromechanical components to influence the movement of the robot arms. For example, each of one or more joints of a robot arm may include a stepper motor, and the processor may be operably coupled to the stepper motor at each joint to actuate the motor by a predetermined increment in a predetermined direction. Alternatively, one or more robot arms may be operably coupled to one or more processors in a console or a separate imaging console, and one or more console processors may be configured to execute instructions for controlling the movement of one or more robot arms and can communicate instructions to the robot arms via a communication circuit. Computer-executable instructions for controlling the movement of the robotic arm may be pre-programmed and stored in memory, or may be provided by the user via one or more user inputs during or in the course of treating a patient using the treatment system.

[0220] One or more computing devices operably coupled to the first and / or second robotic arms may be configured to control the movement of the arms and to adjust the pitch, yaw, roll, and / or linear position of the therapeutic probe 450, the imaging probe 460, or both, along the target site.

[0221] The treatment system may include one or more user input devices to enable a user to control the movement of any of the following under computer commands: the robotic arm, the mobile base, the imaging probe 460, the treatment probe 450, or any operable component associated with the treatment system. For example, the mobile base may include a keyboard, mouse, touchscreen, digital pen, touchpad, voice control input, and / or foot switch. The user input devices may be configured to control the movement of the first robotic arm 442 and / or the second robotic arm 444, for example, through the joint movement of one or both robotic arms in one or more joints. The user input devices may communicate with one or more processors configured to control the movement of the robotic arms. The user input devices may be located in any preferred location, for example, on the console, on the robotic arm, on the mobile base, and there may be one, two, three, four, or more user input devices used in conjunction with the treatment system to provide either redundant means of input, unique input commands, control discrete parts of the treatment system, or a combination thereof. During use, when a user inputs commands via a user input device, these user commands can be received by one or more processors and converted into electrical signals, which can then be transmitted to one or more computer-controllable actuators that are operably coupled to one or more robotic arms. The user input device can control the movement of one or both arms toward or away from a treatment position, a point of focus, a predetermined location, or a user-defined location, or any combination thereof.

[0222] Optionally, the user input device may be configured to control the operation of the treatment probe 450 and / or the imaging probe 460. For example, the user input device may be configured to start, stop, pause, or resume treatment using the treatment probe 450, or to start, stop, freeze, save, or display images using the imaging probe 460.

[0223] The mobile base may further have one or more deployable supports 2404 to stabilize the treatment system by creating contact with the floor. For example, one, two, three, or more deployable supports may extend from the mobile base and make contact with the ground when the mobile base is moved on its wheels to a fixed position. The deployable supports 2404 may extend downward from the mobile base so as to lift the wheels of the mobile base 2402 off the floor, reducing the possibility that the treatment system may move during the procedure. The deployable supports 2404 may be manually operated or motor-deployed when the treatment system is in position. In some cases, the deployable supports 2404 are manually operated by a foot pedal, which the user presses down to deploy the deployable supports and lock them in place.

[0224] The treatment system may include a mobile power system, such as a battery, which is electrically coupled to a treatment probe 450, an imaging probe 460, a display, one or more computing devices, first and second robotic arms, and other equipment associated with the treatment system, so that the treatment system is mobile and can be moved on wheels from room to room within the built-in treatment system.

[0225] The treatment system may include one or more sensors configured to detect movement resulting from collision with the treatment system or patient support, increased pressure on the treatment system or table support, movement of the patient support, or movement of the patient. The sensors may be configured to adjust the position of the imaging probe 460 and / or treatment probe 450 in response to the sensed movement of the treatment system, patient support, or patient. In addition, alarms may be configured to alert the operator if movement of the patient support is present, and may be configured to provide an audible, visual, or combined alert if the movement of the patient support or patient exceeds a threshold movement magnitude.

[0226] In some embodiments, the mobile base is equipped with casters, and may include three, four, five, or more casters. The casters may include brakes, which may be manual or electric, to limit the movement of the mobile base. One or more of the casters may have a motor therein to enable the movement of the mobile base, for example, under the control of one or more computing devices. The casters enable the mobile base to transport the treatment system throughout the hospital and within treatment rooms (e.g., operating rooms) to position the treatment system for procedures.

