Endoscope auto-feed system

Abstract

An auto-feed system for controlling a position of an elongated device in a working channel of an endoscope may include a drive motor which may be coupled to a drive wheel. The drive wheel may interface with the elongated device such that the elongated device at least one of axially inserts or axially retracts when the drive wheel rotates. The auto-feed system may also include a sensor, which may be configured to generate a signal indicative of an axial position of the elongated device in the working channel.

Description

ENDOSCOPE AUTO-FEED SYSTEMCLAIM OF PRIORITY

[0001] This patent application claims the benefit of priority of Baker, U.S.Provisional Patent Application Serial Number 63 / 584,330, entitled “ENDOSCOPE AUTO-FEED SYSTEM,” filed on September 21, 2023 (Attorney Docket No. 5409.830PRV) which is hereby incorporated by reference herein in its entirety.TECHNOLOGICAL FIELD

[0002] The present disclosure relates to endoscopes, and more particularly, but not by way of limitation, to an endoscope auto-feed system that can be used to control the position of an elongated device in an endoscope.BACKGROUND

[0003] An endoscope can be used to gain access inside a patient to perform a procedure. Endoscopes may include a working channel to receive instruments. The axial position of instruments inserted into the working channel may be controlled by pushing or pulling on the portion of the instrument external to the endoscope.SUMMARY

[0004] An operator may control the axial position of a device in an endoscope working channel based upon video or other feedback information. For example, the operator may position a laser fiber inserted through the working channel a desired distance from a stone (e.g., a kidney stone) or other tissue. The positioning of the device may affect the efficiency of the procedure. Positioning of the laser fiber or other device may involve the intermittent or continuous use of one of the operator’s hands. When the operator’s hand is being used to control the device, it may not be available to perform other operations. Such other operations may include adjusting system parameters, or controlling movement of the endoscope, or both. Alternatively or in addition, the positioning of the device may be time consuming, or inefficient, or both. For example, the operator may have torepeatedly adjust the device, verify the adjustment through feedback, and readjust the device.

[0005] The present inventors have recognized, among other things, that it may be desirable to use an auto-feed system that can automate one or more portions of the axial positioning of a diagnostic, interventional, or other device in an endoscope working channel. For example, the auto-feed system may receive a control signal from an operator, or another system, or both. The auto-feed system may one or more of axially insert or retract the device, such as may include axially inserting or retracting the device without requiring the operator to use a free hand to adjust the device.

[0006] The present inventors have also recognized, among other things, that it may be desirable for a monitoring system to monitor one or more of a relative or absolute position of a device in the working channel of an endoscope. Feedback from the monitoring system may be provided to an operator, or an autofeed system, or both. The monitoring system may allow the operator or auto-feed system to work more efficiently, or more accurately, or both. For example, a device can be axially inserted to a position near a distal end of the endoscope at a speed that may be higher than a safe speed without position monitoring. The monitoring system may be separate from or combined with the auto-feed system.

[0007] In an example, an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope may include a drive motor which may be coupled to a drive wheel. The drive wheel may interface with the elongated device such that the elongated device at least one of axially inserts or axially retracts when the drive wheel rotates. The auto-feed system may also include a sensor, which may be configured to generate a signal indicative of an axial position of the elongated device in the working channel.

[0008] In an example, a method of operating an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope may include driving a drive motor based upon at least one of a user input or a software command, where the drive motor may be configured to drive a drive wheel that grips the elongated device, thereby resulting in axial displacement of the elongated device when the drive wheel is turned. The method may also include sensing an axial position of the elongated device in the working channel.

[0009] In an example, an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope may include a linear actuator, the linear actuator interfacing with the elongated device such that the elongated device at least one of linearly axially inserts or linearly axially retracts when the linear actuator actuates. The auto-feed system may also include a processor, configured to control at least one of a linear speed, a linear displacement, or a linear direction of the linear actuator.BRIEF DESCRIPTION OF THE DRAWINGS

[0010] In the drawings, which may not be drawn to scale, like numerals may describe substantially similar components throughout one or more of the views. Like numerals having different letter suffixes may represent different instances of substantially similar components. The drawings illustrate generally, by way of example but not by way of limitation.

[0011] FIG. 1 is a perspective view of an example of portions of an autofeed system coupled to a working channel port on an endoscope handle.

[0012] FIG. 2 is a cross sectional view of an example of portions of an auto-feed system and portions of an environment in which the auto-feed system can be used.

[0013] FIG. 3 is a cross sectional view of an example of portions of an auto-feed system and portions of an environment in which the auto-feed system can be used.

[0014] FIG. 4A is a perspective view of an example of portions of an autofeed system coupled to a working channel port on an endoscope handle.

[0015] FIG. 4B is a cut-away perspective view of an example of portions of the auto-feed system of FIG. 4 A

[0016] FIG. 5 A is a perspective view of an example of portions of an autofeed system at least partially incorporated within endoscope handle.

[0017] FIG. 5B is a cut-away perspective view of an example of portions of the auto-feed system of FIG. 5 A.

[0018] FIG. 5C is a cut-away side view of an example of portions of the auto-feed system of FIG. 5 A.

[0019] FIG. 6 is a graph in time showing an example of operating portions of the auto-feed system of FIG. 2.

[0020] FIG. 7 is a flow chart showing an example of a method for operating portions of an auto-feed system.

[0021] FIG. 8 is a block diagram of an example of portions of a machine upon which one or more portions of the present disclosure may be implemented.

[0022] FIG. 9 is a schematic diagram showing an example of a portion of a computer-based clinical decision support system (CDSS).DETAILED DESCRIPTION

[0023] FIG. 1 is a perspective view of an example of portions of an autofeed system 110 coupled to a working channel port 104 on an endoscope handle 102. FIG. 1 shows that an endoscope system 100 may include an endoscope handle 102. The endoscope system 100 may permit visualization, such as may include visualization of the inside a patient. The visualization may include transmitting a signal from a camera inside a patient to one or more of a screen or display external to the patient. The endoscope handle 102 may include one or more controls 106, a proximal connection 108, a working channel port 104, and an endoscope body connection 105.

[0024] The endoscope handle 102 may be one or more of configured or shaped to be held by an operator, such as may include being held by an operator during a procedure using an endoscope system 100. The proximal connection 108 may receive one or more of signals, irrigation flow, suction, lighting energy, ablation energy (i.e., energy for a lithotripsy procedure), or other electrical, mechanical, or electromagnetic phenomena. The one or more controls 106 may allow an operator to adjust one or more of parameters of functions of the endoscope system 100. For example, the one or more controls 106 may allow an operator to one or more of articulate a distal end of the endoscope system 100, control ablation energy, or control camera configuration. The working channel port 104 may provide access to a proximal end of a working channel of the endoscope system 100.

[0025] The endoscope handle 102 may also include a endoscope body connection 105. The endoscope body connection 105 may connect the endoscope handle 102 to an endoscope body. A portion of the endoscope body may be inserted into a patient to provide access during a procedure.

[0026] The auto-feed system 110 may be configured for mechanical coupling with the working channel port 104. For example, the auto-feed system 110 may have one or more threads that interface with threads on the working channel port 104. In an example, the auto-feed system 110 may be coupled to the working channel port 104 with a snap-fit, interference fit, or other friction fit connection. For example, an inside diameter of the auto-feed system 110 may seat against at least a portion of an outside diameter of the working channel port 104. This may provide a level of mechanical connection between the auto-feed system 110 and the working channel port 104. However, the auto-feed system 110 may be partially or fully included in the endoscope handle 102. For example, one or more portions of the auto-feed system 110 may be integral to the handle.

