Hysteroscopic surgical systems for use with surgical robotic systems and surgical robotic systems incorporating the same

Abstract

A surgical system includes a working device, a hysteroscope configured to receive the working device such that the hysteroscope constrains motion of the working device in at least one degree of freedom while permitting motion of the working device in at least one other degree of freedom, and an ultrasound device configured to receive the hysteroscope such that the ultrasound device constrains motion of the hysteroscope in at least one degree of freedom while permitting motion of the hysteroscope in at least one other degree of freedom. The working device, the hysteroscope, and the ultrasound device are configured to couple to at least one robotic arm.

Description

HYSTEROSCOPIC SURGICAL SYSTEMS FOR USE WITH SURGICAL ROBOTIC SYSTEMS AND SURGICAL ROBOTIC SYSTEMS INCORPORATING THE SAMECROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 626,091, filed January 29, 2024, the entire content of which is incorporated herein by reference.FIELD

[0002] The present disclosure relates to surgical systems and, more specifically, to hysteroscopic surgical systems for use with surgical robotic systems such as, for example, for performing transvaginal hysteroscopic surgical tasks, e.g., intrauterine and / or intramural surgical tasks, and surgical robotic systems incorporating the same.BACKGROUND

[0003] Surgical robotic systems are increasingly utilized in various different surgical procedures. Some surgical robotic systems include one or more consoles each supporting one or more robotic arms. One or more different surgical instruments may be configured for use with the surgical robotic system and selectively mountable to the various robotic arms. The robotic arms provide inputs to the mounted surgical instruments to enable operation of the mounted surgical instruments.

[0004] Transvaginal hysteroscopy includes both intrauterine procedures, e.g., procedures performed within the uterine cavity, and intramural procedures, e.g., procedures performed within the uterine wall. Intrauterine procedures may require different approaches and / or instruments as compared to intramural procedures, and vice versa. Even within the same category, hysteroscopic procedures may require different approaches depending upon, for example, the procedure to be performed, patient anatomy, technique utilized, and / or other considerations.SUMMARY

[0005] As used herein, the term “distal” refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, aremeant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, design variations, and / or other variations, up to and including plus or minus 10 percent. To the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

[0006] Provided in accordance with aspects of the present disclosure is a surgical system including a working device, a hysteroscope, and an ultrasound device. The hysteroscope is configured to receive the working device such that the hysteroscope constrains motion of the working device in at least one degree of freedom while permitting motion of the working device in at least one other degree of freedom. The ultrasound device is configured to receive the hysteroscope such that the ultrasound device constrains motion of the hysteroscope in at least one degree of freedom while permitting motion of the hysteroscope in at least one other degree of freedom. The working device, the hysteroscope, and the ultrasound device are configured to couple to at least one robotic arm.

[0007] In an aspect of the present disclosure, the surgical system includes the at least one robotic arm. The at least one robotic arm may be configured to move at least two of the working device, the hysteroscope, or the ultrasound device relative to one another. The at least one robotic arm may be configured to move each of the working device, the hysteroscope, and the ultrasound device relative to one another. The at least one robotic arm may include a first robotic arm configured to couple to the working device, a second robotic arm configured to couple to the hysteroscope, and a third robotic device configured to couple to the ultrasound device. The at least one robotic arm may include a first robotic arm configured to couple to both the working device and the hysteroscope, and a second robotic arm configured to couple to the ultrasound device.

[0008] In another aspect of the present disclosure, the system includes an adjustment mechanism configured to move the working device relative to the hysteroscope.

[0009] In another aspect of the present disclosure, the surgical robotic system includes at least one controller configured to control movement of the working device, the hysteroscope, and the ultrasound device.

[0010] In yet another aspect of the present disclosure, the at least one controller is configured to control movement of at least one of the working device, the hysteroscope, or the ultrasound device based at least in part on instrument information associated with atleast one of the working device, the hysteroscope, or the ultrasound device. Alternatively or additionally, the at least one controller is configured to control movement of at least one of the working device, the hysteroscope, or the ultrasound device based at least in part on determined positions of at least two of the working device, the hysteroscope, or the ultrasound device.

[0011] In still another aspect of the present disclosure, the at least one controller is configured to inhibit movement of the working device relative to the hysteroscope in the at least one constrained degree of freedom of the working device relative to the hysteroscope. Alternatively or additionally, the at least one controller is configured to define a range of motion of movement of the working device relative to the hysteroscope in at least one of the at least one permitted degrees of freedom of the working device relative to the hysteroscope.

[0012] In another aspect of the present disclosure, the at least one controller is configured to inhibit movement of the hysteroscope relative to the ultrasound device in the at least one constrained degree of freedom of the hysteroscope relative to the ultrasound device. Alternatively or additionally, the at least one controller is configured to define a range of motion of movement of the hysteroscope relative to the ultrasound device in at least one of the at least one permitted degrees of freedom of the hysteroscope relative to the ultrasound device.

[0013] In still another aspect of the present disclosure, the hysteroscope is configured to receive the working device such that the hysteroscope constrains motion of the working device in a plurality of degrees of freedom while permitting motion of the working device in a plurality of other degrees of freedom.

[0014] In yet another aspect of the present disclosure, the ultrasound device is configured to receive the hysteroscope such that the ultrasound device constrains motion of the hysteroscope in a plurality of degrees of freedom while permitting motion of the hysteroscope in a plurality of degrees of freedom.

[0015] In still yet another aspect of the present disclosure, the working device is a tissue resection device, an ablation device, or a biopsy device.

[0016] In another aspect of the present disclosure, the ultrasound device includes an ultrasound sensor assembly defining an imaging plane. The ultrasound device is configured to constrain motion of the hysteroscope to within the imaging plane.

[0017] In yet another aspect of the present disclosure, the hysteroscope includes at least one fluid channel configured for at least one of inflow or outflow of fluid to and from a surgical site.

[0018] In still another aspect of the present disclosure, the surgical system further includes a console configured to receive user input for moving at least one of the working device, the hysteroscope, or the ultrasound device. The surgical system may also include a control tower coupled to the console and each of the working device, the hysteroscope, and the ultrasound device.BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The above and other aspects and features of the present disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements.

[0020] FIG. 1 is a schematic illustration of a surgical robotic system including a control tower, a console, and a plurality of surgical robotic arms according to aspects of the present disclosure;

[0021] FIG. 2 is a perspective view of a surgical robotic arm of the surgical robotic system of FIG. 1 according to aspects of the present disclosure;

[0022] FIG. 3 is a perspective view of a setup arm with the surgical robotic arm of the surgical robotic system of FIG. 1 according to aspects of the present disclosure;

[0023] FIG. 4 is a schematic diagram of a computer architecture of the surgical robotic system of FIG. 1 according to aspects of the present disclosure;

[0024] FIG. 5A is a side view of a hysteroscopic surgical system in accordance with the present disclosure and configured for use with the surgical robotic system of FIG. 1 or any other suitable surgical robotic and / or surgical mounting system, wherein hysteroscopic surgical instruments of the hysteroscopic surgical system are spaced apart from one another;

[0025] FIG. 5B is a side view of the hysteroscopic surgical system of FIG. 5A wherein the hysteroscopic surgical instruments of the hysteroscopic surgical system are operably coupled to one another;

[0026] FIG. 6 is a side view illustrating the hysteroscopic surgical system of FIGS. 5A and 5B wherein each hysteroscopic surgical instrument of the hysteroscopic surgical system is coupled to a robotic and / or mounting arm in accordance with the present disclosure;

[0027] FIG. 7 is a side view illustrating the hysteroscopic surgical system of FIGS. 5 A and 5B wherein a first hysteroscopic surgical instrument of the hysteroscopic surgical system is coupled to a first robotic and / or mounting arm and wherein second and third hysteroscopic surgical instruments of the hysteroscopic surgical system are coupled to a second robotic and / or mounting arm in accordance with the present disclosure; and

[0028] FIG. 8 is a side, partial cross-sectional view illustrating the hysteroscopic surgical system of FIGS. 5 A and 5B inserted transvaginally for performing a surgical procedure on or within a uterus of a patient.DETAILED DESCRIPTION

[0029] The present disclosure provides hysteroscopic surgical systems for performing transvaginal hysteroscopic surgical tasks, e.g., intrauterine and / or intramural surgical tasks. As described in detail below, the hysteroscopic surgical systems of the present disclosure are configured for use with a surgical robotic system, which may include, for example, a surgical console, a control tower, and one or more movable carts having a surgical robotic arm coupled to a setup arm. The surgical console receives user input through one or more interface devices, which are interpreted by the control tower as movement commands for moving the surgical robotic arm. The surgical robotic arm includes a controller, which is configured to process the movement command and to generate a torque command for activating one or more actuators of the robotic arm, which, in turn, move the robotic arm in response to the movement command.

[0030] Although described in connection with surgical robotic system 10 (FIG. 1), it is understood that the hysteroscopic surgical systems of the present disclosure may also be utilized, in accordance with the present disclosure, with any other suitable surgical robotic system. Further, one or more of the hysteroscopic surgical instruments of the hysteroscopic surgical systems the present disclosure may be configured for surgical robotic use or, in aspects, one or more of the hysteroscopic surgical instruments may be adaptable for both handheld use and surgical robotic use. In addition, one or more of the hysteroscopic surgical instruments of the hysteroscopic surgical systems of the present disclosure may be configured for attachment to a mounting arm (e.g., attached to a surgical table) that is fixed in position or manually adjustable separate from surgical robotic system 20 (FIG. 1).

[0031] With reference to FIG. 1, surgical robotic system 10 includes a control tower 20, which is connected to components of the surgical robotic system 10 including a surgicalconsole 30 and a plurality of robotic arms 40. Although two robotic arms 40 are shown, any suitable number of robotic arms 40 may be provided. Each robotic arm 40 is configured to removably connect to at least one surgical instrument 50, 51 which may include, for example, hysteroscopic surgical instruments: working device 100, hysteroscope 200, and / or ultrasound device 300 (see FIGS. 5A and 5B), as detailed below. Each robotic arm 40 is also coupled to a movable cart 60.

[0032] Surgical console 30 includes at least one first display 32, which displays one or more images of the surgical site. For example, first display 32 or multiple first displays 32 may display a video image of the surgical site as provided by hysteroscope 200 (FIGS. 5 A and 5B) and / or an ultrasound image of the surgical site as provided by ultrasound device 300 (FIGS. 5A and 5B). Surgical console 30 further includes a second display 34, which displays a user interface for controlling the surgical robotic system 10. First and second displays 32, 34 may be touchscreens allowing for display of and interaction with various graphical user inputs.

[0033] Surgical console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a, 38b which are used by a user to remotely control robotic arms 40. Surgical console 30 further includes an armrest 33 used to support a clinician’s arms while operating handle controllers 38a, 38b.

[0034] Control tower 20 includes a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs). Control tower 20 also acts as an interface between surgical console 30 and one or more robotic arms 40. In particular, control tower 20 is configured to control robotic arms 40, such as to move robotic arms 40 and the corresponding surgical instrument(s) 50, 51 based on a set of programmable instructions and / or input commands from surgical console 30, in such a way that robotic arms 40 and surgical instruments 50, 51 execute a desired movement sequence in response to input from foot pedals 36 and / or handle controllers 38a, 38b.

[0035] Each of control tower 20, surgical console 30, and each robotic arm 40 includes a respective computer 21, 31, 41. Computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network, and without limitation as to the full scope of the definition of communicationnetworks as encompassed by the present disclosure. Suitable protocols include, but are not limited to, transmission control protocol / intemet protocol (TCP / IP), datagram protocol / intemet protocol (UDP / IP), and / or datagram congestion control protocol (DCCP). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth® (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs)), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122. 15.4-2003 standard for wireless personal area networks (WPANs)).

[0036] Computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, nonvolatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and / or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and / or set of instructions described herein.

[0037] With reference to FIGS. 2 and 3, each robotic arm 40 may include a plurality of links 42a, 42b, 42c, which are interconnected at joints 44a, 44b, 44c, respectively. Joint 44a is configured to secure robotic arm 40 to movable cart 60 and defines a first longitudinal axis. Movable cart 60 includes a lift 61 and a setup arm 62, which provides a base for mounting robotic arm 40. Lift 61 allows for vertical movement of setup arm 62. Movable cart 60 also includes a display 69 for displaying information pertaining to robotic arm 40.

[0038] Setup arm 62 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of robotic arm 40. Links 62a, 62b, 62c are interconnected at joints 63a, 63b, each of which may include an actuator (not shown) for rotating links 62a, 62b relative to each other and link 62c. In particular, links 62a, 62b, 62c are movable in their corresponding lateral planes that are parallel to each other, therebyallowing for extension of robotic arm 40 relative to the patient (e.g., surgical table). In aspects, robotic arm 40 may be coupled to the surgical table (not shown). Setup arm 62 includes controls 65 for adjusting movement of links 62a, 62b, 62c as well as lift 61.

[0039] Third link 62c includes a rotatable base 64 having two degrees of freedom. In particular, rotatable base 64 includes a first actuator 64a and a second actuator 64b. First actuator 64a is rotatable about a first stationary arm axis which is perpendicular to a plane defined by third link 62c and second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis. First and second actuators 64a and 64b allow for full three-dimensional orientation of robotic arm 40.

[0040] With reference again to FIGS. 1 and 2, robotic arm 40 also includes a holder 46 defining a second longitudinal axis and configured to receive an instrument drive unit (IDU) 52. The IDU 52 is configured to couple to an actuation mechanism of the surgical instrument 50, 51, if the surgical instrument 50, 51 is actuatable, and is configured to move (e.g., rotate) and actuate (if enabled) the surgical instrument 50, 51. IDU 52, more specifically, transfers actuation forces from its actuators to the surgical instrument 50, 51 to actuate components (e.g., end effectors) of the surgical instruments 50, 51. Holder 46 includes a sliding mechanism 46a, which is configured to move IDU 52 along the second longitudinal axis defined by holder 46. Holder 46 also includes a joint 46b, which rotates holder 46 relative to link 42c.

[0041] Robotic arm 40 further includes a plurality of manual override buttons 53 disposed on IDU 52 and / or setup arm 62, which may be used in a manual mode. The clinician may press one or more of buttons 53 to move the component associated with the button(s) 53.

[0042] Joints 44a, 44b include respective actuators 48a, 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a, 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like. In particular, actuator 48a is configured to rotate robotic arm 40 about a longitudinal axis defined by link 42a.

[0043] Actuator 48b of joint 44b is coupled to joint 44c via belt 45a, and joint 44c is in turn coupled to joint 46c via belt 45b. Joint 44c may include a transfer case coupling belts 45a and 45b, such that actuator 48b is configured to rotate each link 42b, 42c and holder 46 relative to each other. More specifically, links 42b, 42c, and holder 46 are passively coupledto actuator 48b which enforces rotation about a remote center point “P” which lies at an intersection of the first axis defined by link 42a and the second axis defined by holder 46. Thus, actuator 48b controls the angle “A” between the first and second axes allowing for orientation of surgical instrument 50, 51. Due to the interlinking of links 42a, 42b, 42c, and holder 46 via belts 45a and 45b, the angles between links 42a, 42b, 42c, and holder 46 are also adjusted in order to achieve the desired angle “A.” In aspects, some or all of joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.

[0044] With reference to FIGS. 1 and 4, each of computers 21, 31, 41 of surgical robotic system 10 may include a plurality of controllers, which may be embodied in hardware and / or software. Computer 21 of control tower 20 includes a controller 21a and safety observer 21b. Controller 21a receives data from computer 31 of surgical console 30 about the current position and / or orientation of handle controllers 38a, 38b and the state of foot pedals 36 and other buttons. Controller 21a processes these input positions to determine desired drive commands for each joint of robotic arm 40 and / or IDU 52 and communicates these to computer 41 of robotic arm 40. Controller 21a also receives back the actual joint angles and uses this information to determine force feedback commands that are transmitted back to computer 31 of surgical console 30 to provide haptic feedback through handle controllers 38a, 38b. Handle controllers 38a, 38b include one or more haptic feedback vibratory devices that output haptic feedback. Safety observer 21b performs validity checks on the data going into and out of controller 21a and notifies a system fault handler if errors in the data transmission are detected to place computer 21 and / or surgical robotic system 10 into a safe state.

[0045] Computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an IDU controller 41d. Main cart controller 41a receives and processes joint commands from controller 21a of computer 21 and communicates them to setup arm controller 41b, robotic arm controller 41c, and IDU controller 4 Id. Main cart controller 41a also manages instrument exchanges and the overall state of movable cart 60, robotic arm 40, and IDU 52. Main cart controller 41a also communicates actual joint angles back to controller 21a.

[0046] With additional reference to FIGS. 2 and 3, setup arm controller 41b controls joints 63a, 63b and rotatable base 64 of setup arm 62 and calculates desired motor movement commands (e.g., motor torque) for the pitch axis and controls the brakes. Robotic armcontroller 41c controls each joint 44a, 44b of robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of robotic arm 40. Robotic arm controller 41c calculates a movement command based on the calculated torque. The calculated motor commands are then communicated to one or more of actuators 48a, 48b of robotic arm 40. The actual joint positions are then transmitted by actuators 48a, 48b back to robotic arm controller 41c.

[0047] IDU controller 41d receives desired joint angles for surgical instrument 50, 51, such as wrist and jaw angles, and computes desired currents for the motors in IDU 52. IDU controller 4 Id calculates actual angles based on the motor positions and transmits the actual angles back to main cart controller 41a.

[0048] Robotic arm 40 is controlled as follows. Initially, a pose of the handle controller controlling robotic arm 40, e.g., handle controller 38a, is transformed into a desired pose of robotic arm 40 through a hand eye transform function executed by controller 21a. The hand eye function, as well as other functions described herein, is / are embodied in software executable by controller 21a or any other suitable controller described herein. The pose of handle controller 38a may be embodied as a coordinate position and role-pitch-yaw (“RPY”) orientation relative to a coordinate reference frame, which is fixed to surgical console 30. The desired pose of instrument 50, 51 is relative to a fixed frame on robotic arm 40. The pose of handle controller 38a is then scaled by a scaling function executed by controller 21a. In aspects, the coordinate position is scaled down and the orientation is scaled up by the scaling function. In addition, controller 21a also executes a clutching function, which disengages handle controller 38a from robotic arm 40. In particular, controller 21a stops transmitting movement commands from handle controller 38a to robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.

[0049] The desired pose of robotic arm 40 is based on the pose of handle controller 38a and is then passed by an inverse kinematics function executed by controller 21a. The inverse kinematics function calculates angles for joints 44a, 44b, 44c of robotic arm 40 that achieve the scaled and adjusted pose input by handle controller 38a. The calculated angles are then passed to robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravitycompensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of joints 44a, 44b, 44c.

[0050] Referring to FIGS. 5 A and 5B, a hysteroscopic surgical system 500 provided in accordance with the present disclosure and configured for use with surgical robotic system 10 (FIG. 1) is shown including a working device 100 (e.g., a tissue resection device, an ablation device, a biopsy device, etc.); a hysteroscope 200; and an ultrasound device 300. Ultrasound device 300 is configured for transvaginal insertion into position adjacent to or in abutment with tissue surrounding the cervix. Hysteroscope 200 is configured for insertion through ultrasound device 300 and the cervix into the uterus. Working device 100 is configured for insertion through hysteroscope 200 and into the uterus to perform a surgical procedure in the uterine cavity and / or within the uterine wall.

[0051] Working device 100, as noted above, may be a tissue resection device, an ablation device, a biopsy device, or other suitable working device configured for use on or within the uterus. With respect to a tissue resection device, for example, working device 100 includes a housing 110, an outer shaft 120, an inner cutting member 130, a fluid port 140, and a cable 150. Housing 110 houses drive components (not shown; e.g., gears, linkages, etc.) operably coupled to inner cutting member 130 to drive rotation and / or translation of inner cutting member 130 relative to outer shaft 120 to cut tissue. The drive components may be adapted to connect to one or more of the motors in the IDU 52 of the robotic arm 40 (see FIGS. 1-3) to which working device 100 is connected, or may be actuated in any other suitable manner. Cable 150 may provide power and / or control signals to working device 100. In aspects where working device 100 is an ablation device, cable 150 may connect working device 100 to a source of energy, e.g., for energizing an ablation probe of working device 100. Fluid port 140 is adapted to connect to a fluid pump and / or a suction source to enable the introduction of fluid into the surgical site via working device 100 or the removal of fluid from the surgical site via working device 100. In aspects where working device 100 is a tissue resection device, cut tissue, fluid, and debris may be withdrawn, e.g., under suction, from the surgical site through working device 100 and fluid port 140.

[0052] Continuing with reference to FIGS. 5 A and 5B, hysteroscope 200 includes an elongated tubular member 202 and a proximal body 240. Elongated tubular member 202 of hysteroscope 200 defines a working channel 204 configured to receive a working devicetherethrough, e.g., working device 100. Working channel 204 may also serve as a fluid inflow (or outflow) channel. Alternatively or additionally, a separate fluid inflow (or outflow) channel may be provided. Elongated tubular member 200 further includes optics extending therethrough to enable visualization at the distal end of elongated tubular member 202.

[0053] Proximal body 240 of hysteroscope 200 includes a housing 242, a camera port 244, and a valve assembly 246. Camera port 244 extends from housing 242 and is configured to connect to a camera and / or light source, e.g., to capture a video image from the distal end of elongated tubular member 202 via the optics extending through elongated tubular member 202 and / or to illuminate the distal end of elongated tubular member 202 via one or more fiber optic strands extending though elongated tubular member 202.

[0054] Valve assembly 246 is disposed in fluid communication with working channel 204 and / or a separate fluid channel of hysteroscope 200 and is configured to enable the selective inflow and / or outflow of fluid to / from the surgical site. In configurations where multiple flow channels are provided, multiple valves may likewise be provided.

[0055] Working channel 204 of elongated tubular member 202 of hysteroscope 200, as noted above, is configured to slidably receive working device 100. Thus, with working device 100 extending through hysteroscope 200, working device 100 is permitted to slide longitudinally and / or rotate (about the longitudinal axis) relative to hysteroscope 200 but is constrained in all other degrees of freedom. However, other permitted and / or constrained degrees of freedom are also contemplated.

[0056] Referring still to FIGS. 5A and 5B, ultrasound device 300 includes a frame 302 and an ultrasound sensor assembly 330. Frame 302 is formed from a pair of spaced-apart rails 304 (one of which is obscured in FIGS. 5A and 5B). Rails 304 may be configured as plates extending in substantially parallel orientation relative to one another, or in any other suitable manner. Rails 304 are bent at a bend 306 to define a more-proximal angled portion 310 and a more -distal longitudinal portion 320 disposed at an angle relative to one another. The angle may be, in configurations, from about 60 degrees to about 120 degrees, in other configurations, from about 75 degrees to about 105 degrees, and in yet other configurations, about 30 degrees. A proximal spacer 312 is disposed between the rails 304 at or near angled portion 310, e.g., at the proximal end portion of angled portion 310, and is secured therebetween, e.g., via pins, bolts, adhesive, overmolding, or in any other suitable manner,such that rails 304 are secured to one another and the spacing therebetween along angled portion 310 is maintained. A distal spacer 322 is disposed between the rails 304 at or near longitudinal portion 320, e.g., at the distal end portion of longitudinal portion 320, and is secured therebetween, e.g., via pins, bolts, adhesive, overmolding, or in any other suitable manner, such that rails 304 are secured to one another and the spacing therebetween along longitudinal portion 320 is maintained. Additional or alternative spacers are also contemplated.

[0057] Ultrasound sensor assembly 330 extends distally from the distal end of longitudinal portion 320 of frame 302 and is formed with or attached to or otherwise fixed relative to distal spacer 322. Ultrasound sensor assembly 330 includes one or more ultrasound sensors 332, e.g., ultrasound transducers, to enable ultrasound imaging of tissue, e.g., the uterus, and, more specifically, to enable 2D and / or 3D ultrasound imaging. The field of view produced by ultrasound sensor assembly 330 may be from about 30 degrees to about 180 degrees, in other configurations from about 120 degrees to about 150 degrees. Ultrasound sensor assembly 330 may be oriented such that a longitudinal axis defined by longitudinal portion 320 of frame 302 extends through the field of view, extends along a boundary line of the field of view, or is offset from the field of view. In aspects, ultrasound sensor assembly 330 is orientated such that a center line extending from the ultrasound sensor assembly 330 and bisecting the field of view is disposed at an oblique angle (in some aspects, an acute angle) relative to the longitudinal axis defined by longitudinal portion 320 of frame 302.

[0058] Bend 306 of frame 302 enables insertion of elongated tubular member 202 of hysteroscope 200 between rails 304 in substantially coaxial or parallel orientation relative to the longitudinal axis defined by longitudinal portion 320 of frame 302. Alternatively, elongated tubular member 202 of hysteroscope 200 may be inserted between rails 304 at an angle relative to the longitudinal axis. Regardless of the angle of insertion, with elongated tubular member 202 of hysteroscope 200 extending between rails 304, rails 304 serve to substantially inhibit transverse movement (sliding or tilting) of elongated tubular member 202 relative to the longitudinal axis defined by longitudinal portion 320 of frame 302 while permitting vertical movement (sliding and tilting), axial rotation, and axial sliding of elongated tubular member 202 relative to the longitudinal axis defined by longitudinal portion 320 of frame 302. Thus, movement of elongated tubular member 202 relative toframe 302 is constrained in one or more degrees of freedom and permitted in one or more other degrees of freedom. In aspects, multiple degrees of freedom are constrained, and multiple degrees of freedom are permitted.

[0059] Referring also to FIG. 6, working device 100, hysteroscope 200, and ultrasound device 300 each further include a coupler body 180, 280, 380, respectively, configured to enable operable coupling of each of working device 100, hysteroscope 200, and ultrasound device 300 to the same or different robotic arms 40 (see also FIGS. 1-3). Coupler body 180 may be attached to or integrated with housing 110 of working device 100, coupler body 280 may be attached to or integrated with proximal body 240 of hysteroscope 200, and coupler body 380 may be attached to or integrated with angled portion 310 of frame 302 of ultrasound device 300. Coupler bodies 180, 280, 380 are configured to support working device 100, hysteroscope 200, and ultrasound device 300, respectively, relative to the corresponding robotic arm(s) 40 such that movement of the corresponding robotic arm(s) 40 enables movement of working device 100, hysteroscope 200, and / or ultrasound device 300 in a desired manner and, in aspects, may include suitable mechanical and / or electrical connectors configured to connect to corresponding connectors each of the attached robotic arms 40 (see also FIGS. 1-3) to enable mechanical and / or electrical actuation of working device 100, hysteroscope 200, and / or ultrasound device 300 in response to input commands provided by the robotic arm(s) 40. Thus, working device 100, hysteroscope 200, and ultrasound device 300 may be maneuvered relative to one another and a patient to achieve a desired positioning and may also be actuated to perform a desired surgical task all from console 30 of surgical robotic system 10 (see FIG. 1).

[0060] As shown in FIG. 6, coupler bodies 180, 280, 380 of working device 100, hysteroscope 200, and ultrasound device 300, respectively, are coupled to different robotic arms 40 (see also FIGS. 1-3). Alternatively, as shown in FIG. 7, for example, two or more coupler bodies 180, 280 may be coupled to the same robotic arm 40 such that two or more of the instruments, e.g., working device 100 and hysteroscope 200, are coupled to the same robotic arm 40. In such aspects, the robotic arm 40 may include an adjustment mechanism 700 configured to enable movement of at least one of the attached instruments relative to another attached instrument. For example, adjustment mechanism 700 may include first and second mounting bodies 710, 720 supported on a base 730. First mounting body 710 is configured to engage coupler body 280 of hysteroscope 200 and second mounting body 720is configured to engage coupler body 180 of working instrument 100. Further, one or both of first and second mounting bodies 710, 720 is movable relative to the other and base 730 to thereby enable movement of hysteroscope 200 and working instrument 100 relative to one another. For example, as shown, second mounting body 720 may be slidably coupled to a track 732 defined within base 730 to enable sliding of second mounding body 720 and, thus, working instrument 100 relative to base 730 and, thus, hysteroscope 200. As an alternative or in addition to longitudinal sliding, adjustment mechanism 700 may be configured to enable other suitable relative motion, e.g., rotation, tilting, etc., between hysteroscope 200 and working instrument 100. Further, mounting bodies 710, 720 may be connectable with coupler bodies 180, 280 similarly as detailed above to enable a robotic arm 40 to affect a desired movement and / or actuation of the attached instruments, e.g., working device 100 and hysteroscope 200.

[0061] Turning to FIG. 8, hysteroscopic surgical system 500 is shown in use wherein ultrasound device 300 is inserted trans-vaginally through the vaginal canal “V” such that ultrasound sensor assembly 330 is disposed adjacent or in abutment with the cervix “C.” In this position, more specifically, ultrasound sensor assembly 330 is positioned adjacent or in abutment with the cervix “C” to enable ultrasound imaging of a field of view “Fl” including the uterus “U” and surrounding tissue. Further, in this position, the opening between rails 304 of frame 302 is oriented such that hysteroscope 200 can be inserted therethrough, through the cervix “C,” and into the uterus “U.”

[0062] In this manner, hysteroscope 200 may be utilized for visualization within the uterus “U,” e.g., providing a field of view “F2,” together with or separately from the ultrasound imaging. Hysteroscope 200 may also be used for the introduction of fluid into and / or the removal of fluid from the uterus “U” and / or for passage of working instrument 100 therethrough and into the uterus “U” to perform one or more hysteroscopic tasks therein (e.g., within the uterus “U”) or therethrough (e.g., within the uterine wall). The use of ultrasound imaging of the uterus “U” from the exterior thereof and / or visualization of the uterus “U” from within the uterine cavity provides increased visibility for performing various different hysteroscopic tasks without the need to swap out instruments supporting different imaging modalities and / or providing different imaging perspectives.

[0063] Continuing with reference to FIG. 8, the constrained degrees of freedom of hysteroscope 200 relative to ultrasound device 300 and, in turn, the constrained degrees offreedom of working instrument 100 relative to hysteroscope 200 (and, thus, ultrasound device 300) maintains working instrument 100 and hysteroscope 200 within the same plane as the field of view “Fl” of ultrasound sensor assembly 330 (in 2D ultrasound configurations), thus maintaining ultrasound imaging of working instrument 100 and hysteroscope 200 in addition to the video imaging provided by hysteroscope 200. The constraint of working instrument 100 within hysteroscope 200 likewise maintains visibility of working instrument 100 within the field of view “F2” of hysteroscope 200.

[0064] Referring again to FIGS. 6 and 7, coupling working device 100, hysteroscope 200, and ultrasound device 300 to robotic arms 40 enables working device 100, hysteroscope 200, and ultrasound device 300 to be maneuvered into and maintained in various different positions without requiring the clinician to monitor and maintain the position of each of working device 100, hysteroscope 200, and / or ultrasound device 300 while maneuvering or operating another of working device 100, hysteroscope 200, and / or ultrasound device 300.

[0065] With additional reference to FIGS. 1-4, surgical robotic system 10 may also be configured to control movement and / or operation of working device 100, hysteroscope 200, and ultrasound device 300 based at least in part upon the relative positioning and / or permitted and constrained degrees of freedom of these instruments relative to one another. Various aspects and features of this are detailed below.

[0066] In aspects, coupler bodies 180, 280, 380 of working device 100, hysteroscope 200, and ultrasound device 300, respectively, may be configured for contact or contactless communication with a corresponding robot arms 40. For example, as shown in FIG. 6, coupler bodies 180, 280, 380 may include communication components 182, 282, 382, e.g., electrical contacts, RFID chips, etc., configured to establish communication (contact or contactless) with corresponding communication components 49, e.g., electrical contacts, RFID chips, etc., of a robotic arm 40 to enable communication of data therebetween such as, for example, instrument information identifying the type of instrument, use parameters of the instrument, usage information of the instrument, etc. Alternatively, instrument information may be manually input or acquired in any other suitable manner.

[0067] In aspects, each robotic arm 40 is controlled, e.g., via a corresponding robotic arm controller 41c (FIG. 4), to move the attached instrument based at least in part on the instrument information of the attached instrument (e.g., working device 100, hysteroscope200, or ultrasound device 300) and / or the instrument information of other instruments attached to a robotic arm 40 or otherwise in use. For example, movement of a robotic arm 40 to move an attached instrument may only be enabled in the permitted degrees of freedom of that instrument and, thus, may be inhibited in the constrained degrees of freedom of that instrument (e.g., by inhibiting the robotic arm 40 from driving the instrument in the constrained degree(s) of freedom). Thus, with working device 100 inserted through hysteroscope 200, the robotic arm 40 corresponding to working device 100 may only be permitted to move working device 100 longitudinally through hysteroscope 200 or rotationally within hysteroscope 200. Transverse and / or tilting motion of working device 100 relative to hysteroscope 200, on the other hand, is inhibited to avoid damaging working device 100 and / or hysteroscope 200 as a result of contact therebetween. As another example, with hysteroscope 200 operably positioned through frame 302 of ultrasound device 300, the robotic arm 40 corresponding hysteroscope 200 may inhibit lateral movement or lateral tilting of hysteroscope 200 within and relative to ultrasound device 300, while permitting other relative motion therebetween, thus enabling full operation of hysteroscope 200 and ultrasound device 300 while avoiding damaging as a result of contact therebetween.

[0068] In aspects, computer 21 of control tower 20 may track the kinematics of robotic arms 40 to enable determination of the relative positioning of attached instruments and, based thereon, communicate with the controller 41c (FIG. 4) of the corresponding robotic arm(s) 40 to further constrain or permit motion in one or more degrees of freedom. For example, while working device 100 is generally permitted to slide longitudinally through hysteroscope 200, the relative positioning of working device 100 and hysteroscope 200 may be utilized to define a permitted sliding range of motion beyond which the robotic arm 40 is prevented from driving working device 100, e.g., to ensure that housing 110 of working device 100 does not contact a proximal end of hysteroscope 200 and / or to ensure working device 100 does not extend from hysteroscope 200 beyond a determined distance. The determined distance may be manually or automatically determined such as, for example, based on a patient’s anatomy, thus inhibiting inadvertent breaching of the uterine wall. As another example, a minimum distance working device 100 extends from hysteroscope 200 may also be determined such that, for example, working device 100 is incapable of being activated (e.g., energy applied to an ablation probe, driving of a cutting device, etc.) unlessworking device 100 extends from hysteroscope 200 at least the minimum distance (and, in aspects, not more than a maximum distance).

[0069] Similarly with respect to hysteroscope 200 and ultrasound device 300, the kinematics of robotic arm(s) 40 may be utilized to define the relative range of motion between hysteroscope 200 and ultrasound device 300 in one or more degrees of freedom. For example, although longitudinal tilting (e.g., proximal and distal tilting) of hysteroscope 200 relative to ultrasound device 300 is permitted with hysteroscope 200 received through ultrasound device 300, the range of motion may be defined by maximum and / or minimum values (e.g., in degrees of tilt), to inhibit damage to patient tissue and / or the instruments. That is, robotic arm(s) 40 may be controlled to only enable tilting of hysteroscope 200 relative to ultrasound device 300 up to, in aspects, 45 degrees, in other aspects, up to 60 degrees, etc. The particular angle or angles may be manually or automatically determined such as, for example, based on a patient’s anatomy, thus helping to guide hysteroscope 200 through the cervix and into the uterus. Sliding of hysteroscope 200 through ultrasound device 300 may also be constrained, similarly as detailed above with respect to sliding of working device 100 through hysteroscope 200.

[0070] Aspects of the present disclosure may be further described by reference to the following numbered paragraphs:

[0071] 1. A surgical system, comprising: a working device (100); a hysteroscope (200) configured to receive the working device (100) such that the hysteroscope (200) constrains motion of the working device (100) in at least one degree of freedom while permitting motion of the working device (100) in at least one other degree of freedom; and an ultrasound device (300) configured to receive the hysteroscope (200) such that the ultrasound device (300) constrains motion of the hysteroscope (200) in at least one degree of freedom while permitting motion of the hysteroscope (200) in at least one other degree of freedom, wherein the working device (100), the hysteroscope (200), and the ultrasound device (300) are configured to couple to at least one robotic arm (40).

[0072] 2. The surgical system according to paragraph 1, further comprising the at least one robotic arm (40).

[0073] 3. The surgical system according to paragraph 2, wherein the at least one robotic arm (40) is configured to: move two of the working device (100), the hysteroscope (200),or the ultrasound device (300) relative to one another; or move each of the working device (100), the hysteroscope (200), and the ultrasound device (300) relative to one another.

[0074] 4. The surgical system according to paragraph 2 or 3, wherein the at least one robotic arm (40) include: a first robotic arm (40) configured to couple to the working device (100), a second robotic arm (40) configured to couple to the hysteroscope (200), and a third robotic arm (40) configured to couple to the ultrasound device (300); or a first robotic arm (40) configured to couple to both the working device (100) and the hysteroscope (200), and a second robotic arm (40) configured to couple to the ultrasound device (300).

[0075] 5. The surgical system according to any preceding paragraph, further comprising an adjustment mechanism (700) configured to move the working device (100) relative to the hysteroscope (200).

[0076] 6. The surgical system according to any preceding paragraph, further comprising at least one controller configured to control movement of the working device (100), the hysteroscope (200), and the ultrasound device (300).

[0077] 7. The surgical system according to paragraph 6, wherein the at least one controller is configured to control movement of at least one of the working device (100), the hysteroscope (200), or the ultrasound device (300) based at least in part on a determined position of at least two of the working device (100), the hysteroscope (200), or the ultrasound device (300).

[0078] 8. The surgical system according to paragraph 6 or 7, wherein the at least one controller is configured to inhibit movement of the working device (100) relative to the hysteroscope (200) in the at least one constrained degree of freedom of the working device (100) relative to the hysteroscope (200).

[0079] 9. The surgical system according to any one of paragraphs 6-8, wherein the at least one controller is further configured to define a range of motion of movement of the working device (100) relative to the hysteroscope (200) in at least one of the at least one permitted degrees of freedom of the working device (100) relative to the hysteroscope (200).

[0080] 10. The surgical system according to any one of paragraphs 6-9, wherein the at least one controller is configured to inhibit movement of the hysteroscope (200) relative to the ultrasound device (300) in the at least one constrained degree of freedom of the hysteroscope (200) relative to the ultrasound device (300).

[0081] 11. The surgical system according to any one of paragraphs 6-10, wherein the at least one controller is further configured to define a range of motion of movement of the hysteroscope (200) relative to the ultrasound device (300) in at least one of the at least one permitted degrees of freedom of the hysteroscope (200) relative to the ultrasound device (300).

[0082] 12. The surgical system according to any preceding paragraph, wherein the hysteroscope (200) is configured to receive the working device (100) such that the hysteroscope (200) constrains motion of the working device (100) in a plurality of degrees of freedom while permitting motion of the working device (100) in a plurality of other degrees of freedom.

[0083] 13. The surgical system according to any preceding paragraph, wherein the ultrasound device (300) is configured to receive the hysteroscope (200) such that the ultrasound device (300) constrains motion of the hysteroscope (200) in a plurality of degrees of freedom while permitting motion of the hysteroscope (200) in a plurality of degrees of freedom.

[0084] 14. The surgical system according to any preceding paragraph, wherein at least one of: the working device (100) is a tissue resection device, an ablation device, or a biopsy device; the ultrasound device (300) includes an ultrasound sensor assembly defining an imaging plane, and wherein the ultrasound device (300) is configured to constrain motion of the hysteroscope (200) to within the imaging plane; or the hysteroscope (200) includes at least one fluid channel configured for at least one of inflow or outflow of fluid to and from a surgical site.

[0085] 15. The surgical system according to any preceding paragraph, further comprising a console (30) configured to receive user input for moving at least one of the working device (100), the hysteroscope (200), orthe ultrasound device (300).

[0086] While several aspects of the present disclosure have been shown in the drawings, it is not intended that the present disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular aspects. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

[0087] The following examples are illustrative of the techniques described herein.

[0088] Example 1. A surgical system, comprising: a working device; a hysteroscope configured to receive the working device such that the hysteroscope constrains motion of the working device in at least one degree of freedom while permitting motion of the working device in at least one other degree of freedom; and an ultrasound device configured to receive the hysteroscope such that the ultrasound device constrains motion of the hysteroscope in at least one degree of freedom while permitting motion of the hysteroscope in at least one other degree of freedom, wherein the working device, the hysteroscope, and the ultrasound device are configured to couple to at least one robotic arm.

[0089] Example 2. The surgical system according to Example 1, further comprising the at least one robotic arm.

[0090] Example 3. The surgical system according to Example 2, wherein the at least one robotic arm is configured to move at least two of the working device, the hysteroscope, or the ultrasound device relative to one another.

[0091] Example 4. The surgical system according to Example 2, wherein the at least one robotic arm is configured to move each of the working device, the hysteroscope, and the ultrasound device relative to one another.

[0092] Example 5. The surgical system according to Example 2, wherein the at least one robotic arm includes a first robotic arm configured to couple to the working device, a second robotic arm configured to couple to the hysteroscope, and a third robotic arm configured to couple to the ultrasound device.

[0093] Example 6. The surgical system according to Example 2, wherein the at least one robotic arm includes a first robotic arm configured to couple to both the working device and the hysteroscope, and a second robotic arm configured to couple to the ultrasound device.

[0094] Example 7. The surgical system according to Example 1, further comprising an adjustment mechanism configured to move the working device relative to the hysteroscope.

[0095] Example 8. The surgical system according to Example 1, further comprising at least one controller configured to control movement of the working device, the hysteroscope, and the ultrasound device.

[0096] Example 9. The surgical system according to Example 8, wherein the at least one controller is configured to control movement of at least one of the working device, thehysteroscope, or the ultrasound device based at least in part on a determined position of at least two of the working device, the hysteroscope, or the ultrasound device.

[0097] Example 10. The surgical system according to Example 8, wherein the at least one controller is configured to inhibit movement of the working device relative to the hysteroscope in the at least one constrained degree of freedom of the working device relative to the hysteroscope.

[0098] Example 11. The surgical system according to Example 8, wherein the at least one controller is further configured to define a range of motion of movement of the working device relative to the hysteroscope in at least one of the at least one permitted degrees of freedom of the working device relative to the hysteroscope.

[0099] Example 12. The surgical system according to Example 8, wherein the at least one controller is configured to inhibit movement of the hysteroscope relative to the ultrasound device in the at least one constrained degree of freedom of the hysteroscope relative to the ultrasound device.

[0100] Example 13. The surgical system according to Example 8, wherein the at least one controller is further configured to define a range of motion of movement of the hysteroscope relative to the ultrasound device in at least one of the at least one permitted degrees of freedom of the hysteroscope relative to the ultrasound device.

[0101] Example 14. The surgical system according to Example 1, wherein the hysteroscope is configured to receive the working device such that the hysteroscope constrains motion of the working device in a plurality of degrees of freedom while permitting motion of the working device in a plurality of other degrees of freedom.

[0102] Example 15. The surgical system according to Example 1, wherein the ultrasound device is configured to receive the hysteroscope such that the ultrasound device constrains motion of the hysteroscope in a plurality of degrees of freedom while permitting motion of the hysteroscope in a plurality of degrees of freedom.

[0103] Example 16. The surgical system according to Example 1, wherein the working device is a tissue resection device, an ablation device, or a biopsy device.

[0104] Example 17. The surgical system according to Example 1, wherein the ultrasound device includes an ultrasound sensor assembly defining an imaging plane, and wherein the ultrasound device is configured to constrain motion of the hysteroscope to within the imaging plane.

[0105] Example 18. The surgical system according to Example 1, wherein the hysteroscope includes at least one fluid channel configured for at least one of inflow or outflow of fluid to and from a surgical site.

[0106] Example 19. The surgical system according to Example 1, further comprising: a console configured to receive user input for moving at least one of the working device, the hysteroscope, or the ultrasound device.

[0107] Example 20. The surgical system according to Example 19, further comprising a control tower coupled to the console and at least one of the working device, the hysteroscope, or the ultrasound device.

Claims

WHAT IS CLAIMED IS:

1. A surgical system, comprising: a working device (100); a hysteroscope (200) configured to receive the working device (100) such that the hysteroscope (200) constrains motion of the working device (100) in at least one degree of freedom while permitting motion of the working device (100) in at least one other degree of freedom; and an ultrasound device (300) configured to receive the hysteroscope (200) such that the ultrasound device (300) constrains motion of the hysteroscope (200) in at least one degree of freedom while permitting motion of the hysteroscope (200) in at least one other degree of freedom, wherein the working device (100), the hysteroscope (200), and the ultrasound device (300) are configured to couple to at least one robotic arm (40).

2. The surgical system according to claim 1, further comprising the at least one robotic arm (40).

3. The surgical system according to claim 2, wherein the at least one robotic arm (40) is configured to: move two of the working device (100), the hysteroscope (200), or the ultrasound device (300) relative to one another; or move each of the working device (100), the hysteroscope (200), and the ultrasound device (300) relative to one another.

4. The surgical system according to claim 2 or 3, wherein the at least one robotic arm (40) include: a first robotic arm (40) configured to couple to the working device (100), a second robotic arm (40) configured to couple to the hysteroscope (200), and a third robotic arm (40) configured to couple to the ultrasound device (300); ora first robotic arm (40) configured to couple to both the working device (100) and the hysteroscope (200), and a second robotic arm (40) configured to couple to the ultrasound device (300).

5. The surgical system according to any preceding claim, further comprising an adjustment mechanism (700) configured to move the working device (100) relative to the hysteroscope (200).

6. The surgical system according to any preceding claim, further comprising at least one controller configured to control movement of the working device (100), the hysteroscope (200), and the ultrasound device (300).

7. The surgical system according to claim 6, wherein the at least one controller is configured to control movement of at least one of the working device (100), the hysteroscope (200), or the ultrasound device (300) based at least in part on a determined position of at least two of the working device (100), the hysteroscope (200), or the ultrasound device (300).

8. The surgical system according to claim 6 or 7, wherein the at least one controller is configured to inhibit movement of the working device (100) relative to the hysteroscope (200) in the at least one constrained degree of freedom of the working device (100) relative to the hysteroscope (200).

9. The surgical system according to any one of claims 6-8, wherein the at least one controller is further configured to define a range of motion of movement of the working device (100) relative to the hysteroscope (200) in at least one of the at least one permitted degrees of freedom of the working device (100) relative to the hysteroscope (200).

10. The surgical system according to any one of claims 6-9, wherein the at least one controller is configured to inhibit movement of the hysteroscope (200) relative to the ultrasound device (300) in the at least one constrained degree of freedom of the hysteroscope (200) relative to the ultrasound device (300).

11. The surgical system according to any one of claims 6-10, wherein the at least one controller is further configured to define a range of motion of movement of the hysteroscope (200) relative to the ultrasound device (300) in at least one of the at least one permitted degrees of freedom of the hysteroscope (200) relative to the ultrasound device (300).

12. The surgical system according to any preceding claim, wherein the hysteroscope (200) is configured to receive the working device (100) such that the hysteroscope (200) constrains motion of the working device (100) in a plurality of degrees of freedom while permitting motion of the working device (100) in a plurality of other degrees of freedom.

13. The surgical system according to any preceding claim, wherein the ultrasound device (300) is configured to receive the hysteroscope (200) such that the ultrasound device (300) constrains motion of the hysteroscope (200) in a plurality of degrees of freedom while permitting motion of the hysteroscope (200) in a plurality of degrees of freedom.

14. The surgical system according to any preceding claim, wherein at least one of: the working device (100) is a tissue resection device, an ablation device, or a biopsy device; the ultrasound device (300) includes an ultrasound sensor assembly defining an imaging plane, and wherein the ultrasound device (300) is configured to constrain motion of the hysteroscope (200) to within the imaging plane; or the hysteroscope (200) includes at least one fluid channel configured for at least one of inflow or outflow of fluid to and from a surgical site.

15. The surgical system according to any preceding claim, further comprising a console (30) configured to receive user input for moving at least one of the working device (100), the hysteroscope (200), or the ultrasound device (300).

Images