Port and insertion adjustments of a repositionable assembly using an input system

Abstract

A computer-assisted system includes a repositionable assembly including a proximal repositionable structure having a distal portion and a distal repositionable structure attached to the distal portion. The distal repositionable structure is configured to support an instrument and to move a working portion of the instrument within a reachable space. The computer-assisted system further includes a control system with one or more processors and the control system is communicatively coupled to the repositionable assembly. The control system is configured to receive a user input, the user input indicative of a command to reconfigure the proximal repositionable structure to move the reachable space. The control system is further configured to determine, based on the user input, a motion to reconfigure the proximal repositionable structure, and execute the motion to reconfigure the proximal repositionable structure to move the reachable space.

Description

PORT AND INSERTION ADJUSTMENTS OF A REPOSITIONABLE ASSEMBLY USING AN INPUT SYSTEMCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to and the benefit of the filing date of U.S. Provisional Patent Application 63 / 749,260, filed on January 24, 2025, the contents of which are hereby incorporated by reference herein in their entirety.BACKGROUNDField of Invention

[0002] The present invention generally provides improved computer-assisted devices, systems, and methods.Overview

[0003] Computer-assisted systems can be used to perform a task at a worksite.Example computer-assisted systems include industrial and recreational robotic systems. Example computer-assisted systems also include medical robotic systems used in procedures for diagnosis, non-surgical treatment, surgical treatment, etc. The computer-assisted system may include a repositionable assembly configured to support instruments. An instrument may be an instrument for performing the task. An instrument may also be an instrument for viewing the performing of the task. The computer-assisted system may be equipped with any number of instruments of any type.

[0004] The computer-assisted system can include a user input system including one or more input devices. As an example, in a computer-assisted system configured for teleoperation, an operator at a user input system manipulates a leader device (e.g., an input device configured to accept commands for a follower device) to cause motions of a follower device (e.g., a repositionable assembly that can be teleoperated).

[0005] Operation of the computer-assisted system can include the reception of a user input at a user input system including an input device to reconfigure the repositionable assembly.

[0006] Operation of computer-assisted systems may be improved by adjusting an interface portion of the repositionable assembly or supported instrument(s) using the user input system.SUMMARY

[0007] In general, in one aspect, one or more embodiments relate to a computer-assisted system including a repositionable assembly. The repositionable assembly includes a proximal repositionable structure having a distal portion. The repositionable assembly further includes a distal repositionable structure attached to the distal portion of the proximal repositionable structure. The distal repositionable structure is configured to support an instrument and to move a working portion of the instrument within a reachable space. The computer-assisted system further includes a control system with one or more processors and the control system is communicatively coupled to the repositionable assembly. The control system is configured to receive a user input, the user input indicative of a command to reconfigure the proximal repositionable structure to move the reachable space. The control system is further configured to determine, based on the user input, a motion to reconfigure the proximal repositionable structure, and execute the motion to reconfigure the proximal repositionable structure to move the reachable space.

[0008] In general, in one aspect, one or more embodiments relate to a method for controlling a computer-assisted system, the method performed by a control system of the computer-assisted system. The computer-assisted system includes a repositionable assembly. The repositionable assembly includes a proximal repositionable structure having a distal portion. The repositionable assembly further includes a distal repositionable structure attached to the distal portion of the proximal repositionable structure. The distal repositionable structure is configured to support an instrument and to move a working portion of the instrument within a reachable space. The method includes receiving a user input, the user input indicative of a command to reconfigure the repositionable assembly to move the reachable space. The method further includes determining, based on the user input, a motion to reconfigure the proximal repositionable structure, and executing the motion to reconfigure the proximal repositionable structure to move the reachable space.

[0009] In general, in one aspect, one or more embodiments relate to a non-transitory machine-readable medium comprising a plurality of machine-readable instructions executed by one or more processors associated with a computer-assisted system. The plurality of machine-readable instructions causing the one or more processors to perform a method. The computer-assisted system includes a repositionable assembly. The repositionable assembly includes a proximal repositionable structure having a distal portion. The repositionable assembly further includes a distal repositionable structure attached to the distal portion of the proximal repositionable structure. The distal repositionable structure is configured to supportan instrument and to move a working portion of the instrument within a reachable space. The method includes receiving a user input, the user input indicative of a command to reconfigure the repositionable assembly to move the reachable space. The method further includes determining, based on the user input, a motion to reconfigure the proximal repositionable structure, and executing the motion to reconfigure the proximal repositionable structure to move the reachable space.

[0010] Other aspects of the invention will be apparent from the following description and the appended claims.BRIEF DESCRIPTION OF DRAWINGS

[0011] The accompanying drawings are not intended to be drawn to scale. In the drawings, each identical or nearly identical component that is illustrated in various figures may be represented by a like numeral. For purposes of clarity, not every component may be labeled in every drawing. In the drawings:

[0012] FIG. 1 shows an example repositionable assembly in accordance with one or more embodiments.

[0013] FIG. 2A shows an example computer-assisted system in accordance with one or more embodiments.

[0014] FIG. 2B shows an example system in accordance with one or more embodiments.

[0015] FIGs. 3 A and 3B show example instruments in accordance with one or more embodiments.

[0016] FIGs. 4A-4C depicts a portion of a repositionable assembly and examples of an insertion adjustment and port adjustment under a reachable space viewpoint in accordance with one or more embodiments.

[0017] FIGs. 5A-5C depicts a portion of a repositionable assembly and examples of an insertion adjustment and port adjustment under an interface portion viewpoint in accordance with one or more embodiments.

[0018] FIGs. 6A-6C depicts a portion of a repositionable assembly and examples of an insertion adjustment and port adjustment under a control point viewpoint in accordance with one or more embodiments.

[0019] FIGs. 7A-7C depicts a portion of a repositionable assembly and examples of an insertion adjustment and port adjustment using an access port in accordance with one or more embodiments.

[0020] FIGs. 8A-8D depict instances or portions of an example user interface in accordance with one or more embodiments.

[0021] FIG. 9 shows a flowchart describing an example method for reconfiguring a repositionable assembly to reposition and / or reorient a supported imaging device using a reference frame in accordance with one or more embodiments.DETAILED DESCRIPTION

[0022] Specific embodiments of the disclosure will now be described in detail with reference to the accompanying figures. Like elements in the various figures are denoted by like reference numerals for consistency.

[0023] In the following detailed description of embodiments of the disclosure, numerous specific details are set forth in order to provide a more thorough understanding of the invention. However, it will be apparent to one of ordinary skill in the art that the invention may be practiced without these specific details. In other instances, well-known features have not been described in detail to avoid unnecessarily complicating the description.

[0024] Throughout the application, ordinal numbers (e.g., first, second, third, etc.) may be used as an adjective for an element (i.e., any noun in the application). The use of ordinal numbers is not to imply or create any particular ordering of the elements, and is not to limit any element to being only a single element unless expressly disclosed, such as by the use of the terms “before”, “after”, “single”, and other such terminology. Rather, the use of ordinal numbers is to distinguish between the elements. By way of an example, a first element is distinct from a second element, and the first element may encompass more than one element and succeed (or precede) the second element in an ordering of elements.

[0025] This disclosure describes various devices, elements, and portions of computer-assisted systems and elements in terms of their state in three-dimensional space. As used herein, the term “position” refers to the location of an element or a portion of an element (e.g., three degrees of translational freedom in a three-dimensional space, such as along Cartesian x-, y-, and z-coordinates). As used herein, the term “orientation” refers to the rotational placement of an element or a portion of an element (e.g., three degrees of rotational freedom in three-dimensional space, such as about roll, pitch, and yaw axes, represented in angle-axis, rotation matrix, quaternion representation, and / or the like). As used herein, and for a device with a kinematic series, such as with a repositionable structure with a plurality of links coupled by one or more joints, the term “proximal” refers to a direction toward a base ofthe kinematic series, and “distal” refers to a direction away from the base along the kinematic series.

[0026] As used herein, the term “pose” refers to the multi-degree of freedom (DOF) spatial position and orientation of a coordinate system of interest attached to a rigid body. In general, a pose includes a pose variable for each of the DOFs in the pose. For example, a full 6-DOF pose for a rigid body in three-dimensional space would include 6 pose variables corresponding to the 3 positional DOFs (e.g., x, y, and z) and the 3 orientational DOFs (e.g., roll, pitch, and yaw). A 3-DOF position only pose would include only pose variables for the 3 positional DOFs. Similarly, a 3-DOF orientation only pose would include only pose variables for the 3 rotational DOFs. Further, a velocity of the pose captures the change in pose over time (e.g., a first derivative of the pose). For a full 6-DOF pose of a rigid body in three-dimensional space, the velocity would include 3 translational velocities and 3 rotational velocities. Poses with other numbers of DOFs would have a corresponding number of velocities translational and / or rotational velocities.

[0027] Aspects of this disclosure are described in reference to computer-assisted systems, which can include devices that are teleoperated, externally manipulated, autonomous, semiautonomous, and / or the like. Further, aspects of this disclosure are described in terms of an implementation using a teleoperated surgical system, such as the da Vinci® Surgical System commercialized by Intuitive Surgical, Inc. of Sunnyvale, California. Knowledgeable persons will understand, however, that inventive aspects disclosed herein may be embodied and implemented in various ways, including teleoperated and nonteleoperated, and medical and non-medical embodiments and implementations.Implementations on da Vinci® Surgical Systems are merely exemplary and are not to be considered as limiting the scope of the inventive aspects disclosed herein. For example, techniques described with reference to surgical instruments and surgical methods may be used in other contexts. Thus, the instruments, systems, and methods described herein may be used for humans, animals, portions of human or animal anatomy, industrial systems, general robotic, or teleoperated systems. As further examples, the instruments, systems, and methods described herein may be used for non-medical purposes including industrial uses, general robotic uses, sensing or manipulating non-tissue work pieces, cosmetic improvements, imaging of human or animal anatomy, gathering data from human or animal anatomy, setting up or taking down systems, training medical or non-medical personnel, and / or the like.Additional example applications include use for procedures on tissue removed from human or animal anatomies (with or without return to a human or animal anatomy) and for procedureson human or animal cadavers. Further, these techniques can also be used for medical treatment or diagnosis procedures that include, or do not include, surgical aspects.

[0028] Referring now to the drawings, in which like reference numerals represent like parts throughout the several views, FIG. 1 shows an example repositionable assembly 100, in accordance with one or more embodiments.

[0029] FIG. 1 illustrates an example repositionable assembly 100 of a computer-assisted system. The repositionable assembly 100 includes a proximal repositionable structure 106 and one or more distal repositionable structures 102, 104, according to various embodiments. As shown in FIG. 1, a repositionable assembly 100 includes, without limitation, a proximal repositionable structure 106 that physically supports one or more distal repositionable structures (e.g., a first distal repositionable structure 102 and a second distal repositionable structure 104). The first distal repositionable structure 102 is configured to support a first instrument 122, and the second distal repositionable structure 104 is configured to support a second instrument 124. In various embodiments, each of the proximal repositionable structure 106, the first and second distal repositionable structures 102, 104, and the first and second instruments 122, 124 can include any number of joints 144 of any type, and any number of links 142 of any geometry. While FIG. 1 shows a proximal repositionable structure 106 supporting two distal repositionable structures 102, 104 configured to support instruments 122 and 124, respectively, the proximal repositionable structure 106 can support any number of distal repositionable structures, and the distal repositionable structures 102, 104 can each support any number of instruments. Furthermore, the first instrument 122 and / or the second instrument 124 may include any number of links 142 and any number of joints 144. While FIG. 1 illustrates instrument 122 as an instrument with jawed end effectors and instrument 124 as an imaging instrument, such illustration is merely illustrative. In particular, the distal repositionable structures 102 and 104 may support any instrument type.

[0030] The combination of the first instrument 122 and the first distal repositionable structure 102 may have the same number of joints as the combination of the second instrument 124 and the second distal repositionable structure 104. Alternatively, as shown in FIG. 1, the combination of the first instrument 122 and the first distal repositionable structure 102 may have fewer joints than the combination of the second instrument 124 and the second distal repositionable structure 104.