[0227] The mobile base carries the crossbar 1310 and mounts a robotic arm and two, three, four, or more clamps to the patient support. In some embodiments, two clamps are held by opposing adjustable mounting arms so as to allow the clamps to be positioned on the sides of the patient support. According to some embodiments, additional clamps are provided to increase the number of engaging supports between the treatment system and the patient support and to increase the rigidity of the connection between the treatment system and the patient support. For example, one or more clamps 1302 can be coupled to the crossbar 1310 and clamped onto the proximal portion of the patient support. Additional clamps can be coupled to the crossbar 1310 and clamped onto other parts of the patient support, such as the base, legs, support, frame, rail, or other structures of the patient support.

[0228] The embodiments shown and described offer numerous advantages not previously seen. The deployment of the probe mounting and adjustment assembly 1600 is efficient and can be easily handled by one person, and its flexible design provides the ability to work with a wide range of patient supports, patient presentations, and is positioned offset from the ends of the patient supports, facilitating the mounting of the stirrup on the ends of the patient supports.

[0229] According to some embodiments, the individual components of the probe mounting and adjustment assembly 1600, when disassembled, weigh less than approximately 8 pounds, less than approximately 10 pounds, or less than approximately 12 pounds.

[0230] Figure 25 illustrates a system 2500 for one or more of the following: positioning a probe, calibrating a probe, or training a system using calibrated probe movement. In some embodiments, the calibration device 2502 includes a receptacle for receiving a therapeutic probe 450 and an imaging probe 460. The receptacle is sized and shaped to receive the probe and to allow the probe to be moved to a position where it can be used during surgical procedures. The position of the arm and probe can be monitored during the calibrated movement prior to the placement of the probe in the patient.

[0231] In some embodiments, the processor is configured to accept the mechanical movement of the probe and to establish one or more boundaries, for example, to avoid collisions with another probe or another robotic arm. In some embodiments, the processor is configured to implement a “teaching session” that establishes boundaries, for example, prior to placing one or more of the probes within a patient. During this teaching session, a sterile-protected calibration guide 2502, also referred to as a calibration device, may be provided, into which the imaging probe 460 is inserted and used to measure geographical location data for incorporation into a robotic arm position database. In some embodiments, the guide comprises one or more of the following: a capture lumen 2504 for receiving the imaging probe 460, a touch point 2506 for identifying the tip of the treatment probe 450, one or more double-notched structures 2508, 2510 for identifying the linear shaft location relative to the imaging probe 460, or one or more planar surfaces for identifying a “non-transverse” anatomical plane. Alternatively, or in combination, multiple cameras and machine vision software commands can be used to measure probe positions in 3D space relative to their respective origins and generate a database of allowable relative positions between the two probes.

[0232] The calibration device 2502 may be provided sterile with features that allow for positioning on the first probe 460 and installation for calibration of the second probe 450 relative to the first probe 460. A capture lumen 2504 or open structure allows for one method of positioning the first probe 460 in a known position and orientation. The first probe 460 may be moved into the capture lumen 2504 at a controlled installation depth into the calibration device 2502, and a spatial boundary envelope, e.g., boundary volume, may be generated and stored in a database.

[0233] In some embodiments, the calibration device 2502 includes a tip location pocket 2506 for detecting contact with the tip of the second probe 450. The first notch structure 2508 provides a guide for the shaft of the second probe 450 as the second probe 450 is advanced to the touch point 2506. The combination of the first notch structure 2508 and the touch point 2506 thus provides an instruction path for the placement of the second probe 450, and its position can be stored in a position database that also stores the relative positions of the first probe 460 and the second probe 450.

[0234] With the tip of the second probe located within the tip-position pocket of the calibration device 2502, the shaft of the second probe can be positioned relative to the shaft of the first probe, and a signal can be sent to the processor, taking into account the positions of both arms holding the first and second probes.

[0235] Similarly, the shafts of the first probe 460 and the second probe 450 can be moved in different spatial orientations relative to each other, for example, by advancing the second probe 450 along the second notch structure 2510, and a calibration signal can be sent to a processor to store the relative positions of the first probe and the second probe.

[0236] In addition, the calibration device 2502 may be configured to accept a second probe feature and to detect and determine the rotational position of the first probe 460, which can be used to ensure the rotation of the second probe 450, as well as to align the treatment probe nozzle with respect to both the transverse and sagittal planes of ultrasound, for example.

[0237] The calibration device 2502 thus provides a reliable physical capture area and can ensure simple placement and docking of the tip to the calibration device 2502, and its position and orientation can be stored in a spatial database so as to teach the robot arm controller system the permissible spatial envelope of the relative position and orientation of the first probe 460 to the second probe 450.

[0238] The methods and apparatus disclosed herein may comprise a number of configurations and may comprise a processor comprising references and instructions for providing navigation and surgical guidance to a user such as a surgeon. For example, one or more of the imaging probe 460, e.g., a TRUS probe, a treatment probe 450, the proximal end of the treatment probe 450, the proximal end of the imaging probe 460, or a robotic arm may comprise a navigation reference. These navigation references may be detected using sensors to provide position and orientation information of the treatment probe 450 and imaging probe 460 relative to a patient and a fixed reference frame such as a base as described herein. The references may comprise, for example, a reflective structure, an energy emission structure, a coil, a magnet, or a visual reference. These references may provide position information to a computing navigation system and inform the user of deviant motion. Position information may be used to measure and control the location and movement of the treatment and imaging probes. Position information may also be displayed on a display that is visible to the user. The processor may display treatment references on the display in relation to a target location on the patient and may comprise instructions to align, for example, a real-time image of the patient with a target treatment profile in real time.

[0239] In some embodiments, positional information is used as a feedback loop to monitor relative motion and to control intentional motion or respond to unintentional motion.

[0240] Figure 26 illustrates a system 2600 comprising an arm 2610 coupled to a sheath 2620, a robotic arm 2630 coupled to a therapeutic probe 2640, and an arm 2670 coupled to an ultrasound probe 2680. The arms are coupled to a base 2690, which may have any preferred base as described herein, such as a crossbar coupled to a rail of a patient support. Arm 2610 may have any arm as described herein, such as a robotic arm, or a manually adjustable arm configured to lock in place, for example. The sheath 2610 is configured for insertion into a patient lumen, such as the urethra, and may have, for example, a rigid sheath or a flexible sheath. The robotic arm 2630 may have any preferred robotic arm as described herein. The therapeutic probe 2640 may have any preferred therapeutic probe as described herein. Arm 2670 may comprise any suitable arm as described herein, and may comprise a manually lockable arm or a robotic arm as described herein. Ultrasound probe 2680 may comprise any suitable ultrasound probe as described herein, for example, a TRUS probe. The robotic arm, the therapeutic probe, and the ultrasound probe are operably coupled to a processor as described herein.

[0241] Figure 27 illustrates a robotic arm 2630 coupled to a treatment probe 2640, and an arm 2610 coupled to a sheath 2620, as shown in Figure 26. The sheath 2620 is coupled to the arm 2610. In some embodiments, the sheath 2620 includes an irrigation lumen 2622 extending to one or more openings 2624 for irrigating the surgical site. The irrigation lumen can be connected to an irrigation fluid source such as saline. The sheath may include a lumen 2626 sized to receive the treatment probe. The lumen 2626 has a proximal opening 2625 and extends to a distal opening 2627. In some embodiments, the sheath 2620 includes a suction channel 2629 extending to an opening into the lumen 2620, which fluidly connects the lumen 2626 to a suction pump for removing excision products. The treatment probe 2640 is coupled to an energy source as described herein, such as a laser, water pump, or power supply, and includes an energy emission structure such as a nozzle, optical fiber end, aperture, or electrode for directing energy toward tissue. The treatment probe is configured to translate 2644 and rotate 2648 energy 2644 from the treatment probe. The endoscope 2650 extends into a sheath. The endoscope includes a viewing port, such as a viewing port for an endoscope camera 2652, configured to translate 2654. The endoscope is coupled to a video display to visualize the treatment probe and the treatment site using the endoscope.

[0242] The coupling portion 2700 is coupled to the end portion of the robot arm 2630. The coupling portion 2700 comprises one or more engagement structures 2710 for coupling to the end portion of the robot arm. The robot arm 2630 comprises one or more corresponding engagement structures 2712 for connecting the coupling portion 2700 to the robot arm. In some embodiments, the coupling portion 2700 comprises internal structures such as chains and actuators as described herein for translating one or more of the treatment probe, endoscope, irrigation lumen, or suction lumen relative to the robot arm. In some embodiments, the coupling portion 2700 is configured to rotate the treatment probe independently of the endoscope, irrigation lumen, and suction lumen. In some embodiments, the coupling portion 2700 comprises a structure for receiving the treatment probe and defining the orientation of the treatment probe relative to the coupling portion. The structure for receiving the treatment probe may comprise, for example, one or more of the opening or channels coupled to the chain. In some embodiments, the coupling portion 2700 is coupled to the end portion of the robot arm and includes an engagement structure for establishing the orientation of the treatment probe relative to the end portion of the robot arm.

[0243] In some embodiments, one or more of the arms or sheaths are equipped with a sensor 2750 for determining the orientation of the sheath when placed in a patient. In some embodiments, the robotic arm 2752 is equipped with an orientation sensor 2752 for determining the orientation of a treatment probe 2640 coupled to the robotic arm. Alternatively, or in combination with the sensors, the joint state of the robotic arm 2630 may be used to determine the orientation of the treatment probe, and the joint state of arm 2610 may be used to determine the orientation of the sheath.

[0244] In some embodiments, the treatment probe has an extension axis, and the sheath has an extension axis for receiving the treatment probe.

[0245] The system can be configured in many ways to treat patients in many ways. In some embodiments, the sheath is sized and shaped for insertion into the patient. The sheath has an extension axis, and an arm is coupled to the sheath. The treatment probe has an energy source and an extension axis. The treatment probe is sized and shaped for insertion into the lumen of the sheath. A robotic arm is coupled to the treatment probe and configured to align the extension axis of the treatment probe with the extension axis of the sheath and advance the treatment probe into the sheath. The robotic arm coupled to the treatment probe is configured to align the axis of the treatment probe with the axis of the sheath prior to advancing the treatment probe into the sheath.

[0246] In some embodiments, the robotic arm is equipped with a sensor for determining the orientation of the treatment probe, and the sensor comprises one or more of an accelerometer, gyroscope, or inertial measuring unit (IMU). Alternatively, or in combination, an arm coupled to a sheath is equipped with a sensor for determining the orientation of the sheath, and the sensor may comprise one or more of an accelerometer, gyroscope, or IMU.

[0247] In some embodiments, the sheath comprises a proximal opening and a distal opening for receiving a treatment probe, and the treatment probe is long enough to extend at least to the distal opening. In some embodiments, the treatment probe is sized such that the energy source extends at least to the distal opening when the treatment probe is advanced into the sheath.

[0248] In some embodiments, the energy source extends at least to the distal opening with a gap between the end portion of the robot arm and the sheath.

[0249] While a coupling structure for rotating the treatment probe is referred to, in some embodiments, the robotic arm 2630 is configured to rotate the treatment probe.

[0250] The processor can be coupled to one or more of arms 2610, 2630, or 2720. In some embodiments, the processor comprises instructions for advancing the therapeutic probe into the sheath, which may facilitate alignment of the therapeutic probe with the sheath. In some embodiments, the processor is configured to align the extension axis of the therapeutic probe with the extension axis of the sheath. In some embodiments, the processor receives an input indicating that the extension axis of the therapeutic probe has been aligned with the extension axis of the sheath, and in response to the input, comprises instructions for advancing the therapeutic probe along the extension axis of the therapeutic probe. The input may comprise a user input, or the input may comprise an input from sensor data. In some embodiments, an arm coupled to a rigid sheath comprises a sensor operably coupled to the processor to determine the orientation of the sheath, and the processor comprises instructions for orienting the therapeutic probe with the sheath in response to the orientation of the rigid sheath measured using the sensor. In some embodiments, the robotic arm comprises a sensor for determining the orientation of the therapeutic probe. Alternatively, or in combination, the orientation of the therapeutic probe may be determined from the joint state of the robotic arm. In some embodiments, the orientation of the sheath is determined by the joint state of the arm coupled to the rigid sheath.

[0251] Figure 28A illustrates a coupling 2700 for connecting a robotic arm 2630 to a treatment probe 2640. In some embodiments, the coupling 2700 is configured to connect the treatment probe 2740, an endoscope 2650, an irrigation lumen 2812, and a suction lumen 2814 to the robotic arm. Each of these lumens may be defined by an extension tube that defines the lumen. In some embodiments, the irrigation lumen and the suction lumen comprise the lumens of a double-lumen tube, such as a catheter. Alternatively, the irrigation lumen and the suction lumen may comprise separate catheters.

[0252] Figure 28B illustrates the movement of the treatment probe 2640, endoscope 2650, irrigation lumen 2812, and suction lumen 2814, provided by a joint as shown in Figure 28A. The irrigation lumen 2812 extends to an opening 2813 and releases irrigation fluid. The suction lumen 2814 extends to an opening 2814 and receives the excision product. The sheath 2620 is sized to receive these lumens and corresponding structures defining the lumens, e.g., tubes. The sheath 2620 is sized to receive the treatment probe. In some embodiments, the sheath 2620 is sized to receive the endoscope 2650.

[0253] The coupling 2700 can be configured in many ways to move one or more of the treatment probe, endoscope, irrigation lumen, or suction lumen. In some embodiments, the coupling is connected to a robotic arm 2630, which provides motion to the treatment probe. For example, the robotic arm can be configured to rotate the treatment probe. Alternatively, or in combination, the robotic arm can be configured to rotate and translate the treatment arm.

[0254] In some embodiments, the coupling 2700 is configured to rotate the treatment probe. For example, the coupling may be configured to rotate the treatment probe 2648. The robotic arm may be configured to translate the treatment probe 2646 while the coupling 2700 is rotating the treatment probe. In some embodiments, the endoscope 2750 is configured to translate along with the treatment probe 2654. In some embodiments, the irrigation lumen and suction lumen are configured to translate along with the treatment probe.

[0255] In some embodiments, the coupling 2700 is configured to provide independent translation to the treatment probe and one or more of the endoscope, irrigation lumen, or suction lumen.

[0256] Figure 29 illustrates treatment method 2900 according to several embodiments.

[0257] In step 2910, the orientation of the sheath is determined. The orientation of the sheath can be determined from one or more sensors coupled to the sheath, such as orientation sensors on an arm coupled to the sheath, or from the joint state of the arm coupled to the sheath.

[0258] In step 2920, the orientation of the treatment probe is determined. The orientation of the treatment probe can be determined from one or more sensors coupled to the treatment probe, such as an orientation sensor on an arm coupled to the treatment probe, or from the joint state of the arm coupled to the treatment probe.

[0259] In step 2930, the extension axis of the treatment probe is aligned with the extension axis of the sheath. This alignment can be performed manually. Alternatively, the processor may configure an instruction to align the extension axis of the treatment probe with the extension axis of the sheath.

[0260] In step 2940, an input is received indicating that the extension axis of the treatment probe has been aligned with the extension axis of the sheath. This input may consist of a user input based on visualization, an input from sensor data, or a combination thereof.

[0261] In step 2950, the treatment probe is advanced along the extension axis of the sheath in response to the input.

[0262] As described herein, the computing devices and systems described and / or illustrated herein broadly represent any type or form of computing device or system capable of executing computer-readable instructions, such as those contained within the modules described herein. In their most basic configurations, each of these computing devices may comprise at least one memory device and at least one physical processor.

[0263] As used herein, the terms “memory” or “memory device” generally refer to any type or form of volatile or non-volatile storage device or medium capable of storing data and / or computer-readable instructions. In one embodiment, a memory device may store, load, and / or maintain one or more of the modules described herein. Embodiments of memory devices include, but are not limited to, random-access memory (RAM), read-only memory (ROM), flash memory, hard disk drives (HDDs), solid-state drives (SSDs), optical disk drives, caches, one or more variations or combinations thereof, or any other suitable storage memory.

[0264] In addition, the terms “processor” or “physical processor” as used herein generally refer to any type or form of hardware implementation processing unit capable of interpreting and / or executing computer-readable instructions. In one embodiment, a physical processor may access and / or modify one or more modules stored in a memory device as described above. Embodiments of a physical processor include, but are not limited to, a microprocessor, a microcontroller, a central processing unit (CPU), a field-programmable gate array (FPGA) implementing a soft-core processor, an application-specific integrated circuit (ASIC), one or more parts thereof, one or more modifications or combinations thereof, or any other suitable physical processor.

[0265] Although illustrated as separate elements, method steps described and / or illustrated herein may represent part of a single application. In addition, in some embodiments, one or more of these steps may represent or correspond to one or more software applications or programs that, when performed by a computing device, cause the computing device to perform one or more tasks, such as the method steps.

[0266] In addition, one or more of the devices described herein may convert data, physical devices, and / or representations of physical devices from one form to another. In addition, or alternatively, one or more of the modules described herein may convert processors, volatile memory, non-volatile memory, and / or any other parts of a physical computing device from one form to another by running on a computing device, storing data on a computing device, and / or otherwise interacting with a computing device.

[0267] As used herein, the term “computer-readable medium” generally refers to any form of device, carrier, or medium capable of storing or carrying computer-readable instructions. Examples of computer-readable mediums include, but are not limited to, transmission media such as carrier waves, and non-transient media such as magnetic storage media (e.g., hard disk drives, tape drives, and floppy disks), optical storage media (e.g., compact discs (CDs), digital video discs (DVDs), and Blu-ray® discs), electronic storage media (e.g., solid-state drives and flash media), and other distribution systems.

[0268] Those skilled in the art will recognize that any process or method disclosed herein can be modified in many ways. Process parameters and the sequence of steps described and / or illustrated herein are given only as examples and can be varied as desired. For example, the steps illustrated and / or described herein may be shown or discussed in a particular order, but these steps do not necessarily have to be performed in the order illustrated or discussed.

[0269] The various exemplary methods described and / or illustrated herein may also omit one or more of the steps described or illustrated herein, or may include additional steps in addition to those disclosed herein. Furthermore, any step of any method as disclosed herein may be combined with one or more steps of any other method as disclosed herein.

[0270] A processor as described herein may be configured to perform one or more steps of any of the methods disclosed herein. Alternatively, or in combination, a processor may be configured to combine one or more steps of one or more methods disclosed herein.

[0271] Unless otherwise stated, the terms “connected to” and “joined to” (and their derivatives) as used herein and in the claims shall be interpreted to allow both direct and indirect (i.e., through other elements or components) connections. In addition, the terms “a” or “an” as used herein and in the claims shall be interpreted to mean “at least one of.” Finally, for ease of use, the terms “containing” and “having” (and their derivatives) as used herein and in the claims shall be synonymous with and have the same meaning as the term “equipped with.”

[0272] A processor as disclosed herein may consist of instructions that perform one or more steps in any of the methods disclosed herein.

[0273] It should be understood that the terms “first,” “second,” “third,” etc., may be used herein to describe various layers, elements, components, regions, or divisions without referring to any particular order or sequence of events. These uses are simply used to distinguish one layer, element, component, region, or division from another. A first layer, element, component, region, or division as described herein may be referred to as a second layer, element, component, region, or division without departing from the teachings of this disclosure.

[0274] As used herein, the term "or" is used comprehensively to refer to an item, both as an alternative and in combination.

[0275] As used herein, numbers and other letters refer to similar elements.

[0276] As used herein, the terms “gross” and “total” are used synonymously.

[0277] As used herein, the terms “one or more computing devices” and “processor” are used synonymously.

[0278] This disclosure includes the following numbered annotations:

[0279] (Note 1) A system for treating or imaging a patient's tissue, comprising: a probe sized for insertion into the patient; a robotic arm configured to be coupled to the probe; and one or more computing devices operably coupled to the robotic arm, which establish an allowable range of motion for the probe, which is stored in the memory of one or more computing devices, and which use the probe to treat or image a target tissue of the patient, move the robotic arm, and provide commands to influence the movement of the probe within the allowable range of motion for the probe.

[0280] (Note 2) The probe is configured to be coupled to the robot arm while the robot arm is in passive mode, as described in Note 1.

[0281] (Note 3) The permissible range of motion for the probe is established while the robot arm is in passive mode, as in the system described in Note 1.

[0282] (Note 4) The system as described in Note 1, wherein the step of establishing an allowable range of motion for the probe includes the step of establishing an allowable range of motion for the probe in response to user input.

[0283] (Note 5) The system according to Note 1, wherein the step of establishing an allowable range of motion for the probe includes the step of establishing an allowable range of motion for the probe in response to the position of the probe.

[0284] (Appendix 6) The system as described in Appendix 5, wherein the probe position relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue.

[0285] (Appendix 7) The system as described in Appendix 1, further comprising the step of updating the allowable range of motion for the probe in real time.

[0286] (Appendix 8) The system according to Appendix 1, further comprising a user input device operably coupled with one or more computing devices to provide one or more user commands for controlling the movement of a robot arm, wherein the step of moving the robot arm under the control of one or more computing devices includes the step of moving the robot arm in response to one or more user commands for controlling the movement of the robot arm.

[0287] (Note 9) The system as described in Note 8, wherein the user input device comprises one or more of the following: a controller near the end of the robot arm, a user interface on a display screen, a user interface on a console, or a controller that responds to forces on the end of the arm provided by the user and guides a probe on the robot arm to a fixed position.

[0288] (Appendix 10) The system according to Appendix 1, further comprising a probe and one or more force sensors operably coupled with one or more computing devices to detect compression of patient tissue using the probe.

[0289] (Note 11) The system as described in Note 10, wherein one or more computing devices comprises a processor consisting of instructions for interrupting treatment in response to detected compression of tissue exceeding a predetermined threshold level of compression.

[0290] (Appendix 12) The system as described in Appendix 10, wherein one or more force sensors are operably coupled to a robotic arm.

[0291] (Appendix 13) The system according to Appendix 12, further comprising one or more motion sensors operably coupled with a probe and one or more computing devices to detect patient movement, wherein the one or more computing devices are configured to adjust the position of the probe in response to detected patient movement.

[0292] (Note 14) The system as described in Note 1, wherein the robot arm has a passive mode for manually adjusting the probe to a manually set position. ...

Claims

1. A system for treating target tissue at a target site in a patient, wherein the system is A first robotic arm coupled to a therapeutic probe for treating the target tissue of the patient, A second robotic arm coupled to an imaging probe for imaging the target tissue of the patient, One or more computing devices operably coupled to the first robotic arm and the second robotic arm Equipped with, A system in which one or more computing devices are configured to execute commands to control the movement of one or more of the first robotic arms or the second robotic arms so as to move the treatment probe or the imaging probe within a range of motion established in response to the distance or alignment between the treatment probe and the imaging probe.

2. The system according to claim 1, wherein one or more computing devices are configured to execute commands for controlling the movement of the first robotic arm or the second robotic arm to adjust one or more of the pitch, yaw, roll, or linear position of the treatment probe or the imaging probe along the entry axis of the treatment probe or the imaging probe into the patient.

3. The system according to claim 2, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm, respectively, to retract the treatment probe or the imaging probe along the entry axis.

4. The system according to claim 3, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm, respectively, to retract the treatment probe or the imaging probe along the entry axis but not to advance it.

5. The system according to claim 1, wherein one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm in response to user commands received using user input devices operably coupled with the one or more computing devices.

6. The system according to claim 1, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to user input.

7. The system according to claim 1, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to the distance or alignment between the therapeutic probe and the imaging probe.

8. The system according to claim 1, wherein one or more computing devices are configured to execute instructions including establishing the permissible range of motion for the therapeutic probe or the imaging probe in response to the position of the therapeutic probe or the imaging probe relative to the target tissue.

9. The system according to claim 8, wherein the one or more computing devices are configured to execute instructions that include detecting the position of the therapeutic probe or the imaging probe relative to the target tissue based on one or more images of the target tissue, and the one or more images include one or more tissue markers.

10. The system according to claim 1, wherein one or more computing devices are configured to execute commands to update the permissible range of motion for the therapeutic probe or the imaging probe in real time.

11. The system according to claim 1, wherein one or more computing devices are configured to execute commands including controlling the movement of the first robotic arm or the second robotic arm to maintain alignment between the therapeutic probe and the imaging probe, and optionally the alignment maintains the therapeutic probe within the field of view of the imaging probe.

12. The system according to claim 1, wherein one or more computing devices are configured to execute commands for controlling the movement of the first robotic arm or the second robotic arm to automatically move the therapeutic probe or the imaging probe along a scanning profile stored on the one or more computing devices.

13. The system according to claim 1, wherein the one or more computing devices are configured to execute commands that include controlling the movement of the first robotic arm or the second robotic arm in response to sensor data received from one or more sensors operably coupled with the one or more computing devices.

14. The system according to claim 1, further comprising a common arm, wherein the first robotic arm is operably coupled to the common arm at a first location, and the second robotic arm is operably coupled to the common arm at a second location.

15. The system according to claim 1, wherein one or more computing devices are configured to execute commands for operating the first robotic arm in a passive mode, and the first robotic arm is configured to be manually adjusted in the passive mode to position the therapeutic probe at a manually set position.

16. The system according to claim 1, wherein one or more computing devices are configured to execute commands for operating the second robotic arm in a passive mode, and the second robotic arm is configured to be manually adjusted in the passive mode to position the imaging probe at a manually set position.