[0027] FIG. 2 is a cross sectional view of an example of portions of an auto-feed system 110 and portions of an environment in which the auto-feed system 110 can be used. FIG. 2 shows that the auto-feed system 110 may include a auto-feed system case 212, a drive wheel 220, a drive motor 222, a guide wheel 224, a sensor 250, and a controller 270. FIG. 2 shows that the endoscope system 100 may include an endoscope body 230.

[0028] The endoscope body 230 may define a working channel 232. The working channel 232 may be configured to receive one or more elongated devices 240. For example, the endoscope body 230 may define a working channel 232 from a proximal end beginning at the working channel port 104 to a distal end at the distal end of the endoscope body 230.

[0029] The drive wheel 220 may be mechanically coupled to the drive motor 222. For example, a shaft of the drive motor 222 may couple to an interior mounting interface of the drive wheel 220 to form one or more of a friction or mechanical connection. In an example, the drive wheel 220 may include a set screw in the interior mounting interface to clamp down on the shaft of the drive motor 222. In an example, the shaft of the drive motor 222 may include one or more of a tooth, a key, or a gear that may engage the interior of the drive wheel 220. In an example, the shaft of the drive motor 222 may be pressed into the interior mounting interface of the drive wheel 220 to form a friction connection. In an example, the drive wheel 220 may be at least partially defined by a shaft of the drive motor 222. For example, an outside diameter of the drive motor 222 shaft may comprise the drive wheel 220.

[0030] The drive wheel 220 may be configured to interface with the elongated device 240. For example, an outer surface of the drive wheel 220 may press against an outer surface of the elongated device 240. In an example, a guide wheel 224 may apply a cross-axial force to the elongated device 240 near the drive wheel 220, such as may help hold the elongated device 240 against the drive wheel 220. The guide wheel 224 may be adjustable, such as may allow a user to apply a desired amount of force to the guide wheel 224. In an example, the guide wheel 224 may be spring loaded to provide a specified amount of force against the elongated device 240. In an example, the drive wheel 220 may include at least one of a flexible outer layer or textured outer layer. A flexible outer layer may help the drive wheel 220 conform to a shape of the elongated device 240, such as may help provide a greater degree of friction at the interface between the drive wheel 220 and the elongated device 240. In an example, the outer layer of the drive wheel 220 may include one or more of a hard rubber, a silicone rubber. In an example, the drive wheel 220 may be an uncoated plastic wheel. A textured outer layer may dig into the elongated device 240 (i.e., temporarily deform a surface of the elongated device), such as may help provide a mechanical interface between the drive wheel 220 and the elongated device 240. In an example, one or more portions of the elongated device 240 may have a surface shape that is configured to interface with a surface shape of the drive wheel 220. In an example, the drive wheel 220 may not be circular, but may be one or more of star-shaped, gearshaped, or oblong.

[0031] The drive wheel 220 may be configured such that the elongated device 240 at least one of axially inserts or axially retracts within the working channel 232 when the drive wheel rotates. For example, a rotational motion of the drive wheel 220 may be converted to an axial linear motion of the elongated device 240, such as may be due to the interface between the drive wheel 220 and the elongated device 240. The drive wheel 220 in combination with the elongated device 240 may function as a linear actuator.

[0032] In an example, the drive wheel 220 and the drive motor 222 may be substituted for another style of linear actuator. For example, the drive wheel 220 may be substituted for a driven track system. The track system may include one or more track drive wheels driven by the drive motor 222, and one or more bogey or idler wheels. The track system may include a continuous flexible trackor belt that is driven by the one or more track drive wheels. The track or belt may interface with the elongated device 240, and a rotational motion of one of the track drive wheels may be converted to a linear motion of the elongated device 240. There may be a larger interface between the track and the elongated device 240 than the drive wheel 220 and the elongated device 240, such as may increase a strength of the interface.

[0033] The linear actuator that at least one of axially inserts or axially retracts the elongated device 240 may include a screw-type linear actuator, a rigid- chain linear actuator, an electro-mechanical linear actuator, or a piezoelectric linear actuator. For example, the linear actuator may include an arm that is placed against the elongated device 240, moves the elongated device 240 axially, lifts off the elongated device 240 to recover to an original position, and is placed against the elongated device 240 again to repeat the process. The linear actuator may be capable of inserting the elongated device 240, or retracting the elongated device 240, or both, when the linear actuator actuates.

[0034] In an example, the drive wheel 220 may be coupled to a manual control interface, such as may include coupled through one or more of an axle of the drive wheel 220 or a shaft of the drive motor 222. The manual control interface may allow a user to manually (e.g., without the assistance of an electronic signal or the drive motor 222) control the drive wheel 220. For example, the manual control interface may include a manual control wheel that is accessible on the outside of the auto-feed system 110 that is coupled to the drive wheel 220 such that when the manual control wheel is turned, the drive wheel 220 may also turn. For example, the user may turn the drive wheel using one or more of their fingers (i.e., thumb, index finger, index finger and thumb, etc.). As the drive wheel is turned manually, the elongated device 240 may insert or retract similarly to when the drive wheel 220 is turned by the drive motor 222. This may help with fine and / or precise adjustments of the elongated device 240.

[0035] The manual control wheel may be coaxial with the drive wheel 220. The manual control wheel may be coupled to the drive wheel 220 by a rigid axle. The rigid axle may pass through the auto-feed system case 212. The manual control wheel may have a textured and / or rubberized surface, such as may assist the grip of a user. The manual control interface may be coupled to the drive wheel 220 at all times, or the manual control interface may be decoupled at one or moretimes. In an example, the manual control interface may be coupled when the autofeed system 110 is in a free-wheeling mode, and uncoupled when the auto-feed system 110 is in an auto-feed mode. For example, the manual control interface may not be required to be coupled to the drive wheel 220 when the drive motor 222 is coupled to the drive wheel 220.

[0036] The elongated device 240 may have a length that is substantially longer than a diameter of the elongated device 240. For example, the elongated device 240 may have a length that is 10 times, 100 times, 1,000 times, or 5,000 times longer than the diameter of the elongated device 240. The elongated device 240 may be sized and shaped to pass through the working channel 232. The elongated device 240 may include one or more of a laser fiber, a basket, a grasper, or another endoscope. The elongated device 240 may have a length that exceeds a length of the working channel 232. The elongated device 240 may be controlled by a proximal portion of the elongated device 240 that is external to the patient while a distal portion of the elongated device 240 is inserted into the patient. For example, the elongated device 240 may have a specified axial tension strength and a specified axial compression strength. This may allow an operator to one or more of insert or retract the elongated device 240 in the working channel 232, such as may include by applying a force to a proximal portion of the elongated device 240 external to the working channel 232.

[0037] The elongated device 240 may include one or more markers 242. The one or more markers 242 may be configured to be detected by the sensor 250. The markers 242 may be one or more of colored bands, shaded bands, electrically charged bands, electrically resistive bands, electrically conductive bands, magnetically permeable bands, magnetized bands, or mechanical ridges. The markers 242 may be concentric bands placed on the outer edge of the elongated device 240 around a center axis of the elongated device 240. The markers 242 need not cover the full circumference of the elongated device 240. For example, the markers 242 may cover a portion of the circumference, such as may include 25 percent, 50 percent, or 75 percent. There may be a specified spacing 244 between the markers 242. The specified spacing 244 between markers may be uniform between respective ones of the markers 242, or one or more of the specified spacings 244 may differ. The specified spacing 244 may be large for one or more portions of the elongated device 240, such as may one or more of providea coarse indication of position or allow for quick movement. The specified spacing 244 may be small for one or more portions of the elongated device 240, such as may allow for a fine indication of position. For example, the markers 242 may have a first specified spacing when the elongated device 240 is passing through the working channel 232, and a second specified spacing that is smaller than the first specified spacing when the elongated device is near the tip of the working channel 232.