[0031] In some embodiments, the motion of each of the proximal repositionable structure 106, first distal repositionable structure 102, first instrument 122 with jawed endeffectors (not labeled), second distal repositionable structure 104, and second instrument 124 with an imaging device (not labeled) is relative to a corresponding reference. The corresponding references can be the same reference, or be different references. A reference can be, for example and without limitation, a reference point, a reference line or other geometric feature, a reference frame, etc. The reference can be fixed to the environment (e.g., a point, geometric feature, or frame of reference fixed to the environment or the earth; such a reference frame can be called a “world frame”), to a subject of a procedure such as a workpiece or part of a patient (e.g., a point, geometric feature, or frame of reference fixed to a patient feature and / or the like; such a reference frame can be called a “subject frame”), to a base of the robotic system e.g., a base point, a base plane, frame of reference of the repositionable assembly or some other part of the robotic system), and / or the like. In some embodiments, the motions of the proximal repositionable structure 106, first distal repositionable structure 102, first instrument 122, second distal repositionable structure 104, and / or second instrument 124 are determined, controlled, or sensed relative to a same reference, or to different references. For example, the motion of the proximal repositionable structure 106 could be relative to a world frame while the motion of the first distal repositionable structure 102 and first instrument 122 could be relative to a reference point or reference frame fixed to the proximal repositionable structure 106.

[0032] In the example shown in FIG. 1, the bases of first distal repositionable structure 102 and second distal repositionable structure 104 are attached to a distal portion of the proximal repositionable structure 106, and motion of the proximal repositionable structure 106 moves the bases of first distal repositionable structure 102 and second distal repositionable structure 104. This “caused motion” of the bases of first distal repositionable structure 102 and second distal repositionable structure 104 can move distal portions of first distal repositionable structure 102 and / or second distal repositionable structure 104, and of any instruments or other elements attached to first distal repositionable structure 102 and second distal repositionable structure 104. In some embodiments, a caused motion (e.g., of the first distal repositionable structure 102 and first instrument 122 or of the second distal repositionable structure 104 and second instrument 124) is determined, responded to, or sensed relative to the same or a different reference as used for the motion of the proximal repositionable structure 106.

[0033] FIG. 2A illustrates an example computer-assisted system 200, according to various embodiments. As shown in FIG. 2A, the computer-assisted system 200 includes, without limitation, a repositionable assembly 210 and a user input system 250. In ateleoperation scenario, an operator (not shown) uses the user input system 250 to operate the repositionable assembly 210, such as in a leader-follower configuration (also often called teleoperation configuration or master-slave configuration in industry) of the computer-assisted system 200. In the leader-follower configuration, the user input system 250 is the leader, and the repositionable assembly 210 is the follower of the leader-follower configuration.

[0034] The repositionable assembly 210 can be used to introduce a set of instruments (not shown here; discussed below with reference to FIGs. 3 A and 3B) to a work site through a port or entry guide 230 (a cannula is shown, other examples include an access port) inserted in an aperture. In a medical scenario, the work site can be on or within a body cavity of a patient, and the aperture can be a minimally invasive incision or a natural body orifice. When used, the port or entry guide 230 can be free-floating, held in place by a fixture separate from the repositionable assembly 210, or held by an entry guide supporting link 222 or other part of the repositionable assembly 210.

[0035] The distal portion of the proximal repositionable structure, also referred to as a manipulator-supporting link 224, is coupled to additional joints and links 214, 220 of the repositionable assembly 210, and these additional joints and links 214, 220 are mounted on a base 212.

[0036] In accordance with one or more embodiments, FIG. 2A depicts a set of distal repositionable structures 226 coupled to the manipulator-supporting link 224. Each of the distal repositionable structures 226 includes a carriage (or other instrument-coupling link) configured to couple to an instrument, and each of the distal repositionable structures 226 include one or more joint(s) that can be driven to move the carriage. For example, a distal repositionable structure 226 can include a prismatic joint that, when driven, linearly moves the carriage and any instrument(s) coupled to the carriage. In some embodiments, this linear motion is along an insertion axis of the distal repositionable structure or supported instrument, as further described below with reference to FIGs. 3 A and 3B. In this configuration the elements of the repositionable assembly 210 that are proximal to the distal repositionable structures 226 may be understood as the proximal repositionable structure as previously described in reference to FIG. 1.

[0037] The repositionable assembly 210 can include, or otherwise define, an insertion axis 240. The insertion axis 240 can be considered fixed to a portion of the repositionable assembly 210, e.g., extending between the manipulator-supporting link 224 and the port 230.

[0038] The repositionable assembly 210 includes a plurality of joints. FIG. 2 A illustrates a prismatic joint for vertical adjustment (as indicated by arrow “A”), rotary joints for horizontal adjustment (as indicated by arrow “B”), and another prismatic joint for another horizontal adjustment (as indicated by arrow “C”). In some embodiments, additional joints are used to robotically pivot the distal portion of the proximal repositionable assembly (e.g., manipulator-supporting link 224) in yaw, pitch, and roll angular rotations about a remote center of motion as indicated by arrows D, E, and F, respectively. As discussed above, a distal repositionable structure 226 can include one or more joint(s) that can be driven to linearly move an included carriage and supported instrument along an insertion axis of the distal repositionable structure or supported instrument (e.g., an instrument shaft). The insertion axis of the distal repositionable structure can be parallel to the insertion axis 240 of the repositionable assembly 210. Thus, the plurality of joints of the repositionable assembly 210 can further include one or more joints for adjustment of a distal repositionable structure (as indicated by arrow “G”).

[0039] In some implementations, the plurality of joints of the repositionable assembly 210 provide redundant degrees of freedom, and coordinated motion of the joints can cause part of the proximal and / or distal repositionable structure(s) to pivot about a software-centered remote center of motion (SWC). The location of the SWC can be moved and is enabled by coordinated motion of the joints. As an example, methods for setting and using SWC of a repositionable assembly are described in further detail in International Patent Publication No. WO2023 / 192204A1, entitled “Setting and using software remote centers of motion for computer-assisted systems,” which is incorporated herein by reference. In some implementations, the repositionable assembly 210 has a hardware remote center (HWC) that is maintained through the movement of one or more joints of the repositionable assembly 210 (e.g., a specific set of joints) irrespective of the motion of other joints. In some implementations, the repositionable assembly 210 includes one or more joints that provide redundant degrees of freedom that enable the repositionable assembly 210 to pivot part of the proximal and / or distal repositionable structure (e.g., manipulator-supporting link 224) about a point other than the HWC and can switch between pivoting about a HWC or about a SWC.

[0040] In review, a repositionable assembly 210 can include, without limitation, a proximal repositionable structure that physically supports one or more distal repositionable structures. Each distal repositionable structure is configured to support one or more instruments. In various embodiments, each of the proximal repositionable structure, distal repositionable structure(s), and supported instruments (if any) can include any number ofjoints of any type, and any number of links of any geometry. In the example of FIG. 2A, the repositionable assembly 210 include a plurality of joints providing adjustments (or motion over degrees of freedom) A, B, C, D, E, F, and G. In some examples, the joints of the a repositionable assembly 210 providing adjustments A, B, C, D, E, and F may be considered part of the proximal repositionable structure as previously described in reference to FIG. 1. Further, the joints providing adjustment s) G may be considered part of one or more distal repositionable structures.

[0041] In some instances, the plurality of joints of joints of the repositionable assembly is partitioned into one or more sets of joints. For example, a first set of joints can be composed of the joints responsible for adjustments A, B, and C. The first set of joints can be used to, for example, translate the portion of the repositionable assembly 210 distal to additional link 220 (e.g, manipulator-supporting link 224) with respect to a world frame 245. For example, vertical adjustment according to arrow A can move the manipulator-supporting link 224 along the z axis of the world frame 245. Similarly, horizontal adjustment according to arrow C can move the manipulator-supporting link 224 along the y axis of the world frame 245. As described below, in some scenarios, reconfiguration of the repositionable assembly 210 is limited to a reconfiguration of a prescribed set of joints (e.g., the first set of joints).

[0042] In some embodiments, actuation of the degrees of freedom provided by joint(s) of the instrument(s) is provided by actuators disposed in, or whose motive force (e.g., linear force or rotary torque) is transmitted to, the instrument(s). Examples of actuators include rotary motors, linear motors, solenoids, and / or the like. The actuators drive transmission elements in the manipulators and / or in the instruments to control the degrees of freedom of the instrum ent(s). For example, the actuators can drive rotary discs of the distal repositionable structure(s) that couple with rotary discs of the instrument(s), where driving the rotary discs of the instruments drives transmission elements in the instrument that couple to move the joint(s) of the instrument, or to move the end effector(s) of the instrument, as further discussed below with reference to FIGs. 3 A and 3B. Accordingly, the degrees of freedom of the instrument(s) are controlled by actuators that drive the instrument(s) in accordance with control signals determined based on inputs from the associated input devices (e.g, input devices 252 of the user input system 250). The control signals are determined in order to cause instrument motion or other actuation as indicated by movement of the input control devices or any other control signal. Furthermore, in some embodiments, appropriately positioned sensors, e.g., encoders, potentiometers, and / or the like, are provided to enable measurement of indications of the joint positions, or other data that can be used toderive joint position, such as joint velocity. The actuators and sensors are disposed in, transmit to, and / or receive signals from the distal repositionable structure(s) 226.

[0043] While a particular configuration of the repositionable assembly 210 is shown in FIG. 2A, those skilled in the art will appreciate that embodiments of the disclosure can be used with any design of repositionable assembly. For example, a repositionable assembly can have any number and any types of degrees of freedom, may or may not be configured to couple to a port, use a port other than a cannula, and / or other configuration different from what is shown in FIG 2 A.

[0044] In the embodiments shown in FIG 2A, the user input system 250 includes one or more input devices 252 operated by the operator (not shown). The one or more input devices 252 are contacted and manipulated by the hands of the operator, with one input device for each hand. Examples of such hand-input-devices include any type of device manually operable by human user, e.g., joysticks, trackballs, button clusters, and / or other types of haptic devices typically equipped with multiple degrees of freedom. Additionally, in some embodiments, position, force, and / or tactile feedback devices (not shown) are employed to transmit position, force, and / or tactile sensations from the instruments back to the operator's hands through the input devices 252.

[0045] The input devices 252 are supported by the user input system 250 and are shown as mechanically grounded, and in other implementations may be mechanically ungrounded. An ergonomic support 256 is provided in some implementations. For example, FIG. 2A shows an ergonomic support 256 including forearm rests on which the operator may rest his or her forearms while manipulating the input devices 252. In some examples, the operator performs tasks at a work site near the repositionable assembly 210 during a medical procedure by controlling the repositionable assembly 210 using the input devices 252. In some examples, a single input device 252 is used to control the repositionable assembly 210. In some examples, two input devices 252 are virtually linked such that movement in one input device is mimicked in the other, and / or that the relative position and orientation of the two input devices 252 can control different degrees of freedom of the repositionable assembly 210 and supported elements. For example, two virtually linked input devices 252 can be rotated about a center point between the two input devices 252 (e.g., like the movement of a steering wheel or handlebar), and this rotation can be mapped e.g., to control) a degree of freedom of the repositionable assembly 210 and / or supported elements (e.g., roll or rotation of an instrument).

[0046] In some implementations, the input devices 252 consist of a kinematic series, such as with a repositionable structure with a plurality of links coupled by one or more joints. In general, sensors (e.g, encoders) are coupled to the components or joints of an input device to detect the position (and / or velocity, acceleration) of the components or joints throughout their respective degrees of freedom. Thus, the pose of an input device can be defined by the position and / or orientation of each of its components or joints along with a knowledge of the geometry and disposition of any interconnecting links between joints of the input device. The pose of the input device (or information regarding the position and orientation of each of its components and / or joints can be stored in a variety of mathematical or computational data structures such as a tensor. An input device consisting of a kinematic series may be configured to translate or rotate according to one or more degrees of freedom.

[0047] A display unit 254 is included in the user input system 250. The display unit 254 displays images for viewing by the operator. The display unit 254 provides the operator with a view of the work site with which the repositionable assembly 210 interacts. The view can include, for example, stereoscopic images or three-dimensional images to provide a depth perception of the work site and the instrum ent(s) of the repositionable assembly 210 in the work site. The display unit 254 can be moved in various degrees of freedom to accommodate the operator’s viewing position and / or to provide control functions. Where a display unit (such as the display unit 254) is also used to provide control functions, such as to command the repositionable assembly, the display unit also includes an input device (e.g, another input device 252).

[0048] A display unit (such as display unit 254 or another display unit (not shown)) can include the ability, with one or more synchronized input devices (e.g., buttons), for a user to select control options and indicate control commands. For example, in some implementations, the user input system 250 includes a touchscreen. The touchscreen can display a menu (not shown) providing additional control functionality of the computer-assisted system to a user. For example, and as will be described in greater detail later in the instant disclosure, the touchscreen may be used to, among other things, used to initiate an insertion adjustment or a port adjustment of the repositionable assembly.The touchscreen may provide visual feedback to a user. In other implementations, an additional display unit e.g., touchscreen) is not used or included. In these implementations, selection of control options or control commands (e.g., to initiate an insertion adjustment or port adjustment) are performed using existing input devices 252 and display unit 254. Forexample, the display unit 254 can display a menu and the menu can be navigated using the input devices.

[0049] When using the user input system 250, the operator can sit in a chair or other support in front of the user input system 250, position his or her eyes to see images displayed by the display unit 254, grasp and manipulate the input devices 252, and rest his or her forearms on the ergonomic support 256 as desired. In some implementations, the operator can stand at the workstation or assume other poses, and the display unit 254 and input devices 252 may differ in construction, be adjusted in position (height, depth, efc.), etc.

[0050] FIG. 2B illustrates an example system 270, according to various embodiments. The system 270 corresponds to the computer-assisted system 200 and includes one or more computing systems 272. A computing system 272 includes a processing system and is used to process input provided by the user input system 250, e.g., from the input device(s) 252 manipulated by an operator. In some embodiments, a computing system 272 is further used to provide an output, e.g., a video image to the display unit 274. Examples of display unit 274 include LCDs, LEDs, organic LED displays, projectors, etc. In some embodiments, one or more computing systems 272 are used to control the repositionable assembly 210.

[0051] In one or more embodiments, the computing system(s) 272 executes one or more control methods. The control methods include instructions for controlling one or more components of the repositionable assembly 210. In one or more embodiments, joint movements of the repositionable assembly 210 are controlled by one or more control methods driving one or more joints using actuators of the repositionable assembly 210, the joint movements being calculated by a processor of a processing system of the computing system(s) 272. The control methods process control signals from the user input system 250 or elsewhere, and / or sensor signals (e.g., positional encoder data from joint position sensors, image data from image instruments such as ultrasonic probes or cameras or endoscopes, and / or the like), to calculate commands for the joint actuators.

[0052] In some embodiments, the control methods perform at least some of the calculations of the joint commands using vectors and / or matrices, some of which have elements corresponding to positions, velocities, and / or forces / torques of the joints. The range of alternative joint configurations available to the control methods can be conceptualized as a joint space. For example, in some embodiments, the joint space has as many dimensions as the repositionable assembly has degrees of freedom, and a particular configuration of the repositionable assembly represents a particular point in the joint space, with each coordinate corresponding to a joint state of an associated joint of the repositionable assembly.

[0053] As used herein, the term “state” of a joint or multiple joints refers to the control variables associated with the joint or the multiple joints, respectively. For example, the state of an angular joint refers to the angle defined by that joint within its range of motion, and / or to the angular velocity (or speed or direction) of the joint. Similarly, the state of an axial or prismatic joint refers to the joint's axial or linear position, and / or to its axial or linear velocity (or speed or direction). While one or more of the control methods described herein include position controllers, they often also have velocity control aspects. Alternative embodiments can rely primarily or entirely on velocity controllers, force controllers, acceleration controllers, and / or the like without departing from the disclosure. Various aspects of control systems that can be used in such devices are described in U.S. Pat. No. 6,699,177, which is incorporated herein by reference. In general, as long as the movements described are based on the associated calculations, the calculations of movements of the joints and movements of an end effector described herein are performed using a position control technique, a velocity control technique, an acceleration control technique, a force or torque control technique, a combination of some or all of the foregoing, and / or the like.

[0054] In some embodiments, the control modes include one or more other types of control modes. For example, during a robotic task being performed under the control of input devices 252 operated by a user, various joints of the repositionable assembly can be commanded to a same position and controlled to maintain static positions. However, in another control mode, one or more of the joints can be commanded to be “floating,” and facilitate motion of that joint due to externally applied force. For example, a joint held in place by a brake can be floated by partially or entirely releasing the brake. An example of such a joint includes a passive joint held in place by an electromagnetic brake. As another example, a joint driven by actuator(s) can be held in place by commanding the actuator(s) to hold the joint position and be floating by updating the command to the actuator(s) to the then-current position, velocity, and / or acceleration of the joint. As a result, a floating joint is readily reconfigured by an externally applied force or torque, without a control algorithm and / or a braking force seeking to counteract the reconfiguration caused by sufficient externally applied force or torque. In some embodiments, a floating joint is further controlled to exhibit other characteristics or provide additional responses, such as to provide a certain type or level of damping response. A floating joint can still be braked, actuated, or otherwise managed for friction or gravity compensation. Such compensation can be provided by, for example and without limitation, passive springs, actively driven actuators, and / or the like.Further, in some embodiments, joints that are not moved by actuators can still be gravity compensated, friction compensated, dampened, and / or the like by actuators.

[0055] In various embodiments, multiple different control modes are combined during operation of the repositionable assembly. For example, some joints could be controlled to maintain position and resist or rebound from attempted external articulation of those joints, while other joints could be controlled to be floating and facilitate external articulation of those other joints. Parameters such as joint position, velocity, or acceleration of the joints are detected by joint sensors. The sensor signals are used to provide kinematic information of the repositionable assembly.

[0056] The architecture of the control methods used for controlling the repositionable assembly can be of any appropriate form. As a specific example, the control architecture can be hierarchical, and could include a high-level controller and multiple joint controllers. A commanded movement is received by the high-level controller in, for example, a Cartesiancoordinate space (referred to herein as Cartesian-space). The commanded movement could be, for example, based on a movement command (e.g., in the form of a position and / or velocity) received from the user input system 250, or any other system that provides a movement command. The commanded movement is converted into commanded joint positions or joint velocities (e.g., linear or angular joint positions, linear or angular joint velocities). In some embodiments, the conversion is performed using an inverse kinematics algorithm. Subsequently, the joint controllers convert the received commanded joint positions or velocities into commanded currents to drive the actuators producing joint movements. The joint movements together produce a repositionable assembly movement that reflects the commanded movement.

[0057] In some embodiments, a joint controller controls a joint position. In some embodiments, the joint controller controls other variables such as joint velocity and / or joint force (linear force or angular torque). A joint controller receives a feedback signal in the form of a sensed joint state from an associated joint sensor, which it can use for closed-loop control. The sensed joint state includes, for example and without limitation, a joint position, a joint velocity (or component of velocity such as speed or direction), a joint acceleration (or component of acceleration), and / or the like, representing the joint movement. The sensed joint state is derived from the signals obtained from the joint sensor. A joint sensor can be, for example, an encoder, a potentiometer, an accelerometer, a hall effect sensor, and / or the like. In some embodiments, a state observer or estimator (not shown) is used. Each joint controller can implement any appropriate control scheme, such as a proportional integralderivative (PID), proportional derivative (PD), full state feedback, sliding mode, and / or various other control schemes, without departing from the disclosure.

[0058] In one or more embodiments, the control methods further perform at least one of the steps described in FIG. 9 below.

[0059] A computing system 272 may include, without limitation, one or more computer processors, non-persistent storage (e.g., volatile memory, such as random access memory (RAM), cache memory), persistent storage (e.g., a hard disk, an optical drive such as a compact disk (CD) drive or digital versatile disk (DVD) drive, a flash memory, efc.), a communication interface (e.g., Bluetooth interface, infrared interface, network interface, optical interface, efc.), and / or numerous other elements and functionalities. In some embodiments, a computer processor of a computing system 272 is an integrated circuit for processing instructions. For example, the computer processor can be one or more cores or micro-cores of a processor.

[0060] In some embodiments, a communication interface of a computing system 272 includes an integrated circuit for connecting the computing system 272 to a network (not shown) and / or to another device, such as another computing system 272. Further, in some embodiments, the computing system 272 includes one or more output devices, such as a display unit 274, a printer, a speaker, external storage, or any other output device. Software instructions in the form of computer readable program code to perform embodiments of the disclosure are stored, in whole or in part, temporarily or permanently, on non-transitory computer readable medium. Specifically, the software instructions correspond to computer readable program code that, when executed by a processor(s), is configured to perform one or more embodiments of the disclosure. In some embodiments, a computing system 272 is connected to or configured to be a part of a network. The network may include multiple nodes. Each node corresponds to a different computing system, group of computing systems, group of nodes, and / or the like.

[0061] In some embodiments, the repositionable assembly 210 couples to an instrument when used to perform a procedure. The instrument can include an imaging device, e.g., an endoscope or an ultrasonic probe, usable to capture images of the work site and output the captured images to an auxiliary system 280. In some embodiments, the auxiliary system 280 processes the captured images using one or more image processing techniques prior to any subsequent display. For example, the auxiliary system 280 can overlay the captured images with a virtual control interface prior to displaying the combined images to the operator via the user input system 250. In some embodiments, one or moreseparate display units 274 are coupled with a computing system 272 and / or the auxiliary system 280 for local and / or remote display of images, such as images of the procedure site or other related images.

[0062] FIG. 3A illustrates an example instrument 300 (also referred to herein as an instrument 300), according to various embodiments. The instrument 300 in FIG. 3A includes, without limitation, a shaft 310, and an end effector located at a first end of the instrument 300. A housing 330, arranged to releasably couple the instrument 300 to a distal repositionable structure (shown, for example, in FIG. 2A), is located at a second end of the instrument 300. In some embodiments, the shaft 310 is rotatably coupled to the housing 330 to enable angular displacement of the shaft 310 relative to the housing 330, as indicated by arrows 348. In contrast, in some embodiments, the shaft 310 is not rotatably coupled to the housing 330 and the shaft 310 cannot be angularly displaced relative to the housing 330.

[0063] Various types of end effectors 340 can be used. For example, the end effector 340 can include one finger, two fingers (e.g., jaws 342 that may open and close), or three or more fingers. Examples of end effectors include, but are not limited to, scissors, forceps, staplers, cutting and cautery instruments, and / or the like. As another example, an end effector can further include an imaging device, e.g., an endoscope or an ultrasonic probe, to capture images of the work site.

[0064] In some embodiments, an end effector 340 is actuated by transmission elements (e.g., cables, metal bands, screws, tubes, push rods, etc.) that connect parts of the instrument to drive elements (e.g., pulleys, capstans, spools, nuts, linear slides, or the like) (not shown) in the housing 330. Movement e.g., translation or rotation) of the drive elements thereby controls the position of the end effector, or other degrees of freedom such as jaw opening, such that the end effector may translate or rotate, the jaws may open and close, and / or the like. In some embodiments, upon coupling of an instrument 300 on a distal repositionable structure, the drive elements engage with actuators of the distal repositionable structure, such as by engaging with transmission elements coupled to the actuators. As an example, a description of the control of an instrument like the instrument 300 can be found in U.S. Pat. No. 6,394,998, entitled “Surgical Tools for Use in Minimally Invasive Telesurgical Applications,” which is incorporated herein by reference.

[0065] In the example shown in FIG. 3A, the joints of the instrument 300 include, without limitation, a wrist 320 proximal to the end effector 340 and two shaft offset joints 322, 324 proximal to the wrist 320. The wrist 320 may enable rotation of the end effector 340 in one or more directions. The shaft offset joints 322, 324 can enable, for example, atranslational offset 326 of the end effector 340 relative to the insertion axis 312 using the additional link serially coupled between the instrument shaft 310 and the end effector 340, in addition to the rotating provided by the wrist 320. The shaft offset joints 322, 324 may, thus, increase the work site reachable by the end effector 340 of the instrument 300. Like the end effector 340, the wrist 320 and the shaft offset joints 322, 324 may be actuated by control cables.

[0066] FIG. 3B illustrates an example instrument or instrument 350, according to various other embodiments. Instruments 300 and 350 can be used for robotic procedures such as robotic medical procedures (e.g, surgeries), in accordance with one or more embodiments.

[0067] The instrument 350 shown in FIG. 3B includes, without limitation, various elements of the instrument 300 shown in FIG. 3A and operates in a substantially similar manner to the instrument 300 shown in FIG. 3A. Specifically, the instrument 350 includes a shaft 360 and a wrist 370 proximal to an end effector 390. Further, the instrument 350 has an insertion axis 362 for insertion / retraction of the instrument 350. The instrument 350 also allows angular displacement of the shaft 360 relative to the housing 380 as indicated by the arrows 398. Unlike the instrument 300 in FIG. 3A, the instrument 350 is not equipped with shaft offset joints. Accordingly, the instrument 350 cannot achieve a translational offset of the end effector 340 relative to the insertion axis 362 as can the instrument 300. For example, the shaft 360 without shaft offset joints could be made more rigid, could be configured to allow the transmission of higher forces or torques, could be configured to transmit forces and torques with reduced friction, and / or the like, compared to a similar shaft that includes shaft offset joints (e.g, shaft 310). An example of an instrument that generally utilizes transmission of a higher forces compared to other instruments is a tissue stapler (“stapler”). Additionally, in various implementations, an instrument without shaft offset joints could be less costly, easier to service, maintain and / or clean than a comparable instrument with shaft offset joints. An instrument without shaft offset joints may be said to be “joggle-less” or have a reduced number of degrees of freedom relative to an instrument with shaft offset joints.

[0068] While FIGs. 3 A and 3B show particular configurations of instruments, designed to engage with a particular type of distal repositionable structure, other configurations of instruments are within the scope of the disclosure. For example, embodiments of instruments 300 and 350 could have multi-degree-of-freedom wrists (e.g., pitch and yaw degrees of freedom), single-degree-of-freedom wrists (e.g., pitch or jaw), or nowrists. Also, various embodiments of instruments could have any suitable type of end effector including, for example, scissors, forceps, staplers, irrigation nozzles, hooks, scissors, blunt dissection instruments, needle drivers, imaging devices, and / or the like. Further, different housings can also be used to interface with different types of distal repositionable structure or different structures altogether (e.g., direct interface with the proximal repositionable structure).

[0069] The subsequently discussed figures illustrate a repositionable assembly that is controlled by a computer-assisted system to move or reposition a distal portion of the repositionable assembly (e.g., manipulator-supporting link 224) in response to a user input received at a user input system such that a reachable space (or control point or interface portion, as described later in the instant disclosure) is moved. In particular, embodiments disclosed herein relate to executing an “insertion adjustment” and a “port adjustment,” or combination thereof, with a repositionable assembly of a computer-assisted system.

[0070] As discussed, a repositionable assembly can be used to introduce a set of instruments to a work site via passage through an aperture. That is, a portion of the repositionable assembly e.g., a port or entry guide 230) and / or one or more supported instruments can be inserted into, or otherwise pass through, an aperture. In a medical scenario, the work site can be on or within a body cavity of a patient, and the aperture can be a minimally invasive incision or a natural body orifice. Prior to, or during, a procedure performed with the computer-assisted system, it may be beneficial to move a distal end of a repositionable assembly (e.g., port or entry guide), or portions supported instruments, relative to an aperture. For example, in instances where the repositionable assembly includes a port or entry guide, the repositionable assembly can be reconfigured to position the port or entry guide within (or, more specifically, centered within) an aperture. Further, the repositionable assembly can be reconfigured to adjust the depth or insertion of the port or entry guide within, or with respect to, the aperture. In instances where the repositionable assembly does not include a port or entry guide (e.g., an entry guide is not used or is separate from and not attached to the repositionable assembly), insertion and port adjustments can still be made with reference to a distal end of the repositionable assembly and / or a portion of one or more supported instruments. For example, the repositionable assembly can support one or instruments and the repositionable assembly can be reconfigured to adjust the position of the one or more supported instruments with respect to an aperture. For example, the repositionable assembly can be reconfigured to center the instrument shaft(s) (or cluster of shafts) in the aperture.

[0071] Embodiments of the disclosure relate to repositioning the distal end of a repositionable assembly (e.g., port or entry guide) and supported instruments, if applicable, by reconfiguring the repositionable assembly in response to a received user input at the user input system. In some embodiments, the repositionable assembly includes a proximal repositionable structure and one or more distal repositionable structures attached to a distal portion of the proximal repositionable structure that acts as a common mechanical base (e.g., manipulator-supporting link 224). Each distal repositionable structure can support one or more instruments and translate supported instruments along an insertion axis of the distal repositionable structure. In one or more embodiments, repositioning of the distal end of the repositionable assembly - which may include one or more distal repositionable structures and / or portions of supported instruments (e.g., instrument shafts) - is performed only using the proximal repositionable structure and, in particular, by repositioning the distal portion (e.g., manipulator-supporting link 224) of the proximal repositionable structure. For example, depicted examples of the instant disclosure illustrate that the distal end of the repositionable assembly cannot be moved - at least according to an insertion or port adjustment - without repositioning the distal portion of the proximal repositionable structure. Thus, it may be said that embodiments of the disclosure relate to repositioning the distal portion of the proximal repositionable structure in response to a received user input at the user input system to perform a port or insertion adjustment (e.g., move a reachable space of a supported instrument). Further, repositioning of the distal end of the proximal repositionable structure is effectuated as a reconfiguration of the proximal repositionable structure where the proximal repositionable structure is said to undergo a motion between its configurations. Thus, embodiments disclosed herein relate to receiving a user input at an input device where the user input is indicative of a command to reposition the distal portion of the proximal repositionable structure, determine, based on the user input, a motion to reconfigure the proximal repositionable structure, and execute the motion to reconfigure the proximal repositionable structure to reposition the distal portion of the proximal repositionable structure as to perform a port or insertion adjustment.

[0072] In a medical setting with an aperture, adjustments can be considered with respect to the relative position of the distal end, or supported instruments, to the aperture. For example, during set up or operation, the repositionable assembly can be reconfigured to move the distal end such that one or more supported instruments are centered relative to the aperture. Such an adjustment can be described as a “port adjustment” and is described in greater detail below. As another example, the repositionable assembly can be used toposition its distal end (e.g., port or entry guide) closer to, or further to, the aperture. In this example, the one or more distal repositionable structures can be used to compensate for the repositioning of the distal end such that the position of working portions of the supported instruments (e.g., end effectors) remain fixed in a work site. However, the insertion / retraction of the distal portion of the proximal repositionable structure (e.g., manipulator-supporting link 224), by virtue of moving the origin or base of a distal repositionable structure(s), moves an insertion / retraction range of a supported instrument using the insertion degree of freedom of the distal repositionable structure (i.e., moves a reachable space of the instrument). Adjustment of the distal end (e.g., entry guide) or portions of supported instruments (e.g., instrument shaft(s)) of the repositionable assembly along an insertion axis of the repositionable assembly (or, associated with a depth with respect to an aperture) can be described as an “insertion adjustment” and is discussed in greater detail below.

[0073] Example of use cases for port and insertion adjustments in a medical scenario are as follows. Prior to performing a procedure, a port adjustment can be made to align or center instrument shafts within or above an aperture. Further, during a procedure, the global position of an aperture may change, for example, movement of a patient during surgery. In such cases, instrument shafts inserted into the aperture or a portion the distal end of the repositionable assembly (e.g., entry guide) can make contact with the side wall (e.g., body wall) of the aperture. To prevent collision of the instrument shafts with the aperture side wall and / or prevent friction, a port adjustment can be executed to reposition the distal end of the repositionable assembly, and thus the instrument shafts of the supported instruments, to a center (or effective center) of the aperture in view of its new global position. Another example includes the scenario where a distal repositionable structure has been used to insert, along an insertion axis, a supported instrument into a work site. In particular, in this scenario the distal repositionable structure has reached a range of motion limit along its insertion axis or insertion degree of freedom. As such, the distal repositionable structure cannot be used to insert the supported instrument further (or deeper) into the work site. In this scenario, an insertion adjustment can be performed to reposition the distal portion of the proximal repositionable structure (e.g., manipulator-supporting link 224) such that the distal repositionable structure is positioned closer to the aperture or work site. In some implementations, the distal repositionable structure performs a compensatory motion (e.g., a retraction) in view of the motion of the distal portion of the proximal repositionable structure (e.g., manipulator-supporting link 224) to maintain the position of the working portion of thesupported instrument (e.g., end effector) while regaining its range of motion. Thus, the insertion adjustment can be used to extend the reach (or reachable space) of a supported instrument along an insertion axis or insertion degree of freedom. As another example, a insertion adjustment can be performed to insert one or more supported instruments (e.g., simultaneously) into or through an aperture to a work site to perform a procedure in or at the work site. As another example, an insertion adjustment can be performed to retract one or more supported instruments to facilitate working in a shallow region with respect to the aperture.

[0074] Conventionally, insertion and port adjustments are performed using physical contact of a portion of the repositionable assembly by an operator or assistant (e.g., in a medical context the assistant could be a bed-side assistant). For example, in some implementations, one or more buttons and or handles (e.g., “clutch” button) are disposed on the repositionable assembly. For example, depression of a specified button can initiate a control mode where one or more of the joints of the repositionable assembly can be commanded to be “floating,” and facilitate motion of that joint due to externally applied force. As a result, a floating joint is readily reconfigured by an externally applied force or torque, without a control algorithm and / or a braking force seeking to counteract the reconfiguration caused by sufficient externally applied force or torque. In some embodiments, a floating joint is further controlled to exhibit other characteristics or provide additional responses, such as to provide a certain type or level of damping response. In some implementations, a specified set of joints are floated and available for reconfiguration through an externally applied force while the out-of-set joints are held fixed in their configuration or state. For example, in view of FIG. 2 A, the specified set of joints can include the joints that contribute to adjustments, or degrees of freedom, A, B, and C. As described above, floating of joints can include one or more passive counter-balance mechanisms and active counter-balance mechanism to compensate for forces such as gravity and friction. Nevertheless, initiating and maintaining a controlled motion of the repositionable assembly through physical contact by an operator or assistant can be challenging, at least in part, due to the large inertia and high friction of the repositionable assembly (or moveable portions thereof). That is, under a conventional approach, users may have to exert a large force to overcome an initial static friction threshold and then, once breakaway is achieved, apply large forces to control and stop motion of the repositionable assembly due to its large inertia. Application of these large forces by a user can make repositioning the distal end of the repositionable assembly with fine precision difficult.1

[0075] Embodiments disclosed herein relate to executing insertion and port adjustments of a repositionable assembly by commanding reconfiguration of one or more joints in response to a user input received at the user input system. Thus, insertion and port adjustments can be made without floating joints and without the use of an external and user-applied force to portions of the repositionable assembly. The computer-assisted system is improved by, at least: 1) providing an alternative to the conventional method of port and insertion adjustments by means of manual manipulation of the repositionable assembly by a user (e.g., bed-side assistant); 2) improving accuracy in positioning of the distal end of the repositionable assembly (e.g., port); 3) automatically updating a position of a software remote center in view of an insertion adjustment; and 4) increasing the autonomy of an operator at the user input system, where said operator can make port and insertion adjustments from the user input system without reliance on an assistant to manually manipulate the repositionable assembly (further, this obviates the need for coordination between an operator of the user input system and one or more assistants to perform these operations reducing error and opportunity for miscommunication).

[0076] Embodiments disclosed herein can be described using various viewpoints. To promote understanding, three viewpoints are provided in the instant disclosure, however, these viewpoints do not represent distinct inventions and can be unified under a single control scheme or logic. Further, embodiments can be described under different viewpoints than those given herein. Regardless of the viewpoint used, embodiments of the instant disclosure relate to reconfiguring a repositionable assembly to reposition a distal end (e.g., a port or entry guide) of the repositionable assembly given a user input received at a user input system. The three viewpoints presented are: 1) a reachable space viewpoint; 2) an interface portion viewpoint; and 3) control point viewpoint. The reachable space viewpoint indicates that a feature of embodiments of the instant disclosure is that the reachable space is moved. That is, the reconfiguration of the repositionable assembly is such that the reachable space is moved. For example, and as will be demonstrated, the reachable space of one or more instruments can be extended along a direction of the insertion axis of the repositionable assembly. The interface portion viewpoint is useful in depicting various use cases of embodiments of the disclosure. In particular, the interface portion viewpoint depicts the repositioning of the distal end of the repositionable assembly relative to an aperture. For example, the distal end of the repositionable assembly can be repositioned to align the distal end (e.g., port or entry guide) or portions of one or more supported instruments (e.g., instrument shafts) with the aperture. The control point viewpoint indicates that embodiments of the disclosure can bedescribed and executed in terms of the computer-assisted system and, in particular, the repositionable assembly. That is, in accordance with one or more embodiments, the repositionable assembly can be reconfigured without referencing an aperture. FIGs. 4A-4C depict an example insertion and port adjustment under the reachable space viewpoint. FIGs.5A-5C depict an example insertion and port adjustment under the interface portion viewpoint. FIGs. 6A-6C depict an example insertion and port adjustment under the control point viewpoint.

[0077] The subsequently discussed figures illustrate a repositionable assembly that is controlled by a computer-assisted system to move or reposition the distal end of the repositionable assembly (e.g, port) in response to a user input received at the user input system. In particular, the repositionable assembly is reconfigured to perform an insertion and / or port adjustment.

[0078] The repositionable assembly can include a proximal repositionable structure with a distal portion. The distal portion of the proximal repositionable structure can support, or serve as a common mechanical base (e.g, manipulator-supporting link) for one or more distal repositionable structures each configured to support one or more instruments.

[0079] In some instances, the position and orientation of an instrument is maintained with respect to a world frame (i.e., using a reference fixed to the environment), e.g., through use of degrees of freedom of the instrument, in view of a reconfiguration of the repositionable assembly. An instrument with an end effector that has a position (and, in some instances, an orientation) that is maintained within or relative to a work site (i.e., relative to a world frame) in view of other movements (e.g., repositioning of the proximal repositionable structure) may be said to be “anchored.” As an example, methods for coordinating movements of multiple instruments of a repositionable assembly are described in further detail in International Patent Publication No. WO2022 / 046787A1, entitled “Method and System for Coordinated Multiple-Tool Movement Using a Drivable Assembly,” which is incorporated herein by reference. Anchoring of an instrument can include a change to one or more degrees of freedom or joints of the instrument. That is, during a reconfiguration of the repositionable assembly (e.g., repositioning the distal portion of a proximal repositionable structure) an anchored instrument can execute compensatory adjustments to maintain its position (and, in some instances, orientation) in the work site (i.e., relative to a world frame). In some instances, anchoring is achieved using an instrument equipped with shaft offset joints as described with respect to FIG. 3 A, where the shaft offset joints, in addition to other instrument joints such as a wrist and a rotatably coupled shaft, provide sufficient degrees of freedom to the instrument tomaintain its position and orientation during reconfiguration of the repositionable assembly. In some instances, anchoring of an instrument is achieved using the retraction / insertion adjustment or degree of freedom of a distal repositionable structure that supports the instrument.

[0080] As shown in FIG. 4A, a repositionable assembly includes a proximal repositionable structure that includes a manipulator-supporting link 402 that supports multiple distal repositionable structures 450 and 452 coupled to multiple instruments 404 and 410. In other words, the manipulator-supporting link 402 forms a common mechanical base for the distal repositionable structures 450 and 452 that support the instruments 404 and 410. In some embodiments, the manipulator-supporting link 402 corresponds to the manipulatorsupporting link of a proximal repositionable structure as previously introduced with reference to FIG 2A. That is, in some embodiments, the manipulator-supporting link is considered the distal portion of a proximal repositionable structure. Hereafter, to be explicit, the distal repositionable structures 450 and 452 will be referred to as a first distal repositionable structure 450 and a second distal repositionable structure 452. The first distal repositionable structure 450 can correspond to the first distal repositionable structure 102 of FIG. 1.Similarly, the second distal repositionable structure 452 can correspond to the second distal repositionable structure 104 of FIG. 1. Likewise, instruments 404 and 410 are hereafter referred to as a first instrument 404 and a second instrument 410, where these instruments can correspond to the first instrument 122 and second instrument 124 of FIG. 1. The first instrument 404 includes a first end effector 406 and the second instrument 410 includes a second end effector 412. In the example of FIG. 4A, the first instrument 404 and second instrument 410 are each depicted with jawed end effectors, however, other types of end effectors can be used without departing from the scope of this disclosure. Further, the example of FIG. 4 A depicts the use of two instruments, however, additional or fewer instruments can be used without departing from the scope of this disclosure.

[0081] In one or more embodiments, the proximal repositionable structure, one or more distal repositionable structures, or one or more portions thereof, can define an insertion axis 490. That is, the insertion axis 490 can be described as a feature of, or defined by, the repositionable assembly. Movement of one or more joints of the proximal repositionable structure, for example, can result in movement of the manipulator-supporting link 402. When the manipulator-supporting link 402 is moved, the insertion axis 490 and portions of the first distal repositionable structure 450 and second distal repositionable structure 452 attached to the manipulator-supporting link 402 can also be moved. Such motion of the insertion axis490, first distal repositionable structure 450, and second distal repositionable structure 452 caused by motion of the common mechanical base supporting the first and second distal repositionable structures 450 and 452 (e.g., the manipulator-supporting link 402) can cause motion of the first instrument 404 and the second instrument 410. For example, if the first distal repositionable structure 450 and second distal repositionable structure 452 are held fixed in configuration, then the movement of the manipulator-supporting link 402 also moves the first instrument 404 and the second instrument 410.

[0082] In some embodiments, the proximal repositionable structure includes drivable joints that can be used to pivot the manipulator-supporting link 402 about a remote center of motion (“remote center” 440). Pivoting can consist of angular rotations in yaw, pitch, and roll directions with respect to the remote center 440. For example, FIG. 4A depicts a pitch direction and a roll direction indicated by the arrows E and F, respectively. In the depicted example, a yaw direction (not depicted) may result in a movement of the manipulatorsupporting link 402 that is, at least initially, “into the page” or “out of the page.” Examples of drivable joints of the proximal repositionable structure that can be used to pivot the manipulator-supporting link 402 about the remote center 440 can be seen in FIG. 2A. As will be explained with reference to FIGs. 5A-5C, often the remote center 440 is established at the center of an aperture. As such, reconfiguration of the repositionable assembly to pivot and / or roll the manipulator-supporting link 402 about the remote center 440 cannot affect the spatial relationship between the distal end of the repositionable assembly (e.g., port or entry guide) (or portion of supported instruments) and the aperture. Thus, in general, such a reconfiguration is distinct from port and insertion adjustments where these adjustments need not respect the global or relative location of the remote center.

[0083] FIGs. 4A-4C further depict a world frame 445 or datum. The depicted world frame 445 is a Cartesian coordinate system with x, y, and z axes. The world frame 445 is fixed in space. In some embodiments, the first distal repositionable structure 450 and second distal repositionable structure 452 include one or more joints or links used to insert or retract a supported instrument (e.g., first instrument 404 and second instrument 410) into a work site 498, or relative to the world frame 445 (e.g., prismatic joints). For example, FIG. 4A depicts insertion / retraction directions with arrows G and H for the first distal repositionable structure 450 and the second distal repositionable structure 452, respectively.

[0084] As previously discussed, instruments can have various degrees of freedom. In the example of FIG. 4 A, the first instrument 404 and the second instrument 410 have shaft offset joints; namely, a first set of shaft offset joints 423 corresponding to the first instrument404 and a second set to shaft offset joints 425 corresponding to the second instrument 410. In the example of FIG. 4A, the first instrument 404 includes a first wrist 424 and the second instrument 410 includes a second wrist 426. Various instruments may comprise or lack joints for various degrees of freedom. For example, the first instrument 404 or the second instrument 410 could lack joints to support movement about a roll degree of freedom about a respective roll axis (e.g., insertion axis of the instrument). Further, in other implementations, supported instruments need not include shaft offset joints and / or wrists.

[0085] In the example of FIG. 4 A, the first instrument 404 and the second instrument 410 are inserted through a cannula 430, e.g., toward a work site 498. In the present example, the cannula 430 is said to be attached to, or fixed to, the distal end of the repositionable assembly.

[0086] FIG. 4A depicts a reachable space 411 of the second instrument 410. A reachable space of the first instrument 404 is not depicted. For the present discussion, the reachable space of an instrument is defined as a region or volume accessible to the end effector of the instrument using the degrees of freedom of the instrument (e.g., shaft offset joints, wrist, roll degree of freedom, etc.) and an insertion / retraction degree of freedom of the distal repositionable structure that supports the instrument. Thus, in FIG. 4A, the reachable space 411 of the second instrument is a region or volume accessible to (or reachable by) the second end effector 412 using one or more of the degrees of freedom provided by the second set of offset joints 425, the second wrist 426, the second distal repositionable structure 452, and a roll degree of freedom of the second instrument 410 about its shaft (if applicable). In accordance with one or more embodiments, the reachable space 411 is defined, at least in part, by the movement of the working portion (e.g., second end effector 412) of the second instrument 410 provided by the second distal repositionable structure 452. For example, the second distal repositionable structure 452 provides an insertion / retraction degree of freedom (H) such that use of this degree of freedom retracts and inserts the instrument into the work site 498 along an insertion axis of the second distal repositionable structure 452. The range of motion (or the motion between the fully retracted state and the fully inserted state) of the insertion / retraction degree of freedom (H) defines boundaries of the reachable space of the instrument along the insertion axis of the second distal repositionable structure 452 (or the insertion axis of the instrument). In FIG. 4A, the reachable space 411 of the second instrument 410 has an upper boundary 409 and a lower boundary 415. The upper boundary 409 represents the position (or available positions using the degrees of freedom the second instrument 410) when the second distal repositionable structure 452 is fully retracted withrespect to its insertion / retraction degree of freedom (H). Similarly, the lower boundary 415 represents the position (or available positions using the degrees of freedom the second instrument 410) when the second distal repositionable structure 452 is fully inserted with respect to its insertion / retraction degree of freedom (H). Thus, the second distal repositionable structure 452 is configured to move the working portion of the second instrument 410 within the reachable space 411 (e.g., move the second end effector 412).

[0087] As discussed above, embodiments of the disclosure relate to receiving a user input at the input device to execute an insertion and / or port adjustment of a repositionable assembly. Under the reachable space viewpoint, insertion and port adjustments move the reachable space of one or more supported instruments using the proximal repositionable structure. In FIGs. 4A-4C, the distal end of the repositionable assembly is the cannula 430 supported by, or attached to, the repositionable assembly. As will be seen, the insertion and port adjustments move the cannula 430 with respect to the world frame 445. In accordance with one or more embodiments, reconfiguration of the repositionable assembly to execute an insertion or port adjustment is performed by repositioning the manipulator-supporting link 402 where this repositioning maintains a rigid attachment between the manipulatorsupporting link 402 and the cannula 430 (or the distal end of the repositionable assembly). Thus, in these embodiments, the proximal repositionable structure is reconfigured to reposition the manipulator-supporting link 402 (or distal portion of the proximal repositionable structure) where movement of the manipulator-supporting link is directly transferred to, or mimicked by, the distal end (e.g., cannula 430). That is, reconfiguration of the proximal repositionable structure to reposition the manipulator-supporting link 402 need not maintain, or respect a constraint given by, the remote center 440. In fact, a characterizing feature of the port adjustment is that the remote center 440 is moved, at least laterally or in the x-y plane, with respect to the world frame 445.

[0088] In the example of FIG. 4 A, the second instrument 410 can be seen at the end of its reachable space 411 in the insertion direction. That is, the second instrument 410 is at a lower boundary 415 of the reachable space 411 and the second distal repositionable structure 452 is at its range of motion limit with respect to its insertion / retraction degree of freedom (H). Said differently, the reachable space 411 of the second instrument 410 along, or in a direction parallel with, the insertion axis 490 is provided by the insertion / retraction degree of freedom (H) of the second distal repositionable structure 452. Thus, the second distal repositionable structure 452 cannot effect the global position of the reachable space 411 because the degree(s) of freedom provided by the second distal repositionable structure 452bound the reachable space 411 in one or more associated directions (e.g., a direction parallel to the insertion axis 490). Thus, movement of the reachable space must be effectuated using the proximal repositionable structure or a select subset of its joints.

[0089] FIG. 4B depicts an insertion adjustment in accordance with one or more embodiments. In FIG. 4B, the proximal repositionable structure has been reconfigured to reposition the manipulator-supporting link 402, and all structures distal to the manipulatorsupporting link 402, further down (in a direction nearly along the positive z axis of the world frame 442) the insertion axis 490 of the repositionable assembly. FIG. 4B depicts retraction and insertion directions. Notably, the depicted retraction and insertion directions apply to the proximal repositionable structure, or portions thereof, such as the distal portion or manipulator-supporting link 402.

[0090] The repositioning of the manipulator-supporting link 402 and distal repositionable structures is depicted in FIG. 4B as insertion motion 460. In response to the repositioning of the manipulator-supporting link 402 along the insertion axis 490 (i.e., insertion motion 460), the first distal repositionable structure 450 and the second distal repositionable structure 452 executed compensatory adjustments by means of a retraction along their respective insertion / retraction degrees of freedom. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the insertion adjustment. That is, in the example of FIG. 4B, the first instrument 404 and the second instrument 410 may be said to be anchored, as previously described. Thus, in some scenarios, one or more distal repositionable structures can execute a compensatory adjustment in response to an insertion adjustment of the proximal repositionable structure to maintain a global position of supported instruments, however, this is not a requirement. In other scenarios, one or more distal repositionable structures do not execute a compensatory adjustment in response to an insertion adjustment and the positions of the supported instruments are translated in directions parallel to the insertion axis 490. As seen in FIG. 4B, the reachable space 411 of the second instrument 410 has been translated, due to the insertion adjustment, in a direction parallel to the insertion axis 490. Further, due to the insertion adjustment of the proximal repositionable structure and compensatory adjustment of the second distal repositionable structure 452, the second end effector 412 is no longer at the lower boundary 415 of the reachable space 411. Thus, in the example of FIG. 4B, the depicted insertion adjustment has moved the reachable space 411. Said succinctly, a distal portion of the proximal repositionable structure was repositioned such that the reachable space 411 was moved.

[0091] FIG. 4C depicts a port adjustment in accordance with one or more embodiments. In FIG. 4C, the proximal repositionable structure has been reconfigured to reposition the manipulator-supporting link 402, and all structures distal to the manipulatorsupporting link 402, in a direction along the positive y axis of the world frame 445. The repositioning of the manipulator-supporting link 402 and distal structures is depicted in FIG.4C using a lateral motion 470. In the example of FIG. 4C, the first instrument 404 and the second instrument 410 are anchored. That is, in response to the repositioning of the manipulator-supporting link 402 in the lateral motion 470, the degrees of freedom of the first instrument 404 and the second instrument 410 were used to execute compensatory adjustments and maintain the global positions of the first end effector 406 and the second end effector 412. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the port adjustment. While the example of FIG. 4C depicts the first and second instruments 404, 410 as anchored, a port adjustment can be executed without anchoring an instrument. As seen in FIG. 4C, the reachable space 411 of the second instrument 410 has been translated, due to the port adjustment, in the direction of the positive y axis of the world frame 445. Thus, in the example of FIG. 4C, the depicted port adjustment has moved the reachable space 411.

[0092] As previously stated, FIGs. 5A-5C depict an example insertion and port adjustment under the interface portion viewpoint. FIGs. 5A-5C depict a repositionable assembly including a proximal repositionable structure. In particular, a manipulatorsupporting link 402 is depicted. The manipulator-supporting link 402 supports a first distal repositionable structure 450 coupled with an attached first instrument 404 and a second distal repositionable structure 452 with an attached second instrument 410. The manipulatorsupporting link 402 forms a common mechanical base for the distal repositionable structures 450 and 452 that support the instruments 404 and 410.

[0093] In the example of FIGs. 5A-5C, the first instrument 404 and the second instrument 410 are inserted through a aperture 492 in a barrier 494 toward a work site 498. In a medical scenario, the barrier 494 could be a body wall of a patient, and the aperture 492 could be a minimally invasive incision or a natural body orifice of the patient. FIGs. 5A-5C further depict a center point 485 of the aperture 492 and an interface portion 480 (enclosed by a dashed oval) of the repositionable assembly.

[0094] Under the interface portion viewpoint, the repositionable assembly can be partitioned into portions relative to the aperture 492. For example, in one setting with instruments supported by the repositionable assembly inserted through the aperture 492 into awork site 498, the portion of the repositionable assembly external to the aperture 492 can be considered a first portion and the instruments (and other structure) within the work site 498 can be considered a second portion. An interface can be defined at the aperture that separates the first portion and the second portion. Thus, a portion of the repositionable assembly (or supported instruments) can be considered an interface portion 480, or the portion of the repositionable assembly and / or supported instruments that passes through the aperture 492 (e.g., instrument shaft(s)) and effectively distinguishes between the first and second portions.

[0095] Embodiments of the disclosure relate to adjusting the interface portion 480. Adjustments can be considered with respect to the relative position of the interface portion 480 within the aperture 492 and also a location of the interface portion 480 with respect to the repositionable assembly and / or supported instruments, themselves. For example, during set up or operation, the first portion (or the portion of the repositionable assembly proximal to the aperture) can be reconfigured to adjust the interface portion 480 such that the interface portion 480 is centered relative to the aperture 492. Such an adjustment is a port adjustment. As another example, portions of the repositionable assembly considered as the first, second, and interface portions 480 can be altered. For example, the repositionable assembly can be used to position supported instruments further (or deeper) in to the work site 498 thus changing (or as a result of changing) the portion of the repositionable assembly considered the interface portion 480. Adjustment of the interface portion 480 with respect to the repositionable assembly and / or supported instruments represent an insertion adjustment.

[0096] In other words, embodiments of the disclosure relate to using the portion of the repositionable assembly proximal to an aperture (i.e., first portion) to adjust the interface portion 480 by either adjusting a lateral or planar position of the interface portion 480 relative to the aperture 492 (i.e., port adjustment) or by adjusting which portion of the repositionable assembly and / or supported instruments is considered the interface portion 480 (i.e., insertion adjustment characterized by insertion or extraction of the second portion in the work site using the first portion).

[0097] In some scenarios, it may be desirable to adjust, based on commands received at the input system, the interface portion 480 of the repositionable assembly and supported instruments, if applicable, by either changing the relative position of the interface portion 480 to the aperture 492 or by changing the portion of the repositionable assembly and / or supported instruments considered the interface portion 480 (i.e., adjusting the portion of the repositionable assembly and / or supported instruments that passes through the aperture 492.

[0098] Examples of when an adjustment of the interface portion 480, whether a port or an insertion adjustment, may be used include: establishing a remote center, e.g., positioned at the height of, and centered with, an aperture; adjusting a lateral position of the interface portion in response to a shift of an aperture, e.g., during a medical procedure a patient (and therefore the aperture) may shift; adjusting the reachable space of instruments supported by the repositionable assembly, e.g., to alter the available insertion depth of one or more instruments.

[0099] FIG. 5B depicts an insertion adjustment in accordance with one or more embodiments. In FIG. 5B, the proximal repositionable structure has been reconfigured to reposition the manipulator-supporting link 402 closer to the aperture 492 along the insertion axis 490. The repositioning of the manipulator-supporting link 402 is depicted in FIG. 5B as insertion motion 460. In response to the repositioning of the manipulator-supporting link 402 along the insertion axis 490 (i.e., insertion motion 460), the first distal repositionable structure 450 and the second distal repositionable structure 452 executed compensatory adjustments by means of a retraction along their respective insertion / retraction degrees of freedom. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the insertion adjustment. As seen in FIG. 4B, the portion of the repositionable assembly and / or supported instruments considered as the interface portion 480 is altered. That is, the portion of the repositionable assembly and / or supported instruments that cross the aperture 492, and are thus considered the interface portion 480, is changed. In instances where the repositionable assembly uses a software remote center (remote center 440), in performing an insertion adjustment, the remote center 440 may be adjusted relative to the repositionable assembly. For example, in FIG. 4B, the remote center is fixed in place with respect to a world frame (not depicted in FIG. 4B) by adjusting the remote center 440 to remain in the interface portion 480 of the repositionable assembly even as the portion of the repositionable assembly and / or supported instruments defined as the interface portion changes. In some implementations, adjustment of the remote center 440 with respect to the repositionable assembly (e.g., to maintain a fixed global position of the remote center 440 during an insertion adjustment) is performed automatically by the computer-assisted system. For example, because the depth or length of an insertion adjustment is known by virtue of commanding the insertion adjustment using the user input system, the location of the remote center 440 with respect to the repositionable assembly, or portion thereof, can be automatically determined and updated.

[0100] FIG. 5C depicts a port adjustment in accordance with one or more embodiments. In FIG. 5C, the proximal repositionable structure has been reconfigured to reposition the manipulator-supporting link 402, and all structures distal to the manipulatorsupporting link 402, in a direction along the positive y axis of the world frame 445. The repositioning of the manipulator-supporting link 402 and distal structures is depicted in FIG.5C using a lateral motion 470. In the example of FIG. 5C, the first instrument 404 and the second instrument 410 are anchored. That is, in response to the repositioning of the manipulator-supporting link 402 in the lateral motion 470, the degrees of freedom of the first instrument 404 and the second instrument 410 were used to execute compensatory adjustments and maintain the global positions of the first end effector 406 and the second end effector 412. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the port adjustment. As depicted in FIG. 5C, in the port adjustment the interface portion 480 is moved laterally with respect to the aperture 492 in a plane substantially parallel with the interface and / or a floor, e.g., by repositioning the distal portion of the proximal repositionable structure (i.e., a reconfiguration of the first portion). In some instances, this is to cause one or more instruments (and / or an entry guide attached to the proximal repositionable structure via an entry guide supporting link) to be moved laterally with respect to the aperture 492. As described above, in some instances, distal portions of supported instruments are anchored such that the distal portions of the instruments (e.g., end effectors) remain stationary during the port adjustment, e.g., using degrees of freedom the instruments (e.g., the second portion). However, while a distal portion of an instrument may remain stationary, its shaft, if included in the interface portion 480, must necessarily move (i.e., port adjustment moves the interface portion laterally). In performing a port adjustment, a remote center 440 of the repositionable assembly (e.g., a software remote center, a hardware remote center) is moved correspondingly with said lateral motion of the interface portion 480 (e.g., one or more instrument shafts and / or entry guide). In the example of FIG. 5C, the port adjustment has moved the interface portion 480, including the remote center 440, laterally with respect to the aperture 492 such that the interface portion 480 and remote center 440 are aligned with the center point 485 of the aperture 492.

[0101] While the previous paragraphs with respect to FIGs. 5A-5C discuss adjustment of an interface portion, embodiments of the disclosure can be enacted without reference to an aperture or interface portion. For example, the previously described embodiments can be effectuated by repositioning the distal portion of the proximalrepositionable structure. That is, embodiments of the disclosure relate to repositioning the distal portion of the proximal repositionable structure using one or more joints of the repositionable assembly. Repositioning of the distal portion of the proximal repositionable structure, according to one or more embodiments, affects components of the repositionable assembly and supported instruments distal to the distal portion of the proximal repositionable structure, where, in the presence of an aperture, the effect includes adjustment of an interface portion. Without reference to the aperture, it may be said that positioning, or repositioning, of the distal portion of the proximal repositionable structure moves the reachable space of one or more supported instruments

[0102] As previously stated, FIGs. 6A-6C depict an example insertion and port adjustment under the control point viewpoint. FIGs. 6A-6C depict a repositionable assembly including a proximal repositionable structure. In particular, a manipulator-supporting link 402 is depicted. The manipulator-supporting link 402 supports a first distal repositionable structure 450 coupled with an attached first instrument 404 and a second distal repositionable structure 452 with an attached second instrument 410. The manipulator-supporting link 402 forms a common mechanical base for the distal repositionable structures 450 and 452 that support the instruments 404 and 410.

[0103] FIGs. 6A-6C further depict a world frame 445 or datum. The depicted world frame 445 is a Cartesian coordinate system with x, y, and z axes. The world frame 445 is fixed in space.

[0104] Under the control point viewpoint, a control point 489 is determined for the repositionable assembly. The control point 489 can reside, or be located on, a portion of the repositionable assembly (e.g., a point on a port or entry guide) or can be determined in relation to a portion and / or feature of the repositionable assembly. In the example of FIGs.6A-6C, the control point 489 is located on the insertion axis 490 at a specified distance 493 from the manipulator-supporting link 402. Thus, in some examples, the control point 489 is determined as a virtual point in space without being physically located on a portion of the repositionable assembly. In general, the control point 489 is determined to be located at the distal end of the repositionable assembly, for example, on or near a port or entry guide (if used).

[0105] FIG. 6B depicts an insertion adjustment in accordance with one or more embodiments. In FIG. 6B, the proximal repositionable structure has been reconfigured to reposition the control point 489. As seen, the control point 489 has been moved along the insertion axis 490 by repositioning the manipulator-supporting link 402 where the controlpoint 489 is defined as being located a specified distance 493 from the manipulatorsupporting link 402. The repositioning of the manipulator-supporting link 402 is depicted in FIG. 6B as insertion motion 460. In response to the repositioning of the manipulatorsupporting link 402 along the insertion axis 490 ( / .< ., insertion motion 460), the first distal repositionable structure 450 and the second distal repositionable structure 452 executed compensatory adjustments by means of a retraction along their respective insertion / retraction degrees of freedom. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the insertion adjustment. In instances where the repositionable assembly is configured with a software remote center (remote center 440), in performing an insertion adjustment, the remote center 440 may be adjusted relative to the repositionable assembly. For example, in FIG. 6B, the remote center is fixed in place with respect to the world frame 445 by adjusting the location of the remote center 440 with respect to the repositionable assembly or portion thereof (e.g., manipulator-supporting link 402). In some implementations, adjustment of the remote center 440 with respect to the repositionable assembly (e.g., to maintain a fixed global position of the remote center 440 during an insertion adjustment) is performed automatically by the computer-assisted system. For example, because the depth or length of an insertion adjustment is known by virtue of commanding the insertion adjustment using the user input system, the location of the remote center 440 with respect to the repositionable assembly, or portion thereof, can be automatically determined and updated.

[0106] FIG. 6C depicts a port adjustment in accordance with one or more embodiments. In FIG. 6C, the proximal repositionable structure has been reconfigured to reposition the control point 489 in a direction along the positive y axis of the world frame 445. The repositioning of the control point 489 is depicted in FIG. 6C using a lateral motion 470. In the example of FIG. 6C, the first instrument 404 and the second instrument 410 are anchored. That is, in response to the repositioning of the manipulator-supporting link 402 in the lateral motion 470, the degrees of freedom of the first instrument 404 and the second instrument 410 were used to execute compensatory adjustments and maintain the global positions of the first end effector 406 and the second end effector 412. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the port adjustment. In performing a port adjustment, a remote center 440 of the repositionable assembly (e.g., a software remote center, a hardware remote center) is moved with the control point 489.

[0107] Positioning, or repositioning, of the distal end of the repositionable assembly (e.g., control point, entry guide) is performed according to an input from the user input system. The user input system includes one or more input devices for receiving an input from an operator. Example input devices include: a kinematic series, such as with a repositionable structure with a plurality of links coupled by one or more joints (e.g., a joystick, a hand controller, efc.); a button or collection of buttons; a directional pad; and a touchscreen or touch pad. In general, the control system of the computer-assisted system can provide and / or facilitate a mapping between an input device (e.g., movements of the input device and / or other input signals such as depression of a button) and components of the computer-assisted system such as the proximal repositionable structure. In some embodiments, a port adjustment is performed using one or more input devices each configured as an input repositionable structure e.g., a joystick, a hand controller, etc.). In this case, manipulation of the input device by the user is mapped and commanded to a movement of the distal end of the repositionable assembly (e.g., reconfiguration of the proximal repositionable structure to reposition its distal portion). In other embodiments, repositioning of the distal end of the repositionable assembly for an insertion or port adjustment is performed using a touch screen with at least one virtual button (e.g., a directional button), where depression or selection of a virtual button commands a movement of the distal portion of the proximal repositionable structure. Regardless of the type of input device used, in some embodiments an operator can indicate the implementation of either the port adjustment or the insertion adjustment. For example, in implementing a port adjustment while using an input repositionable structure, movement of the input device in directions relating to insertion can be constrained or otherwise omitted from the resulting commanded motion of the distal portion of the proximal repositionable structure (e.g., by projecting the commanded motion to a lateral plane). As another example, the insertion adjustment can be implemented using an input device that is a touchscreen providing an “insertion” button and a “retraction” button where these buttons alter the position of the distal portion of the proximal repositionable structure to move the distal end of the repositionable assembly, e.g., along the insertion axis.

[0108] In one or more implementations, one or more of a port adjustment and an insertion adjustment are realized by repositioning of the distal portion of the proximal repositionable structure (and thus a control point, interface portion, etc.) through a reconfiguration of the proximal repositionable structure using the user input system. Various types of input devices can be included in the user input system and used to command therepositionable assembly for port and insertion adjustments. Further, a port adjustment and an insertion adjustment may be partitioned, or constrained, to different motions selectable by the operator (e.g, planar motion and insertion / depth (or reach) motion). In some implementations, a specified subset of the plurality of joints of the proximal repositionable structure are used to perform the port or insertion adjustment in response to the received user input. For example, the joints used may be limited to those responsible for the degrees of freedom labelled A, B, and C in FIG. 2A.

[0109] In some implementations, a port or insertion adjustment made using the user input system can also include, or make use of, a view of the work site and / or aperture.Various views can be provided. For example, an instrument can be configured as an imaging device to provide of view of the work site, or, if extracted, a view of the aperture. As another example, an imaging device can be provided on the repositionable assembly, another device (e.g, entry guide), or in the room containing the repositionable assembly. Thus, an operator can perform a port or insertion adjustment using a real time view of the work site, aperture, repositionable assembly, or combination thereof.

[0110] In some implementations, the computer-assisted system uses a view of one or more of the supported instruments, work site, and aperture and detects a need for a port or insertion adjustment. For example, in some implementations the computer-assisted system makes use of one or more computer vision or machine learning techniques to determine a spatial relationship between a portion of the repositionable assembly and / or supported instruments and an aperture or a target structure in the work site using a provided view (e.g., from an imaging device, from a camera proximate the distal end of the repositionable assembly, etc.). The spatial relationship can be used to indicate the distance of an instrument shaft from an aperture wall or the distance of an end effector from a target structure. As an example, using one or more provided view, the computer-assisted system can detect that an instrument shaft or entry guide contacts an aperture wall and alert a user or operator, e.g., at the user input system, to perform a port adjustment. As another example, the computer-assisted system can determine, using one or more views, a distance between an end effector and a target structure along an insertion axis of the instrument and further determine an available insertion / retraction travel of the instrument using the distal repositionable structure that supports the instrument. In instances where the computer-assisted system determines that the distance between the end effector and target structure exceeds the available insertion / retraction travel of the instrument, an alert can be provided to a user or operator to perform an insertion adjustment.

[0111] In some implementations, one or more of the port adjustment and insertion adjustment can be executed pseudo-automatically by the computer-assisted system, where a received user input at the user input system indicates that a specified adjustment (port or insertion) should be performed. In these implementations, the computer-assisted system performs an insertion or port adjustment without further input from the user or operator. For example, a user can provide a user input (e.g., depression of a button, selection of a menu item, etc.) at the user input system to perform a port adjustment (e.g., in response to receiving an alert that an instrument shaft is contacting an aperture wall). In response to receiving the input to perform the port adjustment, the computer-assisted system can command the repositionable assembly to reconfigure to center one or more instrument shafts (or entry guide) in the aperture using one or more provided views. For example, the computer-assisted system can use one or more computer vision techniques or machine learning algorithms to monitor and direct movement of the distal end of the repositionable assembly to the center point of the aperture using one or more provided views.

[0112] Additional constraints or system behavior can be defined. For example, determining limits on repositioning the distal portion of the proximal repositionable structure along the insertion axis based on a type and state of a port or entry guide used. Limits can be determined dynamically, e.g., based on variables of the computer-assisted system such as a number of port or insertion adjustment performed, a type and / or state of an instrument or entry guide, and the range of motion (or available range of motion) of one or more degrees of freedom of the repositionable assembly (e.g., proximity of a distal repositionable structure to a range of motion limit). For example, “budgets” (or available movement or adjustment limits) in different directions (e.g., an insertion direction and a retraction direction) can be determined and the movement of the distal portion of the proximal repositionable structure can be limited to a portion of its given adjustment limit per received input signal from the operator. That is, a user may need to depress or depress and hold a button multiple times to continue movement towards a limit. Other constraints can include: disabling the ability to perform an insertion adjustment from the user input device when a certain type port or entry guide (e.g., cannula) is used; disabling the ability to perform a port adjustment from the user input device when a stapler is clamped or is firing; and requiring an established software remote center that is offset by a predefined distance from the hardware remote center. Thus, the computer-assisted system can also consider instrument types and states as well as consider information related to the use and configuration of a cannula or other port or entry guide.

[0113] In one or more implementations, the control system of the computer-assisted system is configured to enable or disable the receiving of the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space based, at least in part, on one or more of: a first instrument of a first instrument type being attached to the repositionable assembly; a second instrument of a second instrument type not being attached to the repositionable assembly; a first entry guide of a first entry guide type being attached to the repositionable assembly; a software remote center being configured for the repositionable assembly; and the software remote center being offset from a hardware remote center of the repositionable assembly by at least a threshold distance (i.e., offset by at least a predefined distance). For example, in one or more implementations, reception of user input to reconfigure the proximal repositionable structure to move the reachable space is enabled in response to the first instrument having an instrument type of a camera or imaging device. As another example, in some implementations, reception of user input to reconfigure the proximal repositionable structure to move the reachable space is disabled in response to the second instrument having an instrument type of a stapler. As yet another example, in some implementations, reception of user input to reconfigure the proximal repositionable structure to move the reachable space is disabled in response to the medical system including a first entry guide used with the repositionable assembly and the first entry guide having a type of a cannula. As yet another example, in some implementations, reception of user input to reconfigure the proximal repositionable structure to move the reachable space is disabled until a software remote center has been established, or conversely, reception of user input is enabled in response to the establishment of a software remote center. As yet another example, in some implementations, reception of user input to reconfigure the proximal repositionable structure to reposition the distal portion of the repositionable assembly in a retraction direction (based on an insertion axis associated with the proximal repositionable assembly) is disabled in response to an established software remote center not being offset from a hardware remote center by a predefined distance or threshold.

[0114] Enabling and disabling of the reception of user input indicative of the command the reconfigure the proximal repositionable structure can be based on the realization of one or more constraints imposed on the computer-assisted system.

[0115] In one or more embodiments, the computer-assisted system includes a touchscreen with a graphical user interface to receive the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space. Further, and as described above, the motion to reconfigure the proximal repositionablestructure can be constrained by one or more constraints. An element of the graphical user interface (e.g., an insertion button, a retraction button, an insertion adjustment button or menu option, a port adjustment button or menu option, etc.) can be disabled based on a configuration of the proximal repositionable assembly and the one or more constraints. For example, the motion to reconfigure the proximal repositionable structure including a repositioning of the distal portion of the proximal repositionable structure along an insertion axis associated with the proximal repositionable structure (i.e., an insertion adjustment) can be constrained by an insertion adjustment limit that specifies an available travel distance for the distal portion in an insertion direction an a retraction adjustment limit that specifies an available travel distance for the distal portion in a retraction direction. In one or more implementations, the control system of the computer-assisted system can be configured to disable an insertion element (e.g., insertion button) of the graphical user interface in response to travel of the distal portion in the insertion direction being greater than or equal to the insertion adjustment limit and disable a retraction element e.g., retraction button) of the graphical user interface in response to travel of the distal portion in the retraction direction being greater than or equal to the retraction adjustment limit. Example of a user interface and enabling and disabling elements are provided in FIGs. 8A-8D.

[0116] FIGs. 7A-7C depict limitations on an insertion adjustment based on the state of an entry guide. In some implementations, the proximal repositionable assembly includes redundant degrees of freedom to execute a desired movement such as to reposition the distal portion of the proximal repositionable structure to perform a port or insertion adjustment. Additionally, in some scenarios whether redundant degrees of freedom are available or not, there are multiple motions (or paths) that the proximal repositionable structure can take when repositioning itself, or a portion thereof, from a first position to a second position. For example, some scenarios, the same position of a specified portion of the proximal repositionable structure (e.g., distal portion) is obtained using different poses or configurations (i.e., joint states) of the proximal repositionable structure. In one or more implementations, motion or reconfiguration of the proximal repositionable structure is constrained by or informed by (e.g., optimized) information like: proximity to range of motion limits of one or more joints; pose singularity (e.g., a desire to avoid a pose where the number of degrees of freedom is effectively reduced); and so-called “no-fly regions” or avoiding the proximal repositionable structure or portion thereof from physically entering a specified region in its environment (e.g., lack of overhead space).

[0117] FIGs. 7A-7C depict examples of an insertion adjustment and a port adjustment using a specified type of port or entry guide. FIGs. 8A-8C depict examples of a graphical user interface that can be provided at the user input system to receive a user input to perform one or more of an insertion adjustment and a port adjustment. For example, the user interface can contain separate buttons or menu selection items for port and insertion adjustments.

[0118] FIGs. 7A-7C depict a type of entry guide referred to herein as an access port 700. Similar to FIGs. 4A-4C, 5A-5C, and 6A-6C, FIGs. 7A-7C depict examples of an insertion adjustment and a port adjustment. For concision, a description of elements depicted in FIGs. 7A-7C that are common to, or were previously described in, a prior figure is not repeated here. As seen in FIG. 7A, the access port 700 comprises a first port 702 (e.g., an annulus) attached to a distal end of the repositionable assembly and a second port 704 (e.g., an annulus) attached to, or located or placed in, an aperture 492. The first port 702 and the second port 704 are connected using a collapsible or compliant wall 706, where the collapsible wall 706 defines a volume 708 through which one or more supported instruments 404, 410 are passed through to enter the aperture 492. Benefits of the access port 700 can include: providing operators the versatility to work near the aperture 492 and maintain deep multi -quadrant access to the work site 498; providing or maintaining a sterile environment around the aperture 492; and allowing one more instruments (including those configured as an imaging device such as an endoscope) and insufflation to be introduced through the same aperture 492 (e.g., incision).

[0119] In one or more implementations, the locations of the first port 702 and the second port 704 (or, at least their relative locations) are known or approximated. For example, the first port 702 is attached to the distal end of the repositionable assembly such that knowledge of the pose of the repositionable assembly can be used to determine the location of the first port 702 at least with respect to the repositionable assembly or its base (e.g., base 212). Further, the location of the remote center 440 is known, or reasonably approximated by, the computer-assisted system. For example, a software remote center can be established by a user or the computer-assisted system. In one or more implementations, the second port 704 has a location at or near the remote center (e.g., second port 704 can circumscribe the remote center 440). As such, the location of the second port 704 is known, or approximated by, the computer-assisted system even without a rigid attachment between the second port 704 and the repositionable assembly (i.e., the wall 706 is not rigid and does not, in general, form a rigid attachment between the first port 702 and the second port 704).

[0120] In one or more implementations, one or more constraints can be placed on the insertion adjustment or port adjustment based on the state of the port or entry guide, e.g., based on the state or shape of the access port 700. For example, a constraint can specify that an insertion adjustment to insert the distal end of the repositionable assembly relative to the aperture 492 does not fully collapse the access port 700. That is, the constraint can prevent the first port 702 from contacting the second port 704. Constraints can define a “budget” (e.g., adjustment limit), or available movement in a given direction e.g., an insertion direction, a retraction direction, etc.), for the insertion or port adjustments. For example, an access port 700 can have a first constraint that the first port 702 and the second port 704 do not contact each other where this first constraint defines an adjustment limit as a function of the distance between the first port 702 and the second port 704 along (or parallel to) the insertion axis 490. In instances where the insertion axis 490 is not orthogonal to a plane of the aperture 492, the distance between the first port 702 and the second port 704 can be specified as the shortest distance between any two portions of these ports along the insertion axis 490. FIG. 7 A depicts a distance A (shortest distance) between the first port 702 and the second port 704 along (or parallel to) the insertion axis 490. Thus, an adjustment limit corresponding to the first constraint can be provided based on the distance A. For example, the function may specify the adjustment limit as 0.95A.

[0121] As will be discussed with respect to FIGs. 8A-8C, additional constraints or control functionality can be imposed, such as a limitation on the maximum distance the distal end of the repositionable assembly can be moved given a user input for an insertion or port adjustment. For example, another constraint or control function can specify that for each user input for an insertion adjustment, in the insertion direction, reconfiguration of the proximal repositionable assembly is limited to a maximum of half the adjustment limit. Thus, upon reaching this limit another user input is required to initiate another insertion adjustment in the insertion direction, where reconfiguration of the proximal repositionable assembly may again be limited based on an updated adjustment limit based on an updated state of the entry guide (e.g., access port 700).

[0122] Additional constraints and control functionality based on a state or shape of port or entry guide (e.g., access port), or other aspect of the computer-assisted system (e.g., a control mode) can be included without limitation. For example, when using an access port 700, a second constraint can specify that a distance between the first port 702 and the second port 704 does not exceed a specified threshold. Similarly, port adjustments can be based oncorresponding adjustment limits such as a distance of an instrument shaft from the barrier 494 wall.

[0123] FIG. 7B depicts an example insertion adjustment performed with an access port 700 in accordance with one or more embodiments. In FIG. 7B, the proximal repositionable structure has been reconfigured to reposition the distal end of the repositionable assembly (e.g., the first port 702). As seen, the first port 702 has been moved along (or parallel with) the insertion axis 490 by repositioning the manipulator-supporting link 402. The repositioning of the manipulator-supporting link 402 is depicted in FIG. 7B as insertion motion 460. As in FIGs. 4B, 5B, and 6B, in response to the repositioning of the manipulator-supporting link 402 along the insertion axis 490 (i.e., insertion motion 460), the first distal repositionable structure 450 and the second distal repositionable structure 452 executed compensatory adjustments by means of a retraction along their respective insertion / retraction degrees of freedom. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the insertion adjustment. As seen in FIG. 7B, the state (e.g., shape) of the access port 700 is altered as a result of the insertion motion 460. The updated state of the access port 700 can be considered for further insertion and / or port adjustments. For example, new adjustment limits or other constraints can be determined and / or enforced or relaxed based on the updated state of the access port 700. In instances where the repositionable assembly uses a software remote center (remote center 440), in performing an insertion adjustment, the remote center 440 may be adjusted relative to the repositionable assembly. For example, in FIG. 7B, the remote center remains near or at the second port 704. In some implementations, adjustment of the remote center 440 with respect to the repositionable assembly (e.g., to maintain a fixed position of the remote center 440 at or near the second port 704 during an insertion adjustment) is performed automatically by the computer-assisted system. For example, because the depth or length of an insertion adjustment is known by virtue of commanding the insertion adjustment using the user input system, the location of the remote center 440 with respect to the repositionable assembly, or portion thereof, can be automatically determined and updated.

[0124] FIG. 7C depicts a port adjustment in accordance with one or more embodiments. In FIG. 7C, the proximal repositionable structure has been reconfigured to reposition the first port 702 and volume 708 to be better aligned with the aperture 492. This repositioning is depicted in FIG. 7C using a lateral motion 470. In the example of FIG. 7C, the first instrument 404 and the second instrument 410 are anchored. That is, in response tothe repositioning of the manipulator-supporting link 402 in the lateral motion 470, the degrees of freedom of the first instrument 404 and the second instrument 410 were used to execute compensatory adjustments and maintain the global positions of the first end effector 406 and the second end effector 412. As a result of the compensatory adjustments, the global positions of the first end effector 406 and the second end effector 412 are the same as before the port adjustment. In performing a port adjustment, a remote center 440 of the repositionable assembly (e.g, a software remote center, a hardware remote center) is moved.

[0125] As stated above, in some implementations, the computer-assisted system uses a view of one or more of the supported instruments, work site, and aperture and detects, guide, or implement a port or insertion adjustment. As such, FIG. 7C further depicts an imaging device 710 (e.g, camera) that provides a view of the access port 700, instruments 404, 410 (or, at least a portion of the instruments such as the segment of the instrument shafts in the aperture 492), and aperture 492. In some implementations, the view obtained by the imaging device 710 is provided to an operator at the user input system using a display of the user input system or another display. The operator can determine a direction, e.g., in a plane substantially parallel to the aperture 492, for a port adjustment and monitor the port adjustment, in real time, to position the distal end of the repositionable assembly (e.g., instrument shafts centered with aperture 492) as desired. In some implementations, the view provided by the imaging device 710 is used to automatically perform a port adjustment to center the segments of the instrument shafts passing through the aperture 492 in the aperture 492 in response to receiving a user input to do so from the user input system. While FIG. 7C depicts an imaging device 710 as separate from the repositionable assembly (but considered part of the computer-assisted system), in some implementations the imaging device 710 is integrated with, or considered part of, the repositionable assembly or port or entry guide (e.g., contained on the first port 702). Similarly, in some implementations, the imaging device 710 can be an instrument supported by the repositionable assembly and controlled using the computer-assisted system (e.g., an endoscope). For example, and instrument configured as an imaging device 710 can be retracted from the work site 498 and aperture 492 to provide a view of the other instruments (or their shafts) in relation to the aperture 492 to, or when, performing a port or insertion adjustment.

[0126] It is noted that while FIGs. 4A-4C, 5A-5C, 6A-6C, and 7A-7C use a two-dimensional view and depict the use of two instruments, embodiments of the instant disclosure are not limited to use in two-dimensional spaces or with only two instruments. Further, embodiments disclosed herein are readily applicable to scenarios where therepositionable assembly supports one instrument, two instruments, or three or more instruments.

[0127] In one or more implementations, the user input system includes a user interface or display that is provided to an operator. For example, the user interface can be or include a touchscreen, as previously described, where the touchscreen is configured as an input device of the user input system. As another example, a menu or navigation interface can be displayed using the display and one or more input devices (e.g., buttons, computer mouse, trackpad, directional pad, etc.) can be used to interact with the menu or navigation interface. The user interface or display, in addition to allowing selection and implementation of the above-described port and insertion adjustments, can provide alert information, information relating to the state or pose of the repositionable assembly, and a rationale for why system behavior may be limited (e.g., maximum allowed insertion port adjustment reached, which may be defined based on one or more of a hardware remote center, software remote center, and state of a port or entry guide such as an access port). In other embodiments, alerts and / or other audiovisual information can be displayed using existing displays of the computer-assisted system. That is, the user interface or menus, buttons, and information relating to the tasks of a port or insertion adjustment commanded using the user input system, can be integrated into existing user interfaces or displays.

[0128] FIGs. 8A-8D depict various states of an example user interface in accordance with one or more embodiments. FIG. 8A depicts a portion of a first menu 802 displayed to an operator at the user input system. As seen, the first menu includes various options for controlling aspects of a computer-assisted system including a repositionable assembly. In particular, first menu 802 includes a first selection item 804 corresponding an insertion adjustment and a second selection item 806 corresponding to a port adjustment. Note that the insertion adjustment and the port adjustment may each be known as, or called using, different names. For example, in some implementations an insertion adjustment is referