Systems and methods for integrating an elongate sensor in an elongate flexible instrument

Abstract

An instrument system may comprise an instrument base and an elongate flexible device coupled to the instrument base and extending along a longitudinal axis. The elongate flexible device may define a lumen. The instrument system may also include a plurality of elongate flexible components extending within the lumen. The plurality of elongate flexible components may include an elongate sensor that is radially unconstrained within the lumen along at least a portion of a length of the elongate flexible device.

Description

Docket No. P06927-WO (70228.958WO01) Customer No. 160596SYSTEMS AND METHODS FOR INTEGRATING AN ELONGATE SENSOR IN AN ELONGATE FLEXIBLE INSTRUMENTCROSS-REFERENCED APPLICATIONS

[0001] This application claims priority to and benefit of U.S. Provisional Application No. 63 / 728,545 filed December 5, 2024 and entitled “SYSTEMS AND METHODS FOR INTEGRATING AN ELONGATE SENSOR IN AN ELONGATE FLEXIBLE INSTRUMENT” and U.S. Provisional Application No. 63 / 728,607 filed December 5, 2024 and entitled “SYSTEMS AND METHODS FOR INTEGRATING AN ELONGATE SENSOR IN AN ARTICULATION SECTION OF AN ELONGATE FLEXIBLE INSTRUMENT,” which are incorporated by reference herein in their entirety.RELATED APPLICATIONS

[0002] This patent application is related to U.S. Provisional Patent Application 63 / 728,304, entitled “INSTRUMENT SYSTEMS WITH A ROTATABLE ELONGATE FLEXIBLE BODY AND INTERNAL ELONGATE FLEXIBLE COMPONENTS,” filed December 5, 2024; U.S. Provisional Patent Application 63 / 728,352, entitled “INSTRUMENT SYSTEMS WITH A ROTATABLE ELONGATE FLEXIBLE BODY AND DRIVE SYSTEM PLATFORM,” filed December 5, 2024; U.S. Provisional Patent Application 63 / 728,445, entitled “INSTRUMENT SYSTEMS WITH A ROTATABLE ELONGATE FLEXIBLE BODY AND ARTICULATION DRIVE SYSTEMS,” filed December 5, 2024; U.S. Provisional Patent Application 63 / 728,582, entitled “INSTRUMENT SYSTEMS WITH A ROTATABLE ELONGATE FLEXIBLE BODY AND PROXIMAL MANAGEMENT OF INTERNAL ELONGATE FLEXIBLE COMPONENTS,” filed December 5, 2024; U.S. Provisional Patent Application 63 / 728,627, entitled “INSTRUMENT SYSTEMS WITH EXTENDED LENGTH ARCHITECTURE,” filed December 5, 2024, all of which are incorporated by reference herein in their entirety.FIELD

[0003] Examples described herein relate to instrument systems and methods of use that include an elongate flexible body insertable within a patient anatomy and rotatable relative to an instrument base while accommodating operation of an elongate shape sensor extending within the elongate flexible body.BACKGROUND

[0004] Minimally invasive medical techniques may generally be intended to reduce the amount ofDocket No. P06927-WO (70228.958WO01) Customer No. 160596 tissue that is damaged during medical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. Such minimally invasive techniques may be performed through natural orifices in a patient anatomy or through one or more surgical incisions. Through these natural orifices or incisions an operator may insert minimally invasive medical instruments such as therapeutic instruments, diagnostic instruments, imaging instruments, and surgical instruments. Some minimally invasive medical instruments may involve the use of elongate flexible devices that are navigated to a target anatomic location to perform a procedure. Systems and methods are needed integrate an elongate shape sensor into an elongate flexible device that is rotatable relative to an instrument base.Docket No. P06927-WO (70228.958WO01) Customer No. 160596SUMMARY

[0005] The following presents a simplified summary of various examples described herein and is not intended to identify key or critical elements or to delineate the scope of the claims.

[0006] In some examples, an instrument system may comprise an instrument base and an elongate flexible device coupled to the instrument base and extending along a longitudinal axis. The elongate flexible device may define a lumen. The instrument system may also include a plurality of elongate flexible components extending within the lumen. The plurality of elongate flexible components may include an elongate sensor that is radially unconstrained within the lumen along at least a portion of a length of the elongate flexible device.

[0007] In some examples, a sensor assembly may comprise an elongate sensor having a sensor minimum bend radius and a torsion resistant conduit including a multi-layer torque coil through which a lumen extends. The multi-layer torque coil may have a coil minimum bend radius that is greater than the sensor minimum bend radius. The elongate sensor may extend within the lumen and is fixed to a distal end portion of the multi-layer torque coil.

[0008] It is to be understood that both the foregoing general description and the following detailed description are illustrative and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following detailed description.Docket No. P06927-WO (70228.958WO01) Customer No. 160596BRIEF DESCRIPTIONS OF THE DRAWINGS

[0009] FIG. 1 is a simplified diagram of a patient anatomy including a medical instrument system with an elongate flexible device, according to some examples.

[0010] FIG. 2 illustrates a manipulator assembly and medical instrument system, according to some examples.

[0011] FIG. 3 is a schematic illustration of a medical instrument system including a sensor assembly, according to some examples.

[0012] FIG. 4 is a cross-sectional view of a passive flexible section of an elongate flexible device, according to some examples.

[0013] FIG. 5 is a distal end view of a tip portion of an elongate flexible device, according to some examples.

[0014] FIG. 6 illustrates a sensor launch region of a sensor assembly, according to some examples.

[0015] FIG. 7 illustrates a medical instrument system including a sensor assembly, according to some examples.

[0016] FIG. 8 illustrates a medical instrument system including a sensor assembly, according to some examples.

[0017] FIG. 9 illustrates a medical instrument system including a sensor assembly, according to some examples.

[0018] FIG. 10 is a flowchart illustrating a method for operating an instrument system, according to some examples.

[0019] FIG. 11A illustrates an elongate flexible device including a sensor assembly constrained by keying features, according to some examples.

[0020] FIG. 11B illustrates a partial longitudinal cross-sectional view of the elongate flexible device of FIG. 11 A.

[0021] FIG. 11C illustrates a lateral cross-sectional view of the elongate flexible device of FIG. 11A at a passive flexible section.

[0022] FIG. 11D illustrates a lateral cross-sectional view of the elongate flexible device of FIG. 11A at an articulation section.

[0023] FIG. 12A illustrates an elongate flexible device including a sensor assembly constrained by keying features, according to some examples.Docket No. P06927-WO (70228.958WO01) Customer No. 160596

[0024] FTG. 12B illustrates a lateral cross-sectional view of the elongate flexible device of FIG. 12A at a passive flexible section.

[0025] FIG. 12C illustrates a lateral cross-sectional view of the elongate flexible device of FIG. 12A at an articulation section.

[0026] FIG. 13 illustrates a lateral cross-sectional view of an elongate flexible device including a constrained sensor assembly, according to some examples.

[0027] FIG. 14 illustrates a cross-sectional view of a torsion resistant conduit, according to some examples.

[0028] FIG. 15 illustrates a distal end portion of an articulation section of an elongate flexible device, according to some examples.

[0029] FIG. 16 is a flowchart illustrating a method for manufacturing a sensor assembly, according to some examples.

[0030] FIG. 17 is a schematic diagram for a robotically-assisted manipulator system, according to some examples.

[0031] FIG. 18A is a schematic diagram of an instrument system, according to some examples.

[0032] FIG. 18B illustrates a distal portion of the instrument system of FIG. 18A with an extended example of an instrument, according to some examples.

[0033] Examples of the present disclosure and their advantages are best understood by referring to the detailed description that follows. It should be appreciated that like reference numerals are used to identify like elements illustrated in one or more of the figures, wherein showings therein are for purposes of illustrating examples of the present disclosure and not for purposes of limiting the same.Docket No. P06927-WO (70228.958WO01) Customer No. 160596DETAILED DESCRIPTION

[0034] This invention relates to systems and methods for protecting, constraining, and obtaining useful shape data from an elongate shape sensor that extends within an elongate flexible device that rotates relative to an instrument base. Shape data refers to the two dimension or three dimensional shape (e.g., curvature) and / or position of the elongate shape sensor. In some examples, the rotation may be driven by a robotically-assisted manipulator assembly. Sensor data from the elongate shape sensor may be used for assessing an initial straightened homing configuration for the elongate flexible device, generally visualizing or making determinations about the shape of the elongate flexible device in the patient anatomy, registering the shape sensor to the patient anatomy, performing anatomical measurements, and / or providing feedback for the control system of the elongate flexible device. Shape sensor data that accurately reflects the position and orientation of the elongate flexible device in which the sensor is incorporated may be important to the accuracy of subsequent determinations. To maximize the accuracy of the shape sensor data, the shape sensor may be protected to minimize kinks, tight bends, and excess tensile forces. Because some elongate shape sensors do not accurately measure twist or some control systems do not process twist information from a shape sensor, eliminating or minimizing twisting of the elongate shape sensor may result in more accurate shape data. As described in various examples below, systems and methods may be provided for eliminating twisting of the elongate shape sensor by shielding the sensor with a torsion resistant conduit or by unwinding any generated twist at the sensor launch region. In other examples, twist may be prevented by constraining the elongate shape sensor while the elongate flexible device is rotated.

[0035] The elongate flexible device may be used to perform medical procedures such as, surgery, biopsy, suturing, ablation, suturing, illumination, irrigation, suction, or other interventional procedures. Some procedures may be performed in the upper or lower gastrointestinal tract including, for example fistula closure, endoscopic submucosal dissections, endoscopic mucosal resections, peroral endoscopic myotomy, endoscopic sleeve gastroplasty, and / or transoral outlet reduction endoscopy. Although the examples provided herein may be used for introducing an elongate flexible device into the gastrointestinal tract to perform gastrointestinal endoscopy procedures, it is understood that the described technology may be used in performing procedures in artificially created lumens or any endo luminal passageway or cavity, including in a patient trachea, colon, intestines, stomach, liver, kidneys and kidney calices, brain, heart, circulatory system including vasculature, fistulas, and / or the like.