[0038] The markers 242 may all be configured similarly, or one or more of the markers 242 may be configured to be distinguishable from one or more of the other markers 242. The markers 242 may extend across the entire length of a elongated device 240 or the markers 242 may extend across a more limited portion of the elongated device 240, such as may include a distal portion of the elongated device 240. The markers 242 may be one or more of painted onto the elongated device 240, chemically etched onto the elongated device 240, mechanically applied to the elongated device 240 (e.g., through bead blasting), printed onto the elongated device 240, or molded onto the elongated device 240. The marker 242 may include an at least partially continuous spiral band on the elongated device 240. The spiral band may have one or more of a consistent pitch or variable pitch.

[0039] The sensor 250 may be configured to measure a property of the elongated device 240. The sensor 250 may provide a signal indicative of an axial position of the elongated device 240 in the working channel 232. The sensor 250 may include a contact sensor, such as may include a mechanical sensor, which may make contact with the elongated device 240. The sensor 250 may include a non-contact sensor, such as an optical sensor that may include a spectrometer, which may not be required to make contact with the elongated device 240. The sensor 250 may include one or more of a resistive sensor, a capacitive sensor, a conductive sensor, a magnetic sensor, a Hall effect sensor, an electric field sensor, a mechanical sensor, a spectrometer, or a phototransducer. For example, the sensor 250 may measure one or more of an electrical resistance or conductance of the elongated device 240. This may include measuring an absolute resistance or monitoring for a specified resistance or resistance above a specified threshold. For example, the sensor 250 may measure a resistance between the drive wheel 220 and the guide wheel 224. The sensor 250 may measure a capacitance, such as may include a capacitance between the sensor 250 and the elongated device 240. Thesensor 250 may measure one or more of a magnetic field or a magnetic permeability of the elongated device 240, such as may allow the sensor 250 to sense magnetized bands or magnetically permeable bands on the elongated device 240.

[0040] The sensor 250 may include a mechanical sensor, such as may measure a mechanical feature of the elongated device 240. A mechanical feature of the elongated device 240 may include one or more of a circumference, a diameter, a surface shape, or a surface property (e.g., roughness, friction, etc.). The sensor 250 may be one or more of a position or strain gauge connected to the guide wheel 224 axle, such as may generate a signal as the guide wheel 224 passes over a raised or depressed marker 242.

[0041] The sensor 250 may be one or more of an optical detector or a phototransducer, such as may measure one or more optical properties of the elongated device 240. For example, the sensor 250 may be a spectrometer, which may be configured to detect an intensity of one or more colors of light.

[0042] In an example, the sensor 250 may be configured to measure a property of one or more of the drive motor 222 or drive wheel 220 alternatively or in addition to measuring a property of the elongated device 240. For example, the sensor 250 may be a rotary encoder coupled to one or more of the drive wheel 220 or the drive motor 222. The sensor 250 may measure one or more of an angular speed, an angular direction, or an angular displacement.

[0043] In an example, the sensor 250 may be configured to measure a property of the elongated device 240 without requiring that the elongated device 240 include markers 242. For example, the sensor 250 may be a laser Doppler vibrometer, such as may be able to make a non-contact measurement of the movement of the elongated device 240. The use of a sensor 250 that can measure an unmarked elongated device 240 may allow for determining the position of an elongated device 240 that is not specifically configured to be used with the autofeed system 110.

[0044] The drive motor 222 may be configured to provide a motive force to one or more of axially insert or axially retract the elongated device 240. In an example, the drive motor 222 may be an electrical motor that converts an electrical input power into a rotation of a motor shaft. The drive motor 222 may be one or more of a stepper motor, a brushed direct current (DC) motor, a brushless DCmotor, a brushless alternating current (AC) motor, or a servo motor. The drive motor 222 may be coupled to the controller 270 with a bus 272. The controller 270 may control one or more functions of the drive motor 222 such as may include one or more of a number of steps, a step direction, an angular speed, an angular direction, an angular displacement, an absolute angular position, or a torque value.

[0045] The controller 270 may be external to the endoscope system 100. For example, the controller 270 may be included in the endoscope system 100. In an example, the controller 270 may be included within the auto-feed system case 212. The controller 270 may be communicatively coupled with one or more other systems or controllers, such as may include an endoscope system 100. The controller 270 may be coupled to the sensor 250, and may receive a signal from the sensor 250.

[0046] The controller 270 may be able to determine an axial position of the elongated device 240 in the working channel 232 using one or more of a signal received from the sensor 250, a signal received from the drive motor 222, or a signal sent to the drive motor 222. For example, the controller 270 may be able to send an “insert” control signal to the drive motor 222, such as may cause the drive motor 222 to operate in a way that may cause the elongated device 240 to insert. Then the controller 270 may be able to count a number of markers 242 detected by the sensor 250 and use the specified spacing 244 to determine an axial insertion distance. The determined axial insertion distance may be correct even if the drive wheel 220 slips against the elongated device 240, such as may be due to the sensor 250 measuring the elongated device 240 directly.

[0047] In an example, the controller 270 may receive signals from one or more buttons and / or one or more other input devices (e.g., other processors, other systems, etc.). The controller 270 may control a position of the elongated device 240 based on the received signals. For example, the controller 270 may cause the elongated device 240 to insert when a received signal indicates that an insert button is pushed. Various approaches for receiving inputs from a user are described in Leak, et al. U.S. Provisional Patent Application Serial Number 63 / 581,900 entitled “ENGAGABLE ACTUATION MECHANISM” filed on September 11, 2023 (Attorney Docket No. 5409.852PRV), which is hereby incorporated by reference herein in its entirety.

[0048] In an example, the marker 242 may be in the form of an at least partially continuous gradient. For example, the elongated device 240 may change gradually from a green color on one end to a yellow color on the other end, and a given color may indicate correspond to a given position along the elongated device 240. In an example, a resistance of an outer layer of the elongated device 240 may change gradually from one end to another end. In an example, every tenth marker may be distinct to allow the controller 270 to one or more of verify a marker count or update a marker count if one or more markers 242 have been overcounted or missed.

[0049] In an example, the controller 270 may monitor an angular displacement of the drive wheel 220. In an example, the controller 270 may monitor an angular displacement of the drive wheel 220 using a sensor 250 in the form of a rotary encoder coupled to the drive motor 222 or the drive wheel 220. For example, the controller 270 may determine a linear displacement of the elongated device 240 using an angular displacement of the drive wheel 220 and a diameter of the drive wheel 220. In an example, the controller 270 may monitor an angular displacement of the drive wheel 220 without requiring a sensor 250, such as may be determined using one or more of a number of steps of a stepper motor, a step direction of a stepper motor, an angular displacement of a servo motor, or an angular position of a servo motor. The accuracy of the determined axial position of the elongated device 240 may be helped by a limited slip interface between the elongated device 240 and the drive wheel 220.

[0050] The controller 270 may be programmed with one or more parameters of one or more of the endoscope system 100, the auto-feed system 110, the sensor 250, or the elongated device 240. For example, the controller 270 may be programmed with one or more of a length of the working channel 232, a diameter of the drive wheel 220, a sensitivity of the sensor 250, the specified spacing 244, the type of marker 242, an axial compression strength of the elongated device 240, an axial tension strength of the elongated device 240, a diameter of the elongated device 240, or a length of the elongated device 240.

[0051] In an example, the elongated device 240 may include an identifying marking, such as may be near a distal end of the elongated device 240, that may identify one or more parameters of the elongated device 240. The sensor 250 may be able to scan the identifying marking as the elongated device 240 is inserted intothe auto-feed system case 212 and / or working channel 232 and the controller 270 may be able to interpret the identifying marking to automatically program one or more parameters into the controller 270. For example, the identifying marking may include a barcode or a QR code.

[0052] The controller 270 may be configured to consider a reference point236 having a known position within the auto-feed system case 212 or the working channel 232. In an example, the reference point 236 may align with the sensor 250. In an example, the reference point 236 may align with the proximal insertion port of the auto-feed system 110. The controller 270 may be configured to determine a position of the elongated device 240 in terms of a position of a distal tip 237 of the elongated device with respect to the reference point 236.

[0053] The controller 270 may be programmed with a specified length 234 between the reference point 236 and the distal end 238 at the distal end of the endoscope body 230. Using the determined position of the distal end 238 with respect to the reference point 236 and the specified length 234, the controller 270 may be able to determine a position of the distal tip 237 with respect to the distal end 238. For example, the controller 270 may be able to determine if the distal tip237 is within the working channel 232 or outside a distal end of the working channel 232.

[0054] A portion or all of the position information determined by the controller 270 may be provided to an operator, such as may include a visual display. The visual display may allow the operator to perform a procedure more efficiently, such as may be due to being able to one or more of insert or retract the elongated device 240 more quickly when a position of the elongated device 240 is known.

[0055] In an example, the controller 270 may be configured to determine an absolute position of the elongated device 240. This may result in the controller 270 being able to determine a distance between the distal tip 237 and the distal end 238. In an example, the controller 270 may be configured to determine a relative position of the elongated device 240. This may result in the controller 270 being able to determine a distance that the elongated device 240 has moved since a reference time, but the controller 270 may not be able to determine an absolute position of the distal tip 237 with respect to the distal end 238.

[0056] The controller 270 may be programmed with one or more functions, such as may include a “feed device” function. The “feed device” function may result in the elongated device 240 axially inserting until the distal tip 237 is near the distal end 238, such as may include one or more of a specified distance distal from the distal end 238 or a specified distance proximal from the distal end 238. The “feed device” function may allow an operator to automatically insert the elongated device 240, such as may allow the operator to tend to one or more other tasks when the elongated device 240 is inserting. In an example, the "feed device” function may be one or more of more quick or more precise than the operator feeding the elongated device 240 manually. In an example, the controller 270 may also be programmed with a “retract device” function to retract the elongated device 240 until the distal tip 237 is near a proximal end of the working channel 232.

[0057] The drive wheel 220 may be configured to be capable of freewheeling to allow an operator to manually position the elongated device 240 without one or more of damaging or fighting the auto-feed system 110. The autofeed system 110 may have a “disable” feature that one or more of decouples the drive wheel 220 from the drive motor 222 or removes a torque from the drive motor 222. The auto-feed system 110 may have a “hold” feature that is configured to hold a position of the elongated device 240 even when a force is applied to one or more of the distal end of the elongated device 240 or a proximal portion of the elongated device 240. The auto-feed system 110 may have a “hold-assist” feature that is configured to help stabilize the elongated device 240 while still allowing an operator to manually position the elongated device 240. For example, the autofeed system 110 may detect a force on a proximal portion of the elongated device 240 and assist with moving the elongated device 240 in response to the force. Once the force on the proximal portion is removed, the auto-feed system 110 may hold the elongated device 240 in place. The auto-feed system 110 may continue monitoring and / or reporting the position of the elongated device 240 during one or more of the “disable,” “hold”, or “hold-assist” functions. In an example, the auto-feed system 110 may be capable of free-wheeling when the drive motor is not engaged, such as may include when the drive motor is not receiving a signal to operate. In an example, the auto-feed system 110 may be configured to allowan operator to retract the elongated device 240 manually when desired, such as may include when it is desirable to remove the elongated device 240 quickly.

[0058] The auto-feed system 110 may help support the elongated device 240 as it is inserted into the working channel 232. For example, one or more of the drive wheel 220 or the guide wheel 224 may provide stability to the elongated device 240, and may act as a centering device for the elongated device 240 in the working channel 232. The auto-feed system 110 may limit bending or kinking of the elongated device 240, such as may be due to a diameter of the drive wheel 220 and / or the guide wheel 224. This may help prevent premature failure of the elongated device 240 due to bending.

[0059] FIG. 3 is a cross sectional view of an example of portions of an auto-feed system 110 and portions of an environment in which the auto-feed system 110 can be used. FIG. 3 shows that the auto-feed system 110 can include a second sensor 328 that may be configured to measure a motive force 346 on the elongated device 240.

[0060] In the example of FIG. 3, the drive wheel 220 may include a plurality of spokes 324. The spokes 324 may have a specified shape, such as may include being substantially straight, when there is not a motive force 346 being applied to the elongated device 240 by the drive wheel 220. When the drive wheel 220 axially moves the elongated device 240, the drive wheel 220 may have to exert a motive force 346 on the elongated device 240. The motive force 346 exerted on the elongated device 240 may one or more of overcome a static frictional force between the elongated device 240 and the working channel 232, overcome a dynamic frictional force between the elongated device 240 and the working channel 232, or overcome an external force 348 being applied to the distal end of the elongated device 240, such as may be due to the elongated device 240 contacting one or more tissues within a patient’s body.

[0061] The friction between the elongated device 240 and the working channel 232 may increase as one or more of the elongated device 240 is inserted farther into the endoscope body 230, a length of the working channel 232 increases, a bending radius of the endoscope body 230 decreases, or a number of bends in the endoscope body 230 increases. In an example, there may be a limited amount of frictional force, and the majority of the motive force 346 may counteract the external force 348. In an example, the frictional force may beestimated, and the remainder of the motive force 346 may be considered to be applied to counteract the external force 348.

[0062] When the drive wheel 220 exerts a motive force 346 on the elongated device 240, one or more of the plurality of spokes 324 may bend, such as may be due to the transfer of force from the drive motor 222 to an outer circumference of the drive wheel 220. An example of a bent position of the spokes 324 is shown by the bent spokes 326. The second sensor 328 may be a strain gauge that is mounted on one of the spokes 324, and may be configured to measure a level of bending in the spoke 324. For example, as the spoke bends, the strain gauge may increase in length, such as may cause a corresponding increase in a resistance of the strain gauge. The motive force 346 may be determined from the second sensor 328 using one or more of empirical testing or calculated values.

[0063] In an example, the drive motor 222 may be capable of providing a torque value, such as may be due to one or more of a sensor in the drive motor 222 or a configuration of the drive motor 222. From the torque value of the drive motor 222, a motive force 346 may be calculated according to equation 1.F = T / r Equation 1In equation 1, F is the motive force 346, T is the torque of the drive motor 222, and r is the radius of the drive wheel 220.

[0064] The controller 270 may determine the motive force 346. The endoscope system 100 may display the motive force 346. The controller 270 may take one or more actions in response to the motive force 346. For example, the controller 270 may limit the motive force 346, such as may help to prevent damage to one or more of the auto-feed system 110, the elongated device 240, the endoscope system 100, or the patient. The controller 270 may limit the motive force 346 by reducing or removing a power from the drive motor 222 when a specified maximum motive force is met and / or exceeded.

[0065] The controller 270 may be configured to determine whether the motive force 346 is counteracting an external force 348 based upon whether the distal tip of the elongated device 240 is outside of the working channel 232. The distal tip of the elongated device 240 may catch on the inside of the working channel 232, such as may include catching on a bend in the endoscope body 230. The controller 270 may increase a motive force 346 to push through the bend. Once the distal tip of the elongated device 240 is outside the working channel 232,the elongated device 240 may be less likely to bind within the endoscope body 230. A maximum motive force 346 specified to overcome a catch within the working channel 232 may exceed a maximum motive force 346 specified once the elongated device 240 is outside the endoscope body 230, such as may limit a maximum external force 348. Limiting a maximum external force 348 may help to avoid over-insertion or too-forceful impact to a patient.

[0066] The auto-feed system 110 may have a “retract-and-retry” function that may result in the auto-feed system 110 retracting the elongated device 240 a specified distance when the elongated device 240 catches within the working channel 232 and then trying to axially insert the elongated device 240 past the catch point. For example, during a “feed-device” function, the elongated device 240 may catch before it reaches the desired location. The auto-feed system 110 may automatically retract the elongated device 240 a specified distance from the catch point, and then retry the “feed-device” command.

[0067] The auto-feed system 110 may include a “manual override” feature that may allow an operator exceed a specified external force 348. For example, the operator may be able to continue inserting the elongated device 240 while a specified external force 348 limit is exceeded.

[0068] The auto-feed system 110 may have a “touch-and-position” function than may result in the auto-feed system 110 retracting the elongated device 240 a specified distance when the elongated device 240 senses an external force 348. For example, the auto-feed system 110 may insert the elongated device 240 until it touches a stone to be ablated, and then automatically retract the elongated device 240 to a desired ablation distance.

[0069] FIG. 4A is a perspective view of an example of portions of an autofeed system 110 coupled to a working channel port on an endoscope handle. FIG. 4 A shows that the auto-feed system 110 may be an external component coupled to the endoscope handle 102. The auto-feed system 110 of FIG. 4A may be configured similarly to the auto-feed system 110 of FIG. 2 and / or FIG. 3, or may differ in one or more ways.

[0070] FIG. 4B is a cut-away perspective view of an example of portions of the auto-feed system 110 of FIG. 4 A FIG. 4B shows that the auto-feed system 110 may include a drive motor 222 coupled to a drive wheel 220, and a guide wheel 224. The drive motor 222 may be a flat stepper motor, such as may includea Nanotec STF2818 with 0.98 newton / cm of holding torque. The guide wheel 224 may include an extension spring, such as may be configured to apply a force to one or more of the elongated device 240 or the drive wheel 220. The guide wheel 224 may hold the elongated device 240 against the drive wheel 220.

[0071] The auto-feed system 110 may couple to the working channel port with a quick connect thumbwheel 404. The quick connect thumbwheel 404 may be configured to be rotated by an operator, such as may include being rotated using one or more fingers. The quick connect thumbwheel 404 may be configured to threadably couple with the working channel port. For example, one or more internal threads within the quick connect thumbwheel 404 may interface with one or more external threads on the working channel port 104 to couple the auto-feed system 110 to the endoscope handle 102.

[0072] FIG. 4A-4B show an example where the auto-feed system 110 can receive power over a wired connection and may communicate using a wired connection. In an example, one or more of the power or communication connections may be wireless. For example, the auto-feed system 110 may include a battery to power the auto-feed system 110. The battery may be rechargeable, removeable, or both. The auto-feed system 110 may use a wireless communication protocol to send and / or receive data from the endoscope system 100 and / or another system.

[0073] FIG. 5 A is a perspective view of an example of portions of an autofeed system 110 at least partially incorporated within endoscope handle 102. FIG. 5 A shows that the auto-feed system 110 may be an internal component at least partially contained within the endoscope handle 102. The auto-feed system 110 of FIG. 5A may be configured similarly to the auto-feed system 110 of FIG. 2 and / or FIG. 3, or may differ in one or more ways. In an example, the auto-feed system 110 may be fully contained within a housing of the endoscope handle 102, such as may include fully contained within a plastic housing of the endoscope handle 102.

[0074] FIG. 5B is a cut-away perspective view of an example of portions of the auto-feed system 110 of FIG. 5 A. FIG. 5B shows that the auto-feed system 110 may include a drive motor 222 coupled to a drive wheel 220, and a guide wheel 224. The drive motor 222 may be a can stack motor, such as may reducecosts as compared to one or more other motors. In an example, the drive motor 222 may be a Portescap 20M020D2U.

[0075] FIG. 5C is a cut-away side view of an example of portions of the auto-feed system 110 of FIG. 5 A and FIG. 5B. FIG. 5C shows that the interface between one or more of the drive wheel 220, the elongated device 240, or the guide wheel 224 may be arranged between the working channel port 104 and the endoscope body connection 105. For example, the drive wheel 220 may be configured to interface with the elongated device 240 at a location matching or approximately matching the position of the elongated device 240 within the endoscope handle 102 if an auto-feed system 110 is not used.

[0076] FIG. 6 is a graph in time showing an example of operating portions of the auto-feed system 110 of FIG. 2. FIG. 6 shows a predicted graph of intensity measured by the sensor 250 while the auto-feed system 110 is operating. For example, the sensor 250 may be a spectrometer, and the intensity may be a measure of the intensity of a specified color of light. The specified color of light may correspond to a color of markers 242 on the elongated device 240.

[0077] FIG. 6 shows that the intensity may increase as a marker 242 nears, peak as the marker 242 passes, and then decrease us the marker 242 gets farther away. After a period of decreasing intensity, the intensity may climb again as another marker 242 nears. The first peak 602 may be counted by the controller 270 as a first count and the second peak 604 may be counted by the controller 270 as a second count. The controller 270 may know the direction the drive motor 222 is travelling based upon on or more of the signal sent to the drive motor 222 or feedback from another portion of the auto-feed system 110. Using the direction of the drive motor 222, the specified spacing 244, and the number of counts 602 / 604, the controller 270 may be able to determine one or more of the position of the elongated device 240 relative to a reference point 236 or a distance moved by the elongated device 240.

[0078] FIG. 7 is a flow chart 700 showing an example of a method for operating portions of an auto-feed system. At 705 - a drive motor can be driven based upon at least one of a user input or a software command, wherein the drive motor is configured to drive a drive wheel that grips the elongated device, thereby resulting in axial displacement of the elongated device when the drive wheel is turned. At 710 - an axial position of the elongated device in the working channelcan be sensed. The shown order of steps is not intended to be a limitation on the order the steps are performed in. In an example, two or more steps may be performed simultaneously or at least partially concurrently.

[0079] Step 705 may be accomplished using a drive motor 222 coupled to a drive wheel 220. In an example, step 705 may be accomplished using a linear actuator. The user input or software command may be received and / or generated by the controller 270. In an example, the user input or software command may be received from a separate system, such as may include the endoscope system 100. Step 710 may be accomplished using the sensor 250 in combination with the controller 270. In step 710, the auto-feed system 110 may determine an axial position when the elongated device is fully within the working channel 232, extending outside the working channel 232, or both.

[0080] FIG 8 is a block diagram of an example of portions of a machine 800 upon which one or more portions of the present disclosure may be implemented. Examples, as described herein, may include, or may operate by, logic or a number of components, or mechanisms in the machine 800. Circuitry (e.g., processing circuitry) is a collection of circuits implemented in tangible entities of the machine 800 that include hardware (e.g., simple circuits, gates, logic, etc.). Circuitry membership may be flexible over time. Circuitries include members that may, alone or in combination, perform specified operations when operating. In an example, hardware of the circuitry may be immutably designed to carry out a specific operation (e.g., hardwired). In an example, the hardware of the circuitry may include variably connected physical components (e.g., execution units, transistors, simple circuits, etc.) including a machine readable medium physically modified (e.g., magnetically, electrically, moveable placement of invariant massed particles, etc.) to encode instructions of the specific operation. In connecting the physical components, the underlying electrical properties of a hardware constituent are changed, for example, from an insulator to a conductor or vice versa. The instructions enable embedded hardware (e.g., the execution units or a loading mechanism) to create members of the circuitry in hardware via the variable connections to carry out portions of the specific operation when in operation. Accordingly, in an example, the machine readable medium elements are part of the circuitry or are communicatively coupled to the other components of the circuitry when the device is operating. In an example, any of the physicalcomponents may be used in more than one member of more than one circuitry. For example, under operation, execution units may be used in a first circuit of a first circuitry at one point in time and reused by a second circuit in the first circuitry, or by a third circuit in a second circuitry at a different time. Additional examples of these components with respect to the machine 800 follow.

[0081] In alternative embodiments, the machine 800 may operate as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine 800 may operate in the capacity of a server machine, a client machine, or both in server-client network environments. In an example, the machine 800 may act as a peer machine in peer-to-peer (P2P) (or other distributed) network environment. The machine 800 may be a personal computer (PC), a tablet PC, a set-top box (STB), a personal digital assistant (PDA), a mobile telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein, such as cloud computing, software as a service (SaaS), other computer cluster configurations.

[0082] The machine (e.g., computer system) 800 may include a hardware processor 802 (e.g., a central processing unit (CPU), a graphics processing unit (GPU), a hardware processor core, or any combination thereof), a main memory 804, a static memory (e.g., memory or storage for firmware, microcode, a basic- input-output (BIOS), unified extensible firmware interface (UEFI), etc.) 806, and mass storage 808 (e.g., hard drives, tape drives, flash storage, or other block devices) some or all of which may communicate with each other via an interlink (e.g., bus) 830. The machine 800 may further include a display unit 810, an alphanumeric input device 812 (e.g., a keyboard), and a user interface (UI) navigation device 814 (e.g., a mouse). In an example, the display unit 810, input device 812 and UI navigation device 814 may be a touch screen display. The machine 800 may additionally include a storage device (e.g., drive unit) 808, a signal generation device 818 (e.g., a speaker), a network interface device 820, and one or more sensors 816, such as a global positioning system (GPS) sensor, compass, accelerometer, or other sensor. The machine 800 may include an outputcontroller 828, such as a serial (e.g., universal serial bus (USB), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection to communicate or control one or more peripheral devices (e.g., a printer, card reader, etc.).

[0083] Registers of the processor 802, the main memory 804, the static memory 806, or the mass storage 808 may be, or include, a machine readable medium 822 on which is stored one or more sets of data structures or instructions 824 (e.g., software) embodying or utilized by any one or more of the techniques or functions described herein. The instructions 824 may also reside, completely or at least partially, within any of registers of the processor 802, the main memory 804, the static memory 806, or the mass storage 808 during execution thereof by the machine 800. In an example, one or any combination of the hardware processor 802, the main memory 804, the static memory 806, or the mass storage 808 may constitute the machine readable media 822. While the machine readable medium 822 is illustrated as a single medium, the term “machine readable medium” may include a single medium or multiple media (e.g., a centralized or distributed database, and / or associated caches and servers) configured to store the one or more instructions 824.

[0084] The term “machine readable medium” may include any medium that is capable of storing, encoding, or carrying instructions for execution by the machine 800 and that cause the machine 800 to perform any one or more of the techniques of the present disclosure, or that is capable of storing, encoding or carrying data structures used by or associated with such instructions. Non-limiting machine readable medium examples may include solid-state memories, optical media, magnetic media, and signals (e.g., radio frequency signals, other photon based signals, sound signals, etc.). In an example, a non-transitory machine readable medium comprises a machine readable medium with a plurality of particles having invariant (e.g., rest) mass, and thus are compositions of matter. Accordingly, non-transitory machine-readable media are machine readable media that do not include transitory propagating signals. Specific examples of non- transitory machine readable media may include: non-volatile memory, such as semiconductor memory devices (e.g., Electrically Programmable Read-Only Memory (EPROM), Electrically Erasable Programmable Read-Only Memory (EEPROM)) and flash memory devices; magnetic disks, such as internal harddisks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

[0085] In an example, information stored or otherwise provided on the machine readable medium 822 may be representative of the instructions 824, such as instructions 824 themselves or a format from which the instructions 824 may be derived. This format from which the instructions 824 may be derived may include source code, encoded instructions (e.g., in compressed or encrypted form), packaged instructions (e.g., split into multiple packages), or the like. The information representative of the instructions 824 in the machine readable medium 822 may be processed by processing circuitry into the instructions to implement any of the operations discussed herein. For example, deriving the instructions 824 from the information (e.g., processing by the processing circuitry) may include: compiling (e.g., from source code, object code, etc.), interpreting, loading, organizing (e.g., dynamically or statically linking), encoding, decoding, encrypting, unencrypting, packaging, unpackaging, or otherwise manipulating the information into the instructions 824.

[0086] In an example, the derivation of the instructions 824 may include assembly, compilation, or interpretation of the information (e.g., by the processing circuitry) to create the instructions 824 from some intermediate or preprocessed format provided by the machine readable medium 822. The information, when provided in multiple parts, may be combined, unpacked, and modified to create the instructions 824. For example, the information may be in multiple compressed source code packages (or object code, or binary executable code, etc.) on one or several remote servers. The source code packages may be encrypted when in transit over a network and decrypted, uncompressed, assembled (e.g., linked) if necessary, and compiled or interpreted (e.g., into a library, stand-alone executable etc.) at a local machine, and executed by the local machine.

[0087] The instructions 824 may be further transmitted or received over a communications network 826 using a transmission medium via the network interface device 820 utilizing any one of a number of transfer protocols (e.g., frame relay, internet protocol (IP), transmission control protocol (TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP), etc.). Example communication networks may include a local area network (LAN), a wide area network (WAN), a packet data network (e.g., the Internet), LoRa / LoRaWAN, orsatellite communication networks, mobile telephone networks (e.g., cellular networks such as those complying with 3G, 4G LTE / LTE-A, or 5G standards), Plain Old Telephone (POTS) networks, and wireless data networks (e.g., Institute of Electrical and Electronics Engineers (IEEE) 802.11 family of standards known as Wi-Fi®, IEEE 802.15.4 family of standards, peer-to-peer (P2P) networks, among others. In an example, the network interface device 820 may include one or more physical jacks (e.g., Ethernet, coaxial, or phone jacks) or one or more antennas to connect to the communications network 826. In an example, the network interface device 820 may include a plurality of antennas to wirelessly communicate using at least one of single-input multiple-output (SIMO), multipleinput multiple-output (MIMO), or multiple-input single-output (MISO) techniques. The term “transmission medium” shall be taken to include any intangible medium that is capable of storing, encoding or carrying instructions for execution by the machine 800, and includes digital or analog communications signals or other intangible medium to facilitate communication of such software. A transmission medium is a machine readable medium.

[0088] The term “endoscope” is intended to include endoscopes, laparoscopes, ureteroscopes, arthroscopes, duodenoscopes, and other scopes, such as may include scopes designed for accessing a location inside a patient.

[0089] FIG. 9 is a block diagram showing an example of a portion of a computer-based clinical decision support system (CDSS) 900. The CDSS 900 may be configured to determine a position of an instrument, determine another parameter describing the instrument (e.g., velocity, acceleration), or tailor or provide a motor control signal (e.g., to achieve a desired effect on the instrument). The CDSS 900 can include an input interface 902 through which parameters such as the size of a surgical fiber or other elongated instrument, information about the feed system (e.g., motor size and parameters), information about one or more sensors, information about the light sources, information about the optical components, and / or information about the scope which are specific to a patient’s procedure are provided as input features to an artificial intelligence (Al) model 904, a processor which performs an inference operation in which the parameters are applied to the Al model to generate the determination of the instrument position or motor control signal, and an output interface 908 through which thedetermined information can be communicated to a user (e.g., a clinician) or system (e.g., the auto-feed system).

[0090] The input interface 902 may include a direct data link between the CDSS 900 and one or more medical devices that generate at least some of the input features. For example, the input interface 902 may transmit information about the sensor 910 or information about a signal 912 returned from the sensor 910 directly to the CDSS 900 during a therapeutic and / or diagnostic medical procedure. In an example, information about the light sources and / or the optical components, the scope, etc., used during the procedure can be stored in a database 906. Additionally, or alternatively, the input interface 902 may be a classical user interface that facilitates interaction between a user and the CDSS 900. For example, the input interface 902 may facilitate a user interface through which the user may manually enter the information about the surgical fiber, the scope, the optical components, signals to block or allow, etc. Additionally, or alternatively, the input interface 902 may provide the CDSS 900 with access to an electronic patient record or the components being used during the procedure from which one or more input features may be extracted. In any of these cases, the input interface 902 is configured to collect one or more of the following input features in association with one or more of a specific patient, a type of medical procedure, a type of scope, signals that should be rejected during spectroscopic analysis, or the like, on or before a time at which the CDSS 900 is used to assess the input features will take place.

[0091] An example of an input feature can include a dimension of the surgical fiber to be used during the procedure.

[0092] An example of an input feature can include a user input, such as a desired position or speed of an instrument.

[0093] An example of an input feature can include a sensor signal 912, such as received from sensor 910 (e.g., sensor 250).

[0094] An example of an input feature can include a measured effect on the instrument, such as in correspondence with the desired effect (e.g., the signal sent to the drive motor 222).

[0095] An example of an input feature can include a type of light or laser source.

[0096] An example of an input feature can include the type of scope being used during the procedure.

[0097] An example of an input feature can include one or more temperature values, such as may include a temperature inside a patient.

[0098] Based on one or more of the above input features, the processor may perform an inference operation using the Al model 904 to generate determined properties of the instrument or determined outputs to the drive motor. For example, input interface 902 may deliver one or more of the input features listed above into an input layer of the Al model 904 which propagates these input features through the Al model 904 to an output layer. The Al model 904 may provide a computer system the ability to perform tasks, without explicitly being programmed, such as by making inferences based on patterns found in the analysis of data. The Al model 904 may explore the study and construction of algorithms (e.g., machine-learning algorithms) that may learn from existing data and make predictions about new data. Such algorithms may operate by building an Al model from example training data in order to make data-driven predictions or decisions expressed as outputs or assessments.

[0099] Examples of two modes for machine learning (ML) can include: supervised ML and unsupervised ML. Supervised ML may use prior knowledge (e.g., examples that correlate inputs to outputs or outcomes) to learn the relationships between the inputs and the outputs. The goal of supervised ML may be to learn a function that, given some training data, best approximates the relationship between the training inputs and outputs so that the ML model can implement the same relationships when given inputs to generate the corresponding outputs. Unsupervised ML may be the training of an ML algorithm using information that is neither classified nor labeled and allowing the algorithm to act on that information without guidance. Unsupervised ML may be useful in exploratory analysis because it can automatically identify structure in data.

[0100] Tasks for supervised ML can include classification problems and regression problems. Classification problems, also referred to as categorization problems, may aim at classifying items into one of several category values (for example, is this object an apple or an orange?). Regression algorithms may aim at quantifying some items (for example, by providing a score to the value of some input). Some examples of supervised-ML algorithms may include LogisticRegression (LR), Naive-Bayes, Random Forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and Support Vector Machines (SVM).

[0101] Some possible tasks for unsupervised ML can include clustering, representation learning, and density estimation. Some examples of unsupervised- ML algorithms are K-means clustering, principal component analysis, and autoencoders.

[0102] Another type of ML may be federated learning (also known as collaborative learning) that may train an algorithm across multiple decentralized devices holding local data, without exchanging the data. This approach may stand in contrast to centralized machine-learning techniques where all the local datasets may be uploaded to one server, as well as to decentralized approaches which may assume that local data samples are identically distributed. Federated learning may enable multiple actors to build a common, robust machine learning model without sharing data, which may address considerations such as data privacy, data security, data access rights and access to heterogeneous data.

[0103] In some examples, the Al model 904 may be trained continuously or periodically prior to performance of the inference operation by the processor. Then, during the inference operation, the patient specific input features provided to the Al model 904 may be propagated from an input layer, through one or more hidden layers, and ultimately to an output layer that corresponds to the information about the auto-feed system. For example, when evaluating the sensor analysis of the signal from the sensor 250, the CDSS 900 may determine one or more characteristics of the elongated device 240.

[0104] During and / or subsequent to the inference operation, the information about the elongated device 240 may be communicated to the user via the output interface 908 (e.g., a user interface (UI)) and / or automatically cause a therapeutic laser connected to the processor to perform a desired action. For example, based on the position of the elongated device 240, the system may cause the drive motor 222 to receive a specified signal or the therapeutic laser, such as may include the therapy beam 152, to emit energy to ablate the target, adjust the amount of ablation energy, move a portion of the scope, etc.Additional Notes & Examples

[0105] Example 1 is an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the auto-feed system comprising: a drive motor coupled to a drive wheel, the drive wheel interfacing with the elongated device such that the elongated device at least one of axially inserts or axially retracts when the drive wheel rotates; and a sensor, configured to generate a signal indicative of an axial position of the elongated device in the working channel.

[0106] In Example 2, the subject matter of Example 1 optionally includes the elongated device, wherein the elongated device includes one or more markers to be detected by the sensor.

[0107] In Example 3, the subject matter of Example 2 optionally includes wherein the one or more markers include at least one of colored or shaded bands on an outer edge of the elongated device, and wherein the sensor includes an optical sensor.

[0108] In Example 4, the subject matter of any one or more of Examples 2-3 optionally include wherein the elongated device includes an identifying marking to be detected by the sensor, wherein the identifying marking identifies one or more parameters of the elongated device.

[0109] In Example 5, the subject matter of any one or more of Examples 2-4 optionally include wherein the elongated device includes at least one of a laser fiber, a basket, a grasper, or another endoscope.

[0110] In Example 6, the subject matter of any one or more of Examples 1-5 optionally include wherein the sensor includes at least one of a resistive sensor, a capacitive sensor, a conductive sensor, a magnetic sensor, a mechanical sensor, a spectrometer, or a phototransducer.

[0111] In Example 7, the subject matter of any one or more of Examples 1-6 optionally include a processor, wherein the processor is configured to control at least one of an angular speed, an angular displacement, or an angular direction of the drive motor.

[0112] In Example 8, the subject matter of Example 7 optionally includes wherein the processor is configured to determine the axial position of the elongated device based at least in part upon the signal from the sensor.

[0113] In Example 9, the subject matter of any one or more of Examples 1-8 optionally include wherein the sensor includes a rotary encoder coupled to at least one of the drive motor or the drive wheel.

[0114] In Example 10, the subject matter of any one or more of Examples 1-9 optionally include a guide wheel configured to apply a cross-axial force to the elongated device, thereby holding the elongated device against the drive wheel.

[0115] In Example 11, the subject matter of any one or more of Examples 1-10 optionally include a second sensor configured to generate a signal indicative of an axial force on the elongated device.

[0116] In Example 12, the subject matter of any one or more of Examples 1-11 optionally include wherein the drive wheel is capable of free-wheeling when the drive motor is not engaged.

[0117] In Example 13, the subject matter of any one or more of Examples 1-12 optionally include wherein the auto-feed system is at least one of configured to couple to an endoscope insertion port or included in an endoscope handle.

[0118] In Example 14, the subject matter of any one or more of Examples 1-13 optionally include wherein the drive wheel includes at least one of a flexible outer layer or a textured outer layer.

[0119] In Example 15, the subject matter of any one or more of Examples 1-14 optionally include wherein the auto-feed system accepts specified parameters of the endoscope, wherein the specified parameters include at least one of an endoscope working channel length or an endoscope working channel diameter.

[0120] Example 16 is a method of operating an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the method comprising: driving a drive motor based upon at least one of a user input or a software command, wherein the drive motor is configured to drive a drive wheel that grips the elongated device, thereby resulting in axial displacement of the elongated device when the drive wheel is turned; and sensing an axial position of the elongated device in the working channel.

[0121] In Example 17, the subject matter of Example 16 optionally includes wherein the sensing an axial position of the elongated device includes sensing a relative position of the elongated device by determining a rotational position of the drive wheel.

[0122] In Example 18, the subject matter of any one or more of Examples 16-17 optionally include wherein the sensing an axial position of the elongated device includes sensing an absolute position of the elongated device by sensing a feature on the elongated device.

[0123] In Example 19, the subject matter of any one or more of Examples 16-18 optionally include axially displacing the elongated device until a distal end of the elongated device is near a distal end of the working channel when a “feed device” command is received.

[0124] Example 20 is an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the auto-feed system comprising: a linear actuator, the linear actuator interfacing with the elongated device such that the elongated device at least one of linearly axially inserts or linearly axially retracts when the linear actuator actuates; and a processor, configured to control at least one of a linear speed, a linear displacement, or a linear direction of the linear actuator.

[0125] Example 21 is at least one machine-readable medium including instructions that, when executed by processing circuitry, cause the processing circuitry to perform operations to implement of any of Examples 1-20.

[0126] Example 22 is an apparatus comprising means to implement of any of Examples 1-20.

[0127] Example 23 is a system to implement of any of Examples 1-20.

[0128] Example 24 is a method to implement of any of Examples 1-20.

[0129] Each of the non-limiting aspects above can stand on its own or can be combined in various permutations or combinations with one or more of the other aspects or other subject matter described in this document.

[0130] The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to generally as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either withrespect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.

[0131] In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.

[0132] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc., are used merely as labels, and are not intended to impose numerical requirements on their objects.

[0133] Method examples described herein can be machine or computer- implemented at least in part. Some examples can include a computer-readable medium or machine-readable medium encoded with instructions operable to configure an electronic device to perform methods as described in the above examples. An implementation of such methods can include code, such as microcode, assembly language code, a higher-level language code, or the like. Such code can include computer readable instructions for performing various methods. The code may form portions of computer program products. Such instructions can be read and executed by one or more processors to enable performance of operations comprising a method, for example. The instructions are in any suitable form, such as but not limited to source code, compiled code, interpreted code, executable code, static code, dynamic code, and the like.

[0134] Further, in an example, the code can be tangibly stored on one or more volatile, non-transitory, or non-volatile tangible computer-readable media, such as during execution or at other times. Examples of these tangible computer- readable media can include, but are not limited to, hard disks, removable magnetic disks, removable optical disks (e.g., compact disks and digital video disks),magnetic cassettes, memory cards or sticks, random access memories (RAMs), read only memories (ROMs), and the like.

[0135] The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims

What is claimed is:

1. An auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the auto-feed system comprising: a drive motor coupled to a drive wheel, the drive wheel interfacing with the elongated device such that the elongated device at least one of axially inserts or axially retracts when the drive wheel rotates; and a sensor, configured to generate a signal indicative of an axial position of the elongated device in the working channel.

2. The auto-feed system of claim 1, further comprising the elongated device, wherein the elongated device includes one or more markers to be detected by the sensor.

3. The auto-feed system of claim 2, wherein the one or more markers include at least one of colored or shaded bands on an outer edge of the elongated device, and wherein the sensor includes an optical sensor.

4. The auto-feed system of claim 2, wherein the elongated device includes an identifying marking to be detected by the sensor, wherein the identifying marking identifies one or more parameters of the elongated device.

5. The auto-feed system of claim 2, wherein the elongated device includes at least one of a laser fiber, a basket, a grasper, or another endoscope.

6. The auto-feed system of claim 1, wherein the sensor includes at least one of a resistive sensor, a capacitive sensor, a conductive sensor, a magnetic sensor, a mechanical sensor, a spectrometer, or a phototransducer.

7. The auto-feed system of claim 1, further comprising: a processor, wherein the processor is configured to control at least one of an angular speed, an angular displacement, or an angular direction of the drive motor.

8. The auto-feed system of claim 7, wherein the processor is configured to determine the axial position of the elongated device based at least in part upon the signal from the sensor.

9. The auto-feed system of claim 1, wherein the sensor includes a rotary encoder coupled to at least one of the drive motor or the drive wheel.

10. The auto-feed system of claim 1, further comprising a guide wheel configured to apply a cross-axial force to the elongated device, thereby holding the elongated device against the drive wheel.

11. The auto-feed system of claim 1, further comprising a second sensor configured to generate a signal indicative of an axial force on the elongated device.

12. The auto-feed system of claim 1, wherein the drive wheel is capable of free-wheeling when the drive motor is not engaged.

13. The auto-feed system of claim 1, wherein the auto-feed system is at least one of configured to couple to an endoscope insertion port or included in an endoscope handle.

14. The auto-feed system of claim 1, wherein the drive wheel includes at least one of a flexible outer layer or a textured outer layer.

15. The auto-feed system of claim 1, wherein the auto-feed system accepts specified parameters of the endoscope, wherein the specified parameters include at least one of an endoscope working channel length or an endoscope working channel diameter.

16. A method of operating an auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the method comprising:driving a drive motor based upon at least one of a user input or a software command, wherein the drive motor is configured to drive a drive wheel that grips the elongated device, thereby resulting in axial displacement of the elongated device when the drive wheel is turned; and sensing an axial position of the elongated device in the working channel.

17. The method of claim 16, wherein the sensing an axial position of the elongated device includes sensing a relative position of the elongated device by determining a rotational position of the drive wheel.

18. The method of claim 16, wherein the sensing an axial position of the elongated device includes sensing an absolute position of the elongated device by sensing a feature on the elongated device.

19. The method of claim 16, comprising axially displacing the elongated device until a distal end of the elongated device is near a distal end of the working channel when a “feed device” command is received.

20. An auto-feed system for controlling a position of an elongated device in a working channel of an endoscope, the auto-feed system comprising: a linear actuator, the linear actuator interfacing with the elongated device such that the elongated device at least one of linearly axially inserts or linearly axially retracts when the linear actuator actuates; and a processor, configured to control at least one of a linear speed, a linear displacement, or a linear direction of the linear actuator.

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