[0036] FIG. 1 illustrates a medical instrument system 102 including an instrument base or chassis 114Docket No. P06927-WO (70228.958WO01) Customer No. 160596 and an elongate flexible device 112 extending through an anatomic orifice 152 such as a mouth of a patient P, through an anatomic passageway 154 such as the esophagus of the patient P, and into an anatomical structure 156. In some examples, the anatomic structure 156 may be a stomach. The anatomy of the patient P may have an anatomical frame of reference (XA, YA, ZA). A distal portion 158 of the elongate flexible device 112 may be used to perform a medical procedure, such as a suturing, biopsy, ablation procedure, at or near target location 160 located in the anatomic structure 156 using any of the methods or systems described herein. In some examples, the target location may be in the gastrointestinal tract, such as in the stomach, in the intestines, at or near a gastroesophogeal junction or the pylorus, or at other locations along the gastrointestinal tract. The elongate flexible device 112 may be advanced or retracted in a longitudinal degree of freedom of motion 170, and at least an outer elongate flexible housing 119 of the elongate flexible device may rotate in a rotational or roll degree of freedom of motion 172 (e.g.. roll relative to a longitudinal axis of the elongate flexible device 112) relative to the instrument base 114. The distal portion 158 of the elongate flexible device 112 may also be articulatable in steering degrees of freedom of motion 174 (e.g.. pitch and / or yaw orientations). In some examples, the target location 160 may be determined based on a pre-procedure plan (e.g. using pre-operative images of the patient anatomy) and an intraoperative registration between the patient and a robotically-assisted manipulator system (e.g. system 1100) used to implement the pre-procedure plan. In some examples, the target location may be determined based on a combination of kinematic data from the robotically-assisted manipulator system including shape sensor data, image-based feature detection algorithms for analyzing intra-operative images, and intraoperative registration including the detection of one or more anatomical landmarks observed during the procedure or during the procedure set-up.

[0037] FIG. 2 provides a perspective view of a manipulator assembly 100 connected to the medical instrument system 102. The manipulator assembly 100 may be a robotically-assisted manipulator assembly. For example, the manipulator assembly 100 may be a component (e.g., the manipulator assembly 1102) of a robotically-assisted manipulator system (e.g.. the robotically-assisted manipulator system 1100) including a control system (e.g., the control system 1112) for effecting selective control of the medical instrument system 102. The medical instrument system 102 includes the elongate flexible device 112 coupled at a proximal end to the instrument base 114. In various examples, the elongate flexible device 112 may be a flexible catheter or endoscope (e.g., gastroscope, bronchoscope) and may optionally include one or more elongate flexible components extending within an elongate flexible housing. Elongate flexible components may include, for example, working channels or conduits sized and shaped to receiveDocket No. P06927-WO (70228.958WO01) Customer No. 160596 one or more medical instruments, fluid lumens for channeling fluid (e.g., air or lens cleaning fluid) to and from the anatomy, control members for articulating the distal end portion of the elongate flexible device 112, imaging devices, illumination devices, sensors, or other elongate flexible structures that may be used to perform or support a medical procedure.

[0038] The manipulator assembly 100 may include a base stage 104, an insertion stage 106, and an instrument carriage 108. The instrument base 114 may be coupled to the instrument carriage 108. The manipulator assembly 100 may actuate motion in the medical instrument system 102, including a rotation or roll motion of the elongate flexible housing 119 and / or articulation of the distal portion 158 of the elongate flexible device 112. The manipulator assembly 100 may also provide for insertion and retraction of the medical instrument system 102 along an insertion trajectory 103, with respect to the patient anatomy, by moving the instrument carriage 108 and the insertion stage 106 in a telescoping manner or otherwise linearly relative to the base stage 104 and along or parallel to a linear insertion axis L. The insertion trajectory 103 may extend in an insertion / retraction direction of motion for the medical instrument system 102. More specifically, the insertion stage 106 may be coupled to and translate along the insertion axis L with respect to the base stage 104. The instrument carriage 108 may be coupled to and translate along the insertion axis L with respect to the insertion stage 106. As shown, the insertion stage 106 and the instrument camage 108 have respective protective coverings and / or and housings which may at least partially overlap with each other, thereby effecting a telescoping effect, to facilitate sealing and optimal slidable fit. In other embodiment, it should be appreciated that the instrument carriage 108 may move along a fixed length track provided by the insertion stage 106.

[0039] An imaging assembly 118 may be included in the elongate flexible device 112. The imaging assembly 118 may record concurrent or real-time images of an interventional site (which may be a surgical site, an internal surgical site, a procedure site, etc.) and provide the images to an operator (e.g., operator O, FIG. 17) through one or more displays (e.g., one or more displays of display system 1110 in FIG. 17). The instrument carriage 108 may include electronic and optical components providing the imaging assembly 118 with endoscopic capabilities. The imaging assembly 118 may be fixedly coupled or removably coupled to a conduit in the elongate flexible device 112. Optionally, the imaging assembly 118 may be fixedly attached to the elongate flexible device 112 with one or more proximal connectors to connect to cabling to provide illumination and imaging data to be transmitted / receiving by a control system. Optionally, the imaging assembly 118 may couple to the instrument base 114 and extend through an imaging port 115 and into the elongate flexible device 112. In some embodiments, the imagingDocket No. P06927-WO (70228.958WO01) Customer No. 160596 assembly 1 18 may be detached from the manipulator assembly 100 and removed from elongate flexible device 112. Other instruments 113 such as biopsy needles, ablation tools, and other flexible instruments may be coupled to manipulator assembly 100 and / or extend through one or more ports 117 in the instrument base 114 of the elongate flexible device 112 and through the elongate flexible housing 119.

[0040] The base stage 104 may also include a device connector 116 which supports the elongate flexible device 112 along the insertion trajectory 103. The manipulator assembly 100 may also include a guide assembly 110 which is selectively extendable between the instrument base 114 and the device connector 116 to support a flexible length of the elongate flexible device 112. The guide assembly 110, which may be in the form of an anti-buckling device, may have a collapsed state during the installation and set-up of the medical instrument system 102 and may have an extended state, as shown in FIG. 2, to support the elongate flexible device 112 during a procedure. The device connector 116 and / or the base stage 104 may be removably coupled to an anatomic orifice device 120. The anatomic orifice device 120 may be, for example, an endotracheal tube, a laryngeal mask airway, or a cannula, and may be fixed to patient anatomy to facilitate insertion of various medical devices into patient anatomy. For example, the anatomic orifice device 120 may be an endotracheal tube inserted into the mouth and trachea of a patient to help provide mechanical ventilation and to provide a conduit for the elongate flexible device 112 to be navigated into the patient esophagus to facilitate imaging, biopsy, and / or treatment. A procedure, such as a gastrointestinal endoscopy procedure, performed with an elongate flexible device 112 may be performed with an additional patient tracheal intubation, in which a tube is placed into the trachea to control delivery of patient oxygen. Alternatively, the elongate flexible device 112 may be used to perform a gastrointestinal procedure without a patient tracheal intubation. The elongate flexible device 112 may be used to perform any of a variety of medical procedures, including exploratory or interventional endoscopy procedures such a gastroscopy, enteroscopy, sigmoidoscopy, colonoscopy, bariatric procedures such as endoscopic sleeve gastroplasty, ablation procedures, or the like.

[0041] In various examples, a medical instrument system may include an elongate flexible device and a sensor assembly that may provide information about the shape of the elongate flexible device as it rotates and / or articulates. FIG. 3 is a schematic illustration of a medical instrument system 200 (e.g., the medical instrument system 102) including an instrument base 202 coupled to an elongate flexible device 204. The elongate flexible device 204 may extend along a longitudinal axis A and may include an elongate flexible housing 206 including a passive flexible section 208 and an articulation section 210. The instrument base 202 may house one or more components of a rotation drive system 212 that may actuate rotation of theDocket No. P06927-WO (70228.958WO01) Customer No. 160596 elongate flexible device 204 along a longitudinal axis of the elongate flexible device 204 and relative to the instrument base 202. The instrument base 202 may also house one or more components of an articulation drive system 214 that may actuate control members 216a, 216b to articulate bending of the articulation section 210 of the elongate flexible housing (e.g., in pitch and / or yaw directions). In some examples, the articulation section may have a length of approximately 10 cm. The passive flexible section 208 may bend passively in reaction to active bending to the articulation section 210 or forces within the patient anatomy.

[0042] The rotation drive system 212 may couple to and transmit rotational motion from an actuator (e.g., a motor) in the instrument carriage 108 of the manipulator assembly 100 to drive rotation of the elongate flexible device 204 relative to the instrument base 202. In some examples, the rotation drive system 212 may include components such as a rotation input element that couples to the instrument base, a rotation drive shaft, a transmission system, and a rotation engagement member that couples to the elongate flexible device.

[0043] In some examples, the articulation system may include an antagonistic articulation drive system in which articulation of the articulation section 210 in directions DI, D2 in a plane of motion is controlled by the control members 216a, 216b, each coupled to a respective drive system (e.g., input disc, drive shaft, capstan) that provides independent control of the control members 216a, 216b. In some examples, the articulation system may include a non-antagonistic articulation drive system in which articulation of the articulation section 210 in a plane of motion is controlled by the control members 216a, 216b, each coupled to a common drive system (e.g., input disc, drive shaft, capstan) that controls both control members. In a non-antagonistic articulation drive system, the control members 216a, 216b may be oppositely wound around the capstan of the common drive system such that movement of the common drive system causes one control member 216a, 216b to move in a first direction and the other control member 216a, 216b to simultaneously move in a second direction opposite the first direction. The control member 216a, 216b may be internal elongate flexible components that extend from the instrument base 202 and into a lumen 218 that extends through the elongate flexible housing 206. The control members 216a, 216b may include elongate inner and outer portions. For example, the inner portion may include an inner cable portion, such as a tendon or wire, and the outer portion may include an outer coil portion such as a coil pipe. In some examples, the control members may be Bowden cables. The distal end portion each of the control members 216a, 216b may be coupled to the articulation section 210, for example near a tip portion 220, to transfer an actuation force to the articulation section 210. The proximal end portion of theDocket No. P06927-WO (70228.958WO01) Customer No. 160596 control members 216a, 216b may terminate in the instrument base. For example, the inner portions (e.g., cables) of the control members may extend from proximal ends of the outer portions (e.g., control pipes) and be coupled to a capstan of the articulation drive system.

[0044] Various other elongate flexible components may extend within the lumen 218 of the elongate flexible housing 206 and be fixed near the articulation section 210, including at the tip portion 220. Other elongate flexible components may include elongate flexible working channels or conduits that provide a conduit for delivery of an instrument or other materials or components through the elongate flexible device 204. In some examples, elongate flexible components may include a component of an imaging system such electrical or fiber optic cable for carrying imaging data from the tip portion of the elongate flexible device 204. In some examples, elongate flexible components may include a component of an illumination system such as an electrical cable to control a distal lighting element or a fiber optic cable to transmit light through the lumen 218 to the tip portion of the elongate flexible device 204. In some examples, the elongate flexible components may include a flexible fluid conduit that extends through the lumen 218 to provide a conduit for delivery or removal of fluids. The elongate flexible components may have different stiffnesses and may be formed of different types of materials. The elongate flexible components may be radially unconstrained within all or a portion of the length of the flexible housing 206.

[0045] In some examples, the elongate flexible components may include a component of a sensor assembly 222 such as an elongate sensor 224 that may measure a shape along at least a portion of the length of the elongate flexible device 204. The sensor assembly 222 may also include a sensor launch region 226 in the instrument base 202 at which at least a portion of the elongate sensor 224 is fixed in at least one degree of freedom of motion relative to the instrument base 202. For example, the sensor launch region 226 may be positionally fixed and rotationally movable relative to the instrument base 202. The sensor launch region 226 may be located anywhere within the instrument base, including extension portions of the instrument housing that may extend longitudinally distal from the manipulator assembly interface.

[0046] In some examples, shape data or information provided by the shape sensor may be provided for a sensed length of the shape sensor between the sensor launch region 226 and a distal fixation or termination location of the shape sensor in the articulation section 210 or near the tip portion 220. In various examples, the elongate sensor 224 may include an optical fiber extending within the lumen 218. In some examples, the elongate sensor 224 may be generally radially unconstrained or laterally floating / flexing within the lumen 218 along a portion of the length of the flexible housing 206, such asDocket No. P06927-WO (70228.958WO01) Customer No. 160596 between the instrument base 202 and a proximal end of the articulation section 210. In this example, the elongate sensor 224 may be radially constrained along most or all of the articulation section 210. In some examples, the elongate sensor 224 may be generally radially unconstrained or laterally floating / flexing within the lumen 218 along substantially the entire length of the lumen between the instrument base and a distal end of the articulation section 210.

[0047] In some examples, the optical fiber may have a diameter of approximately 200 pm. In other examples, the diameter may be larger or smaller. The optical fiber of the elongate sensor 224 may form a fiber optic bend sensor for determining or approximating the shape of elongate flexible device 204. Optical fibers including Fiber Bragg Gratings (FBGs) may be used to provide strain measurements in structures in one or more dimensions. Various systems and methods for monitoring the shape and relative position of an optical fiber in three dimensions, which may be applicable in some embodiments, are described in U.S. Patent Application Publication No. 2006 / 0013523 (filed July 13, 2005 and titled “Fiber optic position and shape sensing device and method relating thereto”); U.S. Patent No. 7,772,541 (filed on March 12, 2008 and titled “Fiber Optic Position and / or Shape Sensing Based on Rayleigh Scatter”); and U.S. Patent No. 8,773,650 (filed on Sept. 2, 2010 and titled “Optical Position and / or Shape Sensing”), which are all incorporated by reference herein in their entireties. Sensors in some examples may employ other suitable strain sensing techniques, such as Rayleigh scattering, Raman scattering, Brillouin scattering, and Fluorescence scattering.

[0048] As the rotation drive system 212 drives rotation of the elongate flexible device 204 relative to the instrument base 202, the elongate flexible components, including the elongate sensor and the control members 216a, 216b may wrap or twist about the longitudinal axis A with the rotation of the elongate flexible housing 206 to which they are coupled. In various examples, systems and methods may be utilized to prevent or minimize twisting of the elongate sensor about its own axis to maintain the quality of the sensor data.

[0049] FIG. 4 is a cross-sectional view of a passive flexible section of an elongate flexible device 300. The elongate flexible device 300 may be substantially similar to the elongate flexible device 204, with differences as described. A longitudinal axis A may extend centrally through the elongate flexible device 300. The elongate flexible device 300 may include an elongate flexible housing 301 including an outer layer 302 and an inner layer 304. The layers 302, 304 may include any of a variety of bendable or flexible structures including, for example, a series of connected linkages, a braided or woven sheath, and an elastomeric conduit. The layers 302, 304 may surround a lumen 306. In various examples, the housingDocket No. P06927-WO (70228.958WO01) Customer No. 160596301 may include more or fewer layers. A variety of elongate flexible components may extend longitudinally within the lumen 306. In this example, the elongate flexible components may be radially unconstrained (e.g., in a radial direction R) or able to float and flex radially within the passive flexible section. In this example, the elongate flexible components may include control members 308, each including an elongate inner portion 308a and an elongate outer portion 308b. In various examples, fewer or more control members 308 may extend within the lumen 306. The elongate flexible components may also include a flexible working channel 310 and a flexible working channel 312 that provide conduits for delivery of instruments, devices, materials, or other components through the elongate flexible device 204. In various examples, fewer or more working channels may extend within the lumen 306. The elongate flexible components may also include a sensor assembly 314 including an elongate shape sensor 316 (e.g. elongate sensor 224) extending within a torsion resistant conduit 318. The elongate flexible components may also include an imaging system 320 and an imaging wash conduit 322 for carrying a fluid to clean or dislodge debris from a distal end of the imaging system 320 to provide an unobstructed field of view. The elongate flexible components may also include illumination members 324 for providing illumination to a distal end of the elongate flexible device 204 and an irrigation channel 326 for delivering a fluid through the elongate flexible device 204 to irrigate an anatomic area.

[0050] FIG. 5 is a distal end view of a tip portion (e.g. tip portion 220) of the elongate flexible device 300, according to some examples. The elongate flexible device 300 may include a cap member 330 that covers a distal opening of the lumen 306. The cap member 330 may be fixed or removably fixed relative to the elongate flexible housing 301 and may provide a surface to terminate or anchor the distal ends of one or more of the various elongate flexible components. In other examples, some or all of the elongate flexible components may terminate or anchor to a scaffold near the distal tip portion of the elongate flexible device 300 or to an inner wall of the housing 301 near the distal tip portion of the elongate flexible device 300. The cap member 330 may include an opening 334 to the working channel 310 and an opening 336 to the working channel 312. The cap member 330 may include an opening 338 to the imaging wash conduit 322 or through which the imagine wash conduit extends. The cap member 330 may include an opening 340 through which the imaging system 320 extends or through which a field of view of the imaging system is visible. The cap member 330 may include an opening 342 to the irrigation channel 326. The cap member 330 may include openings 343 through which the illumination members 324 or the light emitted therefrom extends. In some examples, the cap member 330 may provide a termination surface for the shape sensor 316, allowing the distal end of the shape sensor 316 to be terminated and fixed in a centralDocket No. P06927-WO (70228.958WO01) Customer No. 160596 region near the longitudinal axis A. In other examples, an adhesive or potting material may fix the distal end of the shape sensor 316 in a central region near the longitudinal axis. In other examples, the shape sensor may terminate off-center at an inner wall of the housing 301 or to another structure or scaffold near the distal tip portion of the elongate flexible device 300.

[0051] FIG. 6 illustrates a sensor launch region 350 (e.g., the sensor launch region 226) of a sensor assembly (e.g.. the sensor assembly 222). The sensor launch region 350 may be coupled to an instrument base 352 (e.g., the instrument base 202) and may be fixed in at least one degree of freedom of motion relative to the instrument base 352. In some examples, the sensor launch region 350 may be entirely static (e.g., fixed in all degrees of freedom of motion) relative to the instrument base 352. In other examples, the sensor launch region 350 may rotate (e.g., move in a rotational degree of freedom of motion) about a fixed axis relative to the instrument base 352. In this example, an elongate shape sensor 354 (e.g., the elongate sensor 224) extends within a lumen of a torsion resistant conduit 356 and may be fixed to a distal end portion of the torsion resistant conduit 356. The sensor launch region 350 may be an assembly that provides a proximal termination to the instrument base 352 for the torsion resistant conduit 356. while the elongate shape sensor 354 may extends through the length of the torsion resistant conduit 356 and extend further proximally from the proximal end of the torsion resistant conduit. In some examples, the elongate shape sensor 354 may be adhesively fixed at or near proximal and distal ends of the torsion resistant conduit 356. In this example, a termination tube 358 may extend along the elongate shape sensor 354 proximal of the torsion resistant conduit 356. A termination ferrule 360 may couple the torsion resistant conduit 356 to the termination tube 358. More specifically, a proximal end of the torsion resistant conduit 356 may be inserted into a distal end of the termination ferrule 360 and a distal end of the termination tube 358 may be inserted into a proximal end of the termination ferrule 360. The termination ferrule 360 may be clamped, fixed with an adhesive, or otherwise fixedly coupled to the torsion resistant conduit 356 and the termination tube 358. The termination ferrule 360 may be fixed in at least one degree of freedom of motion relative to the instrument base 352. In some examples, the termination tube 358 may include a glass, ceramic, or other rigid tubular structure. In some examples, the termination ferrule 360 may include a metal hypotube or other substantially rigid and tubular structure.

[0052] In some examples, the torsion resistant conduit 356 may include a flexible multi-layer torque coil that may transmit torque along a straight or a curved path. For example, the torque coil may have two or more coil layers with adjacent layers wound in opposite directions. The torsion resistant conduit 356 may have a minimum bend radius that is greater than a minimum bend radius of the elongate shape sensorDocket No. P06927-WO (70228.958WO01) Customer No. 160596354 and thus may protect the elongate shape sensor from kinking or sharp bends that may damage the sensor (e.g., as the elongate flexible device 204 is articulated). The torsion resistant conduit 356 may also provide protection or shield the more delicate shape sensor 354 from neighboring components as it extends within the lumen of the elongate flexible housing (e.g., elongate flexible housing 206).

[0053] Accurate shape sensor data from an elongate shape sensor may be important to the accuracy of the subsequent determinations made using the data. To maximize the accuracy of the predicted device shape relative to measured sensor shape, the shape sensor may be protected to minimize kinks, tight bends, and excess tensile forces. Further, eliminating or minimizing twisting of the elongate shape sensor may result in more accurate shape data because some elongate shape sensors do not accurately measure twist or some control systems do not process twist information from a shape sensor. As described in various examples below, systems and methods may be provided for eliminating twisting of the elongate shape sensor relative to the elongate flexible device by housing the sensor within a torsion resistant conduit or by unwinding any generated twist with rotation at the sensor launch region. In other examples, twist may be prevented by constraining the elongate shape sensor while the elongate flexible device is rotated.

[0054] FIG. 7 illustrates a medical instrument system 400 including a sensor assembly 402. The instrument system 400 may include an instrument base 406 coupled to an elongate flexible device 408 through which a lumen 409 extends. The elongate flexible device 408 may extend along a longitudinal axis A and may include an elongate flexible housing 410 including a passive flexible section 412 and an articulation section 414. The instrument base 406 may house one or more components of a rotation drive system 416 that may actuate rotation of the elongate flexible device 408 relative to the instrument base 406. The rotation drive system 416 may couple to and transmit rotational motion from an actuator (e.g., a motor) in the instrument camage 108 of the manipulator assembly 100 to drive rotation of the elongate flexible device 408 relative to the instrument base 406. In some examples, the rotation drive system 416 may include components such as a rotation input element that couples to the instrument base, a rotation drive shaft, a transmission system, and a rotation engagement member that couples to the elongate flexible device 408.

[0055] The sensor assembly 402 may include a torsion resistant sensor apparatus 401 including an elongate shape sensor 420 (e.g., elongate sensor 224, 354) extending within a torsion resistant conduit 404. The sensor assembly 402 may also include a sensor launch region 422 (e.g. sensor launch region 226, 350) in the instrument base 406. The sensor launch region 422 may be fixed in at least one degree of freedom of motion relative to the instrument base 406. The sensor launch region 422 may be locatedDocket No. P06927-WO (70228.958WO01) Customer No. 160596 anywhere within the instrument base, including extension portions of the instrument housing that may extend longitudinally distal from the manipulator assembly interface. The elongate shape sensor 420 and the torsion resistant conduit 404 may be fixed relative to the elongate flexible housing 410 at a distal termination location in the articulation section 414 or near the tip portion of the elongate flexible device 408. In some examples, the distal end of the elongate shape sensor 420 may be fixed in the center of the lumen 409. at or near the axis A, but in other examples could be terminated at a known laterally offset position, such as an inner wall of the elongate flexible housing 410, that may be rotationally tracked or known as the elongate flexible device is rotated. The shape data or information provided by the elongate shape sensor 420 may be provided for a measured length of the elongate shape sensor 420 between the sensor launch region 422 and the distal termination location in the articulation section 414 or near the tip portion. The elongate shape sensor 420 extending within the torsion resistant conduit 404 may be generally radially unconstrained or laterally floating / flexing within at least a portion of the length of the lumen 409.

[0056] In this example, the sensor launch region 422 may be stationary or fixed in all degrees of freedom of motion relative to the instrument base 406. As the rotation drive system 416 is actuated to rotate the proximal end of the elongate flexible housing 410 about the axis A, the elongate shape sensor 420 and the torsion resistant conduit 404 (i.e. the torsion resistant sensor apparatus 401), coupled to the elongate flexible housing 410, may twist T1 about the longitudinal axis of the elongate shape sensor 420. In this example, the torsion resistant conduit 404 may provide a torsional stiffness that causes the twisting to occur in a more predictable way than if the elongate shape sensor was not housed in a torsion resistant component. Additionally, the elongate shape sensor 420 and the torsion resistant conduit 404 may move radially (e.g., radial motion R) within the lumen 409 and may wrap T2 around the longitudinal axis A of the elongate flexible device 408. In some examples, if the elongate shape sensor 420 is unconstrained in both the passive flexible section 412 and the articulation section 414, the twist T1 and wrap T2 may occur in both sections. In some examples, the elongate shape sensor 420 may be rotationally constrained in the articulation section 414 so that twist T1 occurs only in the passive flexible section 412 and not in the articulation section 414.

[0057] FIG. 8 illustrates a medical instrument system 450 including a sensor assembly 452. The instrument system 450 may include an instrument base 456 coupled to an elongate flexible device 458 through which a lumen 459 extends. The elongate flexible device 458 may extend along a longitudinal axis A and may include an elongate flexible housing 460 including a passive flexible section 462 and an articulation section 464. The instrument base 456 may house one or more components of a rotation driveDocket No. P06927-WO (70228.958WO01) Customer No. 160596 system 466 that may actuate rotation of the elongate flexible device 458 relative to the instrument base 456. The rotation drive system 466 may couple to and transmit rotational motion from an actuator (e.g., a motor) in the instrument camage 108 of the manipulator assembly 100 to drive rotation of the elongate flexible device 458 relative to the instrument base 456. In some examples, the rotation drive system 466 may include components such as a rotation input element that couples to the instrument base, a rotation drive shaft, a transmission system, and a rotation engagement member that couples to the elongate flexible device 458.

[0058] The sensor assembly 452 may include a torsion resistant sensor apparatus 451 including an elongate shape sensor 470 (e.g., shape sensor 354) extending within a torsion resistant conduit 454. The sensor assembly 452 may also include a sensor launch region 472 (e.g. sensor launch region 226, 350) in the instrument base 456. The sensor launch region 472 may be fixed in at least one degree of freedom of motion relative to the instrument base 456. The sensor launch region 472 may be located anywhere within the instrument base, including extension portions of the instrument housing that may extend longitudinally distal from the manipulator assembly interface. The elongate shape sensor 470 and the torsion resistant conduit 454 may be fixed relative to the elongate flexible housing 460 at a distal termination location in the articulation section 464 or near the tip portion of the elongate flexible device 458. In some examples, the distal end of the elongate shape sensor 470 may be fixed in the center of the lumen 459, at or near the axis A, but in other examples could be terminated at a known laterally offset position, such as an inner wall of the elongate flexible housing 460, that may be rotationally tracked or known as the elongate flexible device is rotated. The shape data or information provided by the elongate shape sensor 470 may be provided for a sensed length of the shape sensor between the sensor launch region 472 and the distal termination location in the articulation section 464 or near the tip portion. The elongate shape sensor 470 and the torsion resistant conduit 454 may be generally radially unconstrained or laterally floating / flexing within at least a portion of the length of the lumen 459.

[0059] In this example, the sensor launch region 472 may be stationary or fixed in positional degrees of freedom of motion relative to the instrument base 456. In other words, the position of the sensor launch region 472 may not translate relative to the instrument base. In this example, however, the sensor launch region 472 may be movable in a rotation degree of freedom T3 relative to the instrument base 456. A drive component 474 in the instrument base 456 may couple the motion of the rotation drive system 466 to the sensor launch region 472. In some examples, the drive component 474 may be a gear or other transmission member that couples to or extends the gear train or other transmission components of the rotation driveDocket No. P06927-WO (70228.958WO01) Customer No. 160596 system 466 so that rotation motion input to the rotation drive system 466 causes simultaneous rotational motion of the elongate flexible housing 460 and the sensor launch region 472. Thus, the distal and proximal ends to the sensed length (e.g., between the sensor launch region 472 and the distal termination location) of the elongate shape sensor 470, may be rotated at approximately the same rate and in the same direction. In an alternative example, the drive component 474 may be rotationally driven by a separate, dedicated drive system that couples directly to a separate actuator (e.g. a motor) of the manipulator assembly. In this alternative example, the rotational motion inputs for the extended drive component that rotates the sensor launch region may be coordinated with the rotational motion input for the rotation drive system 466 that rotates the elongate flexible housing 460 so that distal and proximal ends to the sensed length of the elongate shape sensor 470 are rotated at approximately the same rate and in the same direction.

[0060] The drive component 474 may unwind or prevent twist that may develop in the elongate shape sensor 470 as the elongate flexible housing 460 is rotated. For example, as the rotation drive system 466 is actuated to rotate the proximal end of the elongate flexible housing 460 about the axis A, the sensor launch region 472 may rotate at approximately the same rate so that the distal and proximal ends of the torsion resistant conduit 454 and the sensed length of the elongate shape sensor 470 extending therethrough are rotated by approximately the same amount. Because of the simultaneous rotation, a twisting (e.g., twisting Tl) of the torsion resistant conduit 454 and elongate shape sensor 470 about the axis of the elongate shape sensor 470 relative to the elongate flexible housing 360 may be prevented or minimized. In this example, the elongate shape sensor 470 and the torsion resistant conduit 454 may move radially (e.g., radial motion R) within the lumen 459 and may wrap T2 around the longitudinal axis A of the elongate flexible device 458.

[0061] FIG. 9 illustrates a medical instrument system 500 including a sensor assembly 502. The instrument system 500 may include an instrument base 506 coupled to an elongate flexible device 508 through which a lumen 509 extends. The elongate flexible device 508 may extend along a longitudinal axis A and may include an elongate flexible housing 510 including a passive flexible section 512 and an articulation section 514. The instrument base 506 may house one or more components of a rotation drive system 516 that may actuate rotation of the elongate flexible device 508 relative to the instrument base 506. The rotation drive system 516 may couple to and transmit rotational motion from an actuator (e.g., a motor) in the instrument camage 108 of the manipulator assembly 100 to drive rotation of the elongate flexible device 508 relative to the instrument base 506. In some examples, the rotation drive system 516Docket No. P06927-WO (70228.958WO01) Customer No. 160596 may include components such as a rotation input element that couples to the instrument base, a rotation drive shaft, a transmission system, and a rotation engagement member that couples to the elongate flexible device 508.

[0062] The sensor assembly 502 may include a torsion resistant sensor apparatus 501 including an elongate shape sensor 520 (e.g., shape sensor 354) extending within a torsion resistant conduit 504. The sensor assembly 502 may also include a sensor launch region 522 (e.g. sensor launch region 226. 350) in the instrument base 506. The sensor launch region 522 may be fixed in at least one degree of freedom of motion relative to the instrument base 506. The sensor launch region 522 may be located anywhere within the instrument base, including extension portions of the instalment housing that may extend longitudinally distal from the manipulator assembly interface. The elongate shape sensor 520 and the torsion resistant conduit 504 may be fixed relative to the elongate flexible housing 510 at a distal termination location in the articulation section 514 or near the tip portion of the elongate flexible device 508. In some examples, the distal end of the elongate shape sensor 520 may be fixed in the center of the lumen 509, at or near the axis A, but in other examples could be terminated at a known laterally offset position, such as an inner wall of the elongate flexible housing 510, that may be rotationally tracked or known as the elongate flexible device is rotated. The shape data or information provided by the shape sensor 520 may be provided for a sensed length of the shape sensor between the sensor launch region 522 and the distal termination location in the articulation section 514 or near the tip portion. The elongate shape sensor 520 and the torsion resistant conduit 504 may be generally radially unconstrained or laterally floating / flexing within at least a portion of the length of the lumen 509.

[0063] In this example, the sensor launch region 522 may be stationary or fixed in positional degrees of freedom of motion relative to the instrument base 506. In other words, the position of the sensor launch region 522 may not translate relative to the instrument base. In this example, however, the sensor launch region 522 may be movable in a rotation degree of freedom T3 relative to the instrument base 506. A passive rotational coupling 524 may rotationally couple the sensor launch region 522 to the instrument base 506. In some examples, the passive rotational coupling 524 may be a swivel joint.

[0064] The passive rotational coupling 524 may unwind or prevent twist that may develop in the elongate shape sensor 520 as the elongate flexible housing 460 is rotated. For example, as the rotation drive system 516 is actuated to rotate the proximal end of the elongate flexible housing 510 about the axis A, the torsion resistant conduit 504, coupled to the elongate flexible housing 510, conveys a torque motion (e.g., a back-drive rotational force) to the sensor launch region 522 that causes the sensor launch regionDocket No. P06927-WO (70228.958WO01) Customer No. 160596 to passively rotate about the passive rotational coupling 524. Thus, the rotation drive system 516 may cause simultaneous passive rotation of the sensor launch region 522. Because of the simultaneous rotation, a twisting (e.g., twisting Tl) of the torsion resistant conduit 504 and elongate shape sensor 520 about the axis of the elongate shape sensor 520 may be prevented, minimized, or reduced. In this example, the elongate shape sensor 520 and the torsion resistant conduit 504 may move radially (e.g., radial motion R) within the lumen 509 and may wrap T2 around the longitudinal axis A of the elongate flexible device 508.

[0065] FIG. 10 is a flowchart illustrating a method 550 for operating an instrument system, including any of the medical instrument systems 450, 500. The method 550 and other methods described herein are illustrated as a set of operations or processes that may be performed in the same or in a different order than the order shown. One or more of the illustrated processes may be omitted in some embodiments of the disclosed methods. Additionally, one or more processes that are not expressly illustrated may be included before, after, in between, or as part of the illustrated processes. In some embodiments, one or more of the processes of a disclosed method may be implemented, at least in part, by a control system executing code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of control system 1112) may cause the one or more processors to perform one or more of the processes.

[0066] The method 1000 may be performed with an instrument system (e.g. medical instrument system 450, 500) coupled to a manipulator assembly (e.g., manipulator assembly 100). At a process 552, an elongate flexible device may be rotated relative to an instrument base. For example, an actuator (e.g., a motor) of the manipulator assembly 100 may couple to and drive a rotation drive system (e.g., rotation drive system 466, 516) to rotate an elongate flexible device (e.g., elongate flexible device 458, 508) about the axis A relative to an instrument base (e.g., instrument base 456, 506).

[0067] At a process 554, a sensor launch region of a sensor assembly may be rotated relative to the instrument base. For example, a sensor launch region (e.g., sensor launch region 472, 522) may be driven to rotate relative to the instrument base (e.g.. instrument base 456. 506). The sensor launch region 472 may be rotated by the drive component 474 at approximately the same rate as the rotation drive system 466 drives the rotation drive system 466. In some examples, the drive component 474 may be an extension of the rotation drive system 466 and may be actuated by the same rotation input from the manipulator assembly 100. In other examples, the drive component may be independently driven by a different rotation input from the manipulator assembly. A control system may be used to coordinate the motion from different rotation inputs to drive the rotations at approximately the same rate. In an alternative example,Docket No. P06927-WO (70228.958WO01) Customer No. 160596 sensor launch region 522 may be back-driven by a torque transmitted by the torsion resistant sensor apparatus 501. In this alternative, the rotation drive system 516 rotates the elongate flexible device 508, the distal end portion of the torsion resistant sensor apparatus 501, coupled to a distal end portion of the elongate flexible device 508, is rotated about the axis A. The rotational motion may also cause the torsion resistant sensor apparatus 501 to twist as it is rotated. The torque forces developed in the torsion resistant sensor apparatus 501 may be delivered to the sensor launch region 522. The passive rotational coupling 524 allows the sensor launch region 522 to rotate relative to the instrument base 506 in response to the received torque from the torsion resistant sensor apparatus to untwist the torsion resistant sensor apparatus.

[0068] At a process 556, shape data is received from the sensor assembly and may be used to determine a shape of the elongate flexible device. For example, shape data from the elongate shape sensor (e.g., elongate shape sensor 470, 520) may be received by a control system (e.g. the control system 1112) and may be processed to determine the shape of the elongate shape sensor along a sensed length of the elongate shape sensor between the sensor launch region and a distal termination location in the articulation section or near the tip portion. Based on the known position of the distal portion of the elongate shape sensor relative to the distal elongate flexible housing (e.g., coupled centrally near the longitudinal axis or off-axis and coupled to an inner wall), the known diameter of the lumen of the elongate flexible device, the known stiffness properties of the torsion resistant sensor apparatus, and other mechanical or structural properties of the components of the elongate flexible device, the data from the shape sensor may be used to estimate, approximate, or determine the a shape of the elongate flexible device. Eliminating or minimizing twist in the elongate shape sensor through the use of the torsion resistant sensor apparatus and the rotating sensor launch region may eliminate noise or artifacts in the data that may be result from twisting of the elongate shape sensor. Thus, minimizing or eliminating twist in the elongate shape sensor may provide a more accurate estimate of the shape of the elongate flexible device.

[0069] In various examples, a torsion resistant sensor apparatus may be constrained within the articulation section of the elongate flexible device to prevent radial movement of the sensor assembly while permitting axial movement of the sensor assembly. FIG. 11A illustrates an elongate flexible device 602 including a sensor assembly constrained by keying features. FIG. 1 IB illustrates a partial longitudinal cross-sectional view of the elongate flexible device 602. FIG. 11C illustrates a lateral cross-sectional view of the elongate flexible device 602 at a passive flexible section. FIG. 11D illustrates a lateral cross- sectional view of the elongate flexible device 602 at an articulation section.

[0070] The elongate flexible device 602 may be used as the elongate flexible device of any medicalDocket No. P06927-WO (70228.958WO01) Customer No. 160596 instrument system described herein and may be rotationally coupled to an instalment base as previously described. The elongate flexible device 602 may include an elongate flexible housing 604 including a passive flexible section 606 and an articulation section 608. The elongate flexible device 602 may include a lumen 610 and may extend along a longitudinal axis A. The elongate flexible housing 604 may include any of a variety of bendable or flexible structures including, for example, a series of connected linkages, a braided or woven sheath, and an elastomeric conduit. In some examples the structures forming the elongate flexible housing may vary at different sections of the elongate flexible device. For example, the passive flexible section 606 be constructed of different bendable or flexible materials or structures as compared to the articulation section 608. In this example, the elongate flexible housing at the articulation section 608 and the passive flexible section 606 may include a series of multi-layer interconnected links. Examples of articulation section architectures including multi-layer interconnected links are disclosed in International Patent Application PCT / US24 / 37602, filed July 11, 2024 and entitled “Systems and Methods for Flexible Medical Device Articulation,” which is incorporated by reference herein in its entirety.

[0071] A torsion resistant sensor apparatus 612, including an elongate shape sensor 614 (e.g., shape sensor 354) extending within a torsion resistant conduit 616, may extend within the lumen 610. In some examples, one or more control members 618 (e.g. control member 216a, 216b) may extend within the lumen 610. Each control member 618 may include an elongate inner portion 618a (e.g., a wire or tendon) extending within an elongate outer portion 618b (e.g., a coil pipe).

[0072] The torsion resistant conduit 616 of the torsion resistant sensor apparatus 612 may be. for example, an elongate keyed member or may be a multi-layer torque coil as previously described. In some examples, as shown in FIG. 14, the torsion resistant conduit 616 may include an elongate keyed member 622. When attached to the elongate flexible housing 604 as described below, the elongate keyed member 622 may constrain the elongate shape sensor 614 radially and circumferentially while allowing the elongate shape sensor to bend and pivot with the bending of the elongate flexible housing 604. The keyed elongate member 622 may also provide stiffness and protect the elongate shape sensor within the lumen 610.

[0073] In some examples, the elongate keyed member 622 may have a cross-sectional shape, such as an oblong shape, that may prevent twisting relative to a keyed passage with an oblong cross-section as described below. In other examples, the cross-sectional shape may be square, angular, or another nonround shape that may mate with a corresponding keyed passage to prevent twisting or rotation of the elongate shape sensor about its own axis. In some examples, an elongate keyed member may have a roundDocket No. P06927-WO (70228.958WO01) Customer No. 160596 cross-sectional shape and mate with a round keyed passage, but the elongate shape sensor would only be constrained radially and circumferentially, not rotationally about its own axis.

[0074] The elongate keyed member 622 may be formed of an extruded polymer such as a flexible thermoplastic elastomer or a thermoplastic polyurethane. The elongate keyed member 622 may include a plurality of channels including a central channel 624 and one or more side channels 626. In this example, three channels may be included, but in other examples fewer or more channels may be formed. The central channel 624 may be sized to receive the elongate shape sensor 614, and the side channels 626 may be sized to receive elongate reinforcement members 628. In some examples, the elongate reinforcement members 628 may be stiffening mandrels formed of a material such as stainless steel or nitinol with a greater rigidity than the polymer material forming the elongate keyed member 622. The elongate reinforcement member 628 may extend in the side channels 626 on opposite sides of the elongate shape sensor 614 to provide protection to the sensor and provide a selectable stiffness to the torsion resistant sensor apparatus. As shown in the detailed image of the distal end of the articulation section 608 in FIG. 15, in some examples, the distal ends of the elongate reinforcement members 628 may extend beyond a distal end of the elongate keyed member 622 and may be soldered 607 or otherwise affixed at the distal end of the articulation section 608. In some examples, the distal end of the elongate shape sensor 614 may be glued or otherwise affixed to the torsion resistant conduit 616. In some examples, the torsion resistant conduit 616 may be glued or otherwise affixed to the distal end of the articulation section 608

[0075] As shown in FIG. 1 IB, a plurality of eyelets 630 may extend from the inner wall of the elongate flexible housing 604 within the articulation section 608. The eyelets may be laser-cut and pressed-in portions of the elongate flexible housing, machined features, or other projections that provide a keyed passage for the torsion resistant conduit. The eyelets 630 may extend into the lumen 610 and may have an inner wall or keyed passage shaped to match the keyed shape of the elongate keyed member 622 to prevent rotation of the torsion resistant conduit relative to the eyelets 630 and relative to the elongate flexible housing 604. For example, the eyelets may have an oblong shaped passage that matches an oblong shape of the elongate keyed member. The eyelets 630 may restrain the radial motion of the torsion resistant sensor apparatus 612 within the lumen 610 and may maintain the torsion resistant sensor apparatus in a predetermined shape within the articulation section 608. For example, the eyelets 630 may be longitudinally aligned which may maintain the torsion resistant sensor apparatus 612 in an approximately straight or linear shape when the articulation section 608 is in an unbent configuration. In some examples, the torsion resistant sensor apparatus 612 may float axially within the eyelet 630. In some examples, aDocket No. P06927-WO (70228.958WO01) Customer No. 160596 service loop of excess length of the torsion resistant sensor apparatus 612 may extend within the instrument base to accommodate any axial motion (e.g., a piston motion) of the torsion resistant sensor apparatus 612.

[0076] In some examples, the elongate shape sensor 614 may be glued or otherwise affixed to the torsion resistant conduit 616 at distal and proximal areas of the articulation section 608, near distal-most and proximal-most eyelets, to prevent twisting of the elongate shape sensor 614 in the articulation section 608 For example, at the proximal end of the articulation section 608, the torsion resistant conduit 616 may be skived or otherwise penetrated to allow gluing of elongate shape sensor 614 to torsion resistant conduit 616.

[0077] As shown in FIG. 1 ID, in the articulation section 608, the keyed passage of eyelet 630 and the keyed shape of the elongate keyed member 622 may prevent twisting of the torsion resistant sensor apparatus 612 (including the elongate shape sensor 614) about the axis A of the articulation section 608. The eyelets 630 may also prevent radial flexure or motion of the torsion resistant sensor apparatus 612 within the lumen 610. As the elongate flexible housing 604 is rotated with the rotation of the elongate flexible device 602 relative to the instrument base, the torsion resistant sensor apparatus 612 (including the elongate shape sensor 614) may rotate about the longitudinal axis A with the rolling or rotation motion of the elongate flexible device 602. As the elongate flexible device 602 is rotated, the torsion resistant sensor apparatus 612 may maintain a shape determined by the shape of the articulation section 608. As shown in FIG. 1 ID, the inner portions 618a of the control members 618 may extend within a set of eyelets 632.

[0078] As shown in FIG. 11C, in the passive flexible section 606, the torsion resistant sensor apparatus 612 may be unrestrained by eyelets and therefore may twist, flex, or otherwise move radially within lumen 610 of elongate flexible device 602. Similarly, in the passive flexible section 606, the control members 618 may be unrestrained by eyelets and therefore may twist, flex, or otherwise move radially within lumen 610 of elongate flexible device 602.

[0079] In various examples, a torsion resistant sensor apparatus may be constrained within both the passive flexible section and the articulation section of the elongate flexible device to prevent radial movement of the sensor assembly. FIG. 12A illustrates an elongate flexible device 702 including a sensor assembly constrained by keying features. FIG. 12B illustrates a lateral cross-sectional view of the elongate flexible device 702 at a passive flexible section. FIG. 12C illustrates a lateral cross-sectional view of the elongate flexible device 702 at an articulation section.Docket No. P06927-WO (70228.958WO01) Customer No. 160596

[0080] The elongate flexible device 702 may be used as the elongate flexible device of any medical instrument system described herein and may be rotationally coupled to an instrument base as previously described. The elongate flexible device 702 may be substantially similar to the elongate flexible device 602, but in this example, the radial movement of the sensor assembly may also be constrained along at least a portion of the passive flexible section. In this example, the elongate flexible device 702 may include an elongate flexible housing 704 including a passive flexible section 706 and an articulation section 708. The elongate flexible device 702 may include a lumen 710 and may extend along a longitudinal axis A. As shown in the cross-sectional view of the articulation section 708 at FIG. 12C, a torsion resistant sensor apparatus 712 may be substantially similar to and may restrained within the articulation section in the same manner as the torsion resistant sensor apparatus 612 by eyelets 730. In this example, as shown in the cross-sectional view of the passive flexible section 706 at FIG. 12B, the longitudinal series of eyelets 730 may extend from the inner wall of the elongate flexible housing 604 within the passive flexible section 706. The eyelets 730 may extend into the lumen 710 and may prevent rotation of the torsion resistant sensor apparatus 712 relative to the eyelets 730 and relative to the elongate flexible housing 604 at the passive flexible section 706. The eyelets 730 may restrain the radial motion of the torsion resistant sensor apparatus 712 within the lumen 710 and may maintain the torsion resistant sensor apparatus in a predetermined shape within the passive flexible section 706. In some examples, the eyelets may extend the entire length of the passive flexible section 706, but in other examples, the eyelets may be present along less than the entire length of the passive flexible section.

[0081] In some examples, the torsion resistant sensor apparatus 712 includes an elongate shape sensor 714 that may be glued or otherwise affixed to a torsion resistant conduit 716 at the distal and of the articulation section 708 and near the proximal-most eyelet 730 in the passive flexible section 706 to prevent twisting of the elongate shape sensor 714 between the fixation locations. For example, near the proximal-most eyelet 730 of the passive flexible section 706, the torsion resistant conduit 716 may be skived or otherwise penetrated to allow gluing of elongate shape sensor 714 to torsion resistant conduit 716.

[0082] The eyelets 730 may prevent twisting of the torsion resistant sensor apparatus 712 (including the elongate shape sensor 714) about the axis A in the articulation section 708 and along the length of the passive flexible section 706 that includes the eyelets 730. The eyelets 730 may also prevent radial flexure or motion of the torsion resistant sensor apparatus 712 within the lumen 710. As the elongate flexible housing 704 is rotated with the rotation of the elongate flexible device 702 relative to the instrument base,Docket No. P06927-WO (70228.958WO01) Customer No. 160596 the torsion resistant sensor apparatus 712 (including the elongate shape sensor 714) may rotate about the longitudinal axis with the rolling or rotation motion of the elongate flexible device 702. As the elongate flexible device 702 is rotated, the length of the torsion resistant sensor apparatus 612, restrained by the eyelets 730, may maintain the same shape as the elongate flexible housing 704 along the same length.

[0083] In an alternative example, restraint may be provided without the use of the keyed features of elongate flexible devices 602, 702. FIG. 13 illustrates a lateral cross-sectional view of an elongate flexible device 802 including a constrained torsion resistant sensor apparatus 812 within a lumen 810. In this example, a torsion resistant sensor apparatus 812 includes an elongate shape sensor 814 extending within a torsion resistant conduit 816. In this example the torsion resistant conduit 816 may include a torque coil that has a stiffness that may generally resist or prevent twist about the axis of the elongate shape sensor 814 when the elongate flexible device 802 is rotated. The torsion resistant sensor apparatus 812 may extend through eyelets 830 that may restrain the radial motion of the torsion resistant sensor apparatus 812 within the lumen 810 and may maintain the torsion resistant sensor apparatus in a predetermined shape within the articulation section 608. The passage in the eyelets 830 may be circular or have another non-keyed shape because twist of the torsion resistant sensor apparatus 812 may be prevented by the stiffness of the torque coil rather than mated keyed features. In some examples, the elongate shape sensor 814 may be adhesively fixed to the torque coil (e.g., through separations in the coil) at the proximal end of the articulation section or at the proximal-most eyelet in the passive flexible section of the elongate flexible device 802.

[0084] FIG. 16 includes a flowchart illustrating a method 900 for manufacturing sensor components of an elongate flexible device, such as the elongate flexible device 602 of FIGS. 11A-11D, 14, and 15. The method may be used to minimize damage to the elongate sensor that may occur if the torsion resistant sensor apparatus is inserted into the eyelets of the elongate flexible device while the elongate sensor is extended within the torsion resistant conduit. The method 900 and other methods described herein are illustrated as a set of operations or processes that may be performed in the same or in a different order than the order shown. One or more of the illustrated processes may be omitted in some embodiments of the disclosed methods. Additionally, one or more processes that are not expressly illustrated may be included before, after, in between, or as part of the illustrated processes.

[0085] At a process 902, a torsion resistant conduit may be inserted through a plurality of eyelets of an elongate flexible device. For example, the torsion resistant conduit 616 may be inserted through a longitudinal series of eyelets 630 of the elongate flexible device 602.Docket No. P06927-WO (70228.958WO01) Customer No. 160596

[0086] At a process 904, an elongate reinforcement member may be inserted into a first channel of the torsion resistant conduit. For example, an elongate reinforcement member 628 may be inserted into a channel 626 in the elongate keyed member 622 of the torsion resistant conduit 616. In various examples, the insertion of the reinforcement member may occur before or after the torsion resistant conduit is inserted through the plurality of eyelets at process 902. In some examples, a second elongate reinforcement member 628 may be inserted into another channel 626 of the elongate keyed member 622 of the torsion resistant conduit 616.

[0087] At a process 906, the elongate reinforcement member may be fixed to a distal end portion of the elongate flexible device. For example, as shown in FIG. 15, the elongate reinforcement member(s) 628 may be fixed to the distal end portion of the articulation section 608 of the elongate flexible device 602 by solder 607, an adhesive, or other fixation methods.

[0088] At a process 908, an elongate sensor may be inserted into a second channel of the torsion resistant conduit. For example, the elongate sensor 614 may be inserted into the central channel 624 of the elongate keyed member 622 of the torsion resistant conduit 616.

[0089] At a process 910, the distal end portion of the torsion resistant conduit may be fixed to the distal end portion of the elongate flexible device. For example, the distal end portion of the elongate keyed member 622 of the torsion resistant conduit 616 may be glued or otherwise affixed to the distal end portion of the articulation section 608 of the elongate flexible device 602.

[0090] At a process 912, the distal end portion of the elongate sensor may be fixed to the distal end portion of the elongate flexible device. For example, the distal end portion of the elongate sensor 614 may be glued or otherwise affixed to the distal end portion of the articulation section 608 of the elongate flexible device 602.

[0091] Instrument systems and methods disclosure herein may be used with a computer-assisted, teleoperational manipulator system, sometimes referred to as a robotically-assisted manipulator system or a robotic system. The manipulator system may include one or more manipulator assemblies that may be operated with the assistance of an electronic controller (e.g., computer) to move and control functions of one or more instrument systems when coupled to the manipulators.

[0092] FIG. 17 illustrates an embodiment of a robotically-assisted manipulator system for use with the instrument systems described herein. The manipulator system can be used, for example, in surgical, diagnostic, therapeutic, biopsy, or non-medical procedures, and is generally indicated by the reference numeral 1100. As shown in FIG. 17, a robotically-assisted manipulator system 1100 can include one orDocket No. P06927-WO (70228.958WO01) Customer No. 160596 more manipulator assemblies 1102 (e.g. the manipulator assembly 100) for operating one or more medical instrument systems 1104 (e.g., the medical instrument system 102) in performing various procedures on a patient P positioned on a table T in a medical environment 1101. For example, the manipulator assembly 1102 can drive catheter or end effector motion, can apply treatment to target tissue, and / or can manipulate control members. The manipulator assembly 1102 can be teleoperated, non- teleoperated, or a hybrid teleoperated and non-teleoperated assembly with select degrees of freedom of motion that can be motorized and / or teleoperated and select degrees of freedom of motion that can be non-motorized and / or non-teleoperated. An operator input system 1106, which can be inside or outside of the medical environment 1101, generally includes one or more input control devices for controlling manipulator assembly 1102. Input control devices may include a scroll wheel, a trackball, a touch pad, a joystick, touch screens, and / or the like. Manipulator assembly 1102 supports medical instrument system 1104 and can optionally include a plurality of actuators or motors that drive inputs on medical instrument system 1104 in response to commands from a control system 1112. The actuators can optionally include drive systems that when coupled to medical instrument system 1104 can advance medical instrument system 1104 into a naturally or surgically created anatomic orifice. Other drive systems can move the distal end of medical instrument in multiple degrees of freedom, which can include three degrees of linear motion (e.g., linear motion along the X, Y, Z Cartesian axes) and in three degrees of rotational motion (e.g., rotation about the X, Y, Z Cartesian axes). The manipulator assembly 1102 can support various other systems for irrigation, treatment, or other purposes. Such systems can include fluid systems (including, for example, reservoirs, heating / cooling elements, pumps, and valves), generators, lasers, interrogators, and ablation components.

[0093] Robotically-assisted manipulator system 1100 also includes a display system 1110 for displaying an image or representation of the surgical site and medical instrument system 1104 generated by an imaging system 1109 which can include an imaging system, such as an endoscopic imaging system. Display system 1110 and operator input system 1106 can be oriented so an operator O can control medical instrument system 1104 and operator input system 1106 with the perception of telepresence. A graphical user interface can be display able on the display system 1110 and / or a display system of an independent planning workstation.

[0094] In some examples, the endoscopic imaging system components of the imaging system 1109 can be integrally or removably coupled to medical instrument system 1104. However, in some examples, a separate imaging device, such as an endoscope, attached to a separate manipulator assembly can be usedDocket No. P06927-WO (70228.958WO01) Customer No. 160596 with medical instrument system 1 104 to image the surgical site. The endoscopic imaging system 1109 can be implemented as hardware, firmware, software, or a combination thereof which interact with or are otherwise executed by one or more computer processors, which can include the processors of the control system 1112.

[0095] Robotically-assisted manipulator system 1100 can also include a sensor system 1108. The sensor system 1108 can include a position / location sensor system (e.g., an actuator encoder or an electromagnetic (EM) sensor system) and / or a shape sensor system (e.g., an optical fiber shape sensor) for determining the position, orientation, speed, velocity, pose, and / or shape of the medical instrument system 1104. The sensor system 1108 can also include temperature, pressure, force, or contact sensors or the like.

[0096] Robotically-assisted manipulator system 1100 can also include a control system 1112. Control system 1112 includes at least one memory 1116 and at least one computer processor 1114 for effecting control between medical instrument system 1104, operator input system 1106, sensor system 1108, and display system 1110. Control system 1112 also includes programmed instructions (e.g., a non-transitory machine-readable medium storing the instructions) to implement a procedure using the robotically- assisted manipulator system including for navigation, steering, imaging, engagement feature deployment or retraction, applying treatment to target tissue (e.g., via the application of energy), or the like.

[0097] Control system 1112 can optionally further include a virtual visualization system to provide navigation assistance to operator O when controlling medical instrument system 1104 during an image- guided surgical procedure. Virtual navigation using the virtual visualization system can be based upon reference to an acquired pre-operative or intra-operative dataset of anatomic passageways. The virtual visualization system processes images of the surgical site imaged using imaging technology such as computerized tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, thermography, ultrasound, optical coherence tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, and / or the like. The control system 1112 can use a pre-operative image to locate the target tissue (using vision imaging techniques and / or by receiving user input) and create a preoperative plan, including an optimal first location for performing treatment. The pre-operative plan can include, for example, a planned size to expand an expandable device, a treatment duration, a treatment temperature, and / or multiple deployment locations.

[0098] FIG. 18A shows a medical instrument system 1200 (e.g. instrument system 102 or any of the medical instrument systems described herein) according to some embodiments. In some embodiments,Docket No. P06927-WO (70228.958WO01) Customer No. 160596 medical instrument system 1200 can be used in an image-guided medical procedure. In some examples, medical instrument system 1200 can be used for non-teleoperational exploratory procedures or in procedures involving traditional manually operated medical instruments, such as endoscopy. In some embodiments, medical instrument system 1200 is interchangeable with, or a variation of, medical instrument system 1104 of FIG. 17.

[0099] Medical instrument system 1200 includes elongate flexible device 1202, such as a flexible catheter or endoscope (e.g., gastroscope, bronchoscope), coupled to a drive unit 1204. Elongate flexible device 1202 includes a flexible body 1216 having proximal end 1217 and distal end, or tip portion, 1218. In some embodiments, flexible body 1216 has an approximately 14-20 mm outer diameter. Other flexible body outer diameters can be larger or smaller. Flexible body 1216 can have an appropriate length to reach certain portions of the anatomy, such as the lungs, sinuses, throat, or the upper or lower gastrointestinal region, when flexible body 1216 is inserted into a patient’s oral or nasal cavity.

[0100] Medical instrument system 1200 optionally includes a tracking system 1230 for determining the position, orientation, speed, velocity, pose, and / or shape of distal end 1218 and / or of one or more segments 1224 along flexible body 1216 using one or more sensors and / or imaging devices. The entire length of flexible body 1216, between distal end 1218 and proximal end 1217, can be effectively divided into segments 1224. Tracking system 1230 can optionally be implemented as hardware, firmware, software or a combination thereof which interact with or are otherwise executed by one or more computer processors, which can include the processors of control system 1112 in FIG. 17.

[0101] Tracking system 1230 can optionally track distal end 1218 and / or one or more of the segments 1224 using a shape sensor 1222. In some embodiments, tracking system 1230 can optionally and / or additionally track distal end 1218 using a position sensor system 1220, such as an electromagnetic (EM) sensor system. In some examples, position sensor system 1220 can be configured and positioned to measure six degrees of freedom, e.g., three position coordinates X, Y, Z and three orientation angles indicating pitch, yaw, and roll of a base point or five degrees of freedom, e.g., three position coordinates X, Y, Z and two orientation angles indicating pitch and yaw of a base point.

[0102] Flexible body 1216 includes one or more channels 1221 sized and shaped to receive one or more medical instruments 1226. In some embodiments, flexible body 1216 includes two channels 1221 for separate instruments 1226, however, a different number of channels 1221 can be provided. FIG. 18B is a simplified diagram of flexible body 1216 with medical instrument 1226 extended according to some embodiments. In some embodiments, medical instrument 1226 can be used for procedures and aspects ofDocket No. P06927-WO (70228.958WO01) Customer No. 160596 procedures, such as surgery, biopsy, ablation, mapping, imaging, illumination, irrigation, or suction. Medical instrument 1226 can be deployed through channel 1221 of flexible body 1216 and used at a target location within the anatomy. Medical instrument 1226 can include, for example, image capture devices, biopsy instruments, ablation instruments, catheters, laser ablation fibers, and / or other surgical, diagnostic, or therapeutic tools. Medical tools can include end effectors having a single working member such as a scalpel, a blunt blade, a lens, an optical fiber, an electrode, and / or the like. Other end effectors can include, for example, forceps, graspers, balloons, needles, scissors, clip appliers, and / or the like. Other end effectors can further include electrically activated end effectors such as electrosurgical electrodes, transducers, sensors, imaging devices and / or the like. Medical instrument 1226 can be advanced from the opening of channel 1221 to perform the procedure and then retracted back into the channel when the procedure is complete. Medical instrument 1226 can be removed from proximal end 1217 of flexible body 1216 or from another optional instrument port (not shown) along flexible body 1216. The medical instrument 1226 can be used with an image capture device (e.g., an endoscopic camera) also within the elongate flexible device 1202. Alternatively, the medical instrument 1226 can itself be the image capture device.

[0103] Medical instrument 1226 can additionally house cables, linkages, or other actuation controls (not shown) that extend between its proximal and distal ends to controllably bend the distal end of medical instrument 1226. Flexible body 1216 can also house cables, linkages, or other steering controls (not shown) that extend between drive unit 1204 and distal end 1218 to controllably bend distal end 1218 as shown, for example, by broken dashed line depictions 1219 of distal end 1218. In some examples, at least four cables are used to provide independent “up-down” steering to control a pitch motion of distal end 1218 and “left-right” steering to control a yaw motion of distal end 1218. In embodiments in which medical instrument system 1200 is actuated by a robotically-assisted assembly, drive unit 1204 can include drive input elements that removably couple to and receive power from actuators of the teleoperational assembly. In some embodiments, medical instrument system 1200 can include gripping features, manual actuators, or other components for manually controlling the motion of medical instrument system 1200. The information from tracking system 1230 can be sent to a navigation system 1232 where it is combined with information from visualization system 1231 and / or the preoperatively obtained models to provide the physician or other operator with real-time position information.

[0104] In the description, specific details have been set forth describing some examples. Numerous specific details are set forth to provide a thorough understanding of the examples. It will be apparent,Docket No. P06927-WO (70228.958WO01) Customer No. 160596 however, to one skilled in the art that some examples may be practiced without some or all these specific details. The specific examples disclosed herein are meant to be illustrative but not limiting. One skilled in the art may realize other elements that, although not specifically described here, are within the scope and the spirit of this disclosure.

[0105] Elements described in detail with reference to one example, implementation, or application optionally may be included, whenever practical, in other examples, implementations, or applications in which they are not specifically shown or described. For example, if an element is described in detail with reference to one example and is not described with reference to a second example, the element may nevertheless be claimed as included in the second example. Thus, to avoid unnecessary repetition in the description, one or more elements shown and described in association with one example, implementation, or application may be incorporated into other examples, implementations, or aspects unless specifically described otherwise, unless the one or more elements would make an example or implementation nonfunctional, or unless two or more of the elements provide conflicting functions. Not all the illustrated processes may be performed in all examples of the disclosed methods. Additionally, one or more processes that are not expressly illustrated in may be included before, after, in between, or as part of the illustrated processes. In some examples, one or more of the processes may be performed by a control system or may be implemented, at least in part, in the form of executable code stored on non- transitory, tangible, machine-readable media that when run by one or more processors may cause the one or more processors to perform one or more of the processes.

[0106] Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In addition, dimensions provided herein are for specific examples and it is contemplated that different sizes, dimensions, and / or ratios may be utilized to implement the concepts of the present disclosure. To avoid needless descriptive repetition, one or more components or actions described in accordance with one illustrative example can be used or omitted as applicable from other illustrative examples. For the sake of brevity, the numerous iterations of these combinations will not be described separately. For simplicity, in some instances the same reference numbers are used throughout the drawings to refer to the same or like parts.

[0107] The systems and methods described herein may be suited for imaging and treatment, via natural or surgically created connected passageways, in any of a variety of anatomic systems, including the lung,Docket No. P06927-WO (70228.958WO01) Customer No. 160596 colon, the intestines, the stomach, the liver, the kidneys and kidney calices, the brain, the heart, the circulatory system including vasculature, and / or the like. While some examples are provided herein with respect to medical procedures, any reference to medical or surgical instruments and medical or surgical methods is non-limiting. For example, the instruments, systems, and methods described herein may be used for non-medical purposes including industrial uses, general robotic uses, and sensing or manipulating non-tissue work pieces. Other example applications involve cosmetic improvements, imaging of human or animal anatomy, gathering data from human or animal anatomy, and training medical or non-medical personnel. Additional example applications include use for procedures on tissue removed from human or animal anatomies (without return to a human or animal anatomy) and performing procedures on human or animal cadavers. Further, these techniques can also be used for surgical and nonsurgical medical treatment or diagnosis procedures.

[0108] The methods described herein may be illustrated as a set of operations or processes that may be performed in the same or in a different order than the order shown in the provided flowcharts. One or more of the illustrated processes may be omitted in some examples of the method. Additionally, one or more processes that are not expressly illustrated in the flowchart may be included before, after, in between, or as part of the illustrated processes. In some examples, one or more of the processes of a method may be implemented, at least in part, by a control system executing code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of a control system) may cause the one or more processors to perform one or more of the processes.

[0109] One or more elements in examples of this disclosure may be implemented in software to execute on a processor of a computer system such as control processing system. When implemented in software, the elements of the examples of this disclosure may be code segments to perform various tasks. The program or code segments can be stored in a processor readable storage medium or device that may have been downloaded by way of a computer data signal embodied in a earner wave over a transmission medium or a communication link. The processor readable storage device may include any medium that can store information including an optical medium, semiconductor medium, and / or magnetic medium. Processor readable storage device examples include an electronic circuit; a semiconductor device, a semiconductor memory device, a read only memory (ROM), a flash memory, an erasable programmable read only memory (EPROM): a floppy diskette, a CD-ROM, an optical disk, a hard disk, or other storage device. The code segments may be downloaded via computer networks such as the Internet, Intranet, etc. Any of a wide variety of centralized or distributed data processing architectures may be employed.Docket No. P06927-WO (70228.958WO01) Customer No. 160596Programmed instructions may be implemented as a number of separate programs or subroutines, or they may be integrated into a number of other aspects of the systems described herein. In some examples, the control system may support wireless communication protocols such as Bluetooth, Infrared Data Association (IrDA), HomeRF, IEEE 802.11, Digital Enhanced Cordless Telecommunications (DECT), ultra-wideband (UWB), ZigBee, and Wireless Telemetry.

[0110] Note that the processes and displays presented might not inherently be related to any particular computer or other apparatus. Various general-purpose systems may be used with programs in accordance with the teachings herein, or it may prove convenient to construct a more specialized apparatus to perform the operations described. The required structure for a variety of these systems will appear as elements in the claims. In addition, the examples of the invention are not described with reference to any particular programming language. It will be appreciated that a variety of programming languages may be used to implement the teachings of the invention as described herein.

[0111] This disclosure describes various instruments, portions of instruments, and anatomic structures in terms of their state in three-dimensional space. As used herein, the term position refers to the location of an object or a portion of an object in a three-dimensional space (e.g., three degrees of translational freedom along Cartesian x-, y-, and z-coordinates). As used herein, the term orientation refers to the rotational placement of an object or a portion of an object (e.g., in one or more degrees of rotational freedom such as roll, pitch, and / or yaw). As used herein, the term pose refers to the position of an object or a portion of an object in at least one degree of translational freedom and to the orientation of that object or portion of the object in at least one degree of rotational freedom (e.g., up to six total degrees of freedom). As used herein, the term shape refers to a set of poses, positions, or orientations measured along an object.

[0112] While certain illustrative examples of the invention have been described and shown in the accompanying drawings, it is to be understood that such examples are merely illustrative of and not restrictive on the broad invention, and that the examples of the invention are not limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art.

Claims

Docket No. P06927-WO (70228.958WO01) Customer No. 160596CLAIMSWhat is claimed is:

1. An instrument system, comprising: an instrument base; an elongate flexible device coupled to the instrument base and extending along a longitudinal axis, the elongate flexible device defining a lumen; and a plurality of elongate flexible components extending within the lumen, the plurality of elongate flexible components including an elongate sensor, wherein the elongate sensor is radially unconstrained within the lumen along at least a portion of a length of the elongate flexible device.2 The instrument system of claim 1, wherein the portion of the length of the elongate flexible device is between the instrument base and a proximal end of an articulation section of the elongate flexible device.3 The instrument system of claim 1, wherein the radially unconstrained portion of the elongate sensor is a first portion of the length of the elongate device and wherein the elongate sensor is radially constrained along a second portion of the length of the elongate flexible device.4 The instrument system of claim 3, wherein the second portion is an articulation section of the elongate flexible device.5 The instrument system of claim 1, wherein the elongate flexible device includes an elongate flexible housing rotatable relative to the instrument base.6 The instrument system of claim 5, wherein the plurality of elongate flexible components are configured to wrap about the longitudinal axis as the elongate flexible housing is rotated about the longitudinal axis.7 The instrument system of claim 1, wherein the plurality of elongate flexible components areDocket No. P06927-WO (70228.958WO01) Customer No. 160596 radially unconstrained within the lumen along the portion of a length of the elongate flexible device.

8. The instrument system of claim 1, wherein a distal end portion of the elongate sensor is fixed to a distal end portion of the elongate flexible device.9 The instrument system of claim 8, wherein the distal end portion of the elongate sensor is fixed along the longitudinal axis at the distal end portion of the elongate flexible device.10 The instrument system of claim 1 wherein a proximal end of the elongate sensor includes a sensor launch region.11 The instrument system of claim 10, wherein the sensor launch region is fixed positionally relative to the instrument base.12 The instrument system of claim 10, wherein the sensor launch region is rotatable relative to the instrument base.13 The instrument system of claim 12, wherein the elongate flexible device includes an elongate flexible housing and wherein the sensor launch region is coupled to a rotation drive system configured to drive rotation of the elongate flexible housing.14 The instrument system of claim 12, wherein the elongate flexible device includes an elongate flexible housing and wherein the sensor launch region is configured to rotate in response to a rotational force provided by the elongate sensor as the elongate flexible housing is rotated.15 The instrument system of claim 12, wherein the sensor launch region is fixed positionally.16 The instrument system of claim 1, wherein the elongate sensor includes a torsion resistant conduit through which an elongate sensor extends.17 The instrument system of claim 16, wherein the elongate sensor includes an optical fiber shapeDocket No. P06927-WO (70228.958WO01) Customer No. 160596 sensor.

18. The instrument system of claim 16, wherein the torsion resistant conduit includes a multi-layer torque coil.

19. The instrument system of claim 16, wherein the torsion resistant conduit includes an elongate keyed member.

20. The instrument system of claim 19, wherein the elongate keyed member includes at least one elongate channel through which the elongate sensor extends and at least one elongate channel through which a reinforcement member extends.

21. The instrument system of claim 16, wherein the torsion resistant conduit is radially constrained within the lumen by a plurality of eyelets extending along an inner wall of the elongate flexible device.

22. A sensor assembly comprising: an elongate sensor having a sensor minimum bend radius; and a torsion resistant conduit including a multi-layer torque coil through which a lumen extends, the multi-layer torque coil having a coil minimum bend radius that is greater than the sensor minimum bend radius, wherein the elongate sensor extends within the lumen and is fixed to a distal end portion of the multi-layer torque coil.

23. The sensor assembly of claim 22, further comprising a sensor launch region configured to couple to an instrument base of a medical instrument system.

24. The sensor assembly of claim 23, wherein the sensor launch region includes a termination tube coupled to a proximal end portion of the elongate sensor and a termination ferrule coupling the termination tube and the proximal end portion of the multi-layer torque coil.

25. The sensor assembly of claim 23, wherein the sensor launch region is configured to rotatablyDocket No. P06927-WO (70228.958WO01) Customer No. 160596 couple to the instrument base.

26. The sensor assembly of claim 22, wherein the torsion resistant conduit is flexible.

27. The sensor assembly of claim 22, wherein the elongate sensor is fixed to the distal end portion of the multi-layer torque coil with an adhesive.

28. An instrument system, comprising: an instrument base; an elongate flexible device coupled to and rotatable relative to the instrument base and extending along a longitudinal axis, the elongate flexible device defining a lumen; and an elongate sensor extending within the lumen, wherein the elongate flexible device includes an articulation section including a plurality of eyelets extending into the lumen, wherein the elongate sensor extends through the plurality of eyelets which constrain radial movement of the elongate sensor and allow axial movement of the elongate sensor.

29. The instrument system of claim 28, wherein the elongate flexible device includes the articulation section and a passive flexible section and wherein the eyelets extend only within the lumen in the articulation section to constrain radial movement of the elongate sensor within the articulation section.

30. The instrument system of claim 29, wherein in the articulation section, the elongate sensor is configured to rotate about the longitudinal axis in a predetermined shape as the elongate flexible device is rotated about the longitudinal axis.

31. The instrument system of claim 30, wherein the predetermined shape is approximately linear.

32. The instrument system of claim 30, wherein in the passive flexible section the elongate sensor is configured to wrap about the longitudinal axis as the elongate flexible device is rotated about the longitudinal axis.Docket No. P06927-WO (70228.958WO01) Customer No. 16059633. The instrument system of claim 28, wherein the elongate flexible device includes the articulation section and a passive flexible section and wherein the eyelets extend within the lumen in both the articulation section and the passive flexible section to constrain radial movement of the elongate sensor within the articulation section and the passive flexible section.

34. The instrument system of claim 33. wherein in the articulation section and the passive flexible section, the elongate sensor is configured to rotate about the longitudinal axis in a predetermined shape as the elongate flexible device is rotated about the longitudinal axis.

35. The instrument system of claim 28, wherein each of the plurality of eyelets includes an inner wall shaped to constrain rotation of the elongate sensor.

36. The instrument system of claim 28, wherein in the articulation section, the elongate sensor is configured to rotate about the longitudinal axis in a predetermined shape as the elongate flexible device is rotated about the longitudinal axis.

37. The instrument system of claim 28, wherein the elongate sensor includes a torsion resistant conduit through which an elongate sensor extends.

38. The instrument system of claim 37, wherein the torsion resistant conduit includes a multi-layer torque coil.

39. The instrument system of claim 37, wherein the torsion resistant conduit includes an elongate keyed member.

40. The instrument system of claim 39, wherein the elongate keyed member includes at least one elongate channel through which the elongate sensor extends and at least one elongate channel through which a reinforcement member extends.

41. The instrument system of claim 37, wherein the elongate sensor is fixed to the torsion resistant conduit at a distal end portion of the torsion resistant conduit.Docket No. P06927-WO (70228.958WO01) Customer No. 16059642. The instrument system of claim 37, wherein the elongate sensor is fixed to the torsion resistant conduit proximate to a proximal-most eyelet of the plurality of eyelets.

43. The instrument system of claim 37, wherein the elongate sensor includes an optical fiber shape sensor.

44. A method comprising: inserting a torsion resistant conduit through a plurality of eyelets of an elongate flexible device; inserting an elongate reinforcement member into a first channel of the torsion resistant conduit; fixing the elongate reinforcement member to a distal end portion of elongate flexible device; inserting an elongate sensor into a second channel of the torsion resistant conduit; fixing a distal end portion of the torsion resistant conduit to the distal end portion of the elongate flexible device: and fixing a distal end portion of the elongate sensor to the distal end portion of the elongate flexible device.

45. The method of claim 44, wherein inserting the elongate reinforcement member into the first channel occurs before the insertion of the torsion resistant conduit through the plurality of eyelets.

46. The method of claim 44, further comprising: inserting a second elongate reinforcement member into a third channel of the torsion resistant conduit.

47. The method of claim 46, wherein the second channel is between the first and second channels.

48. The method of claim 44, wherein fixing the elongate reinforcement member to the distal end portion of the elongate flexible device includes soldering the elongate reinforcement member.Docket No. P06927-WO (70228.958WO01) Customer No. 16059649. The method of claim 44, wherein fixing the distal end portion of the torsion resistant conduit to the distal end portion of the elongate flexible device includes gluing the distal end portion of the torsion resistant conduit.

50. The method of claim 44, wherein fixing the distal end portion of the elongate sensor to the distal end portion of the elongate flexible device includes gluing the distal end portion of the elongate sensor.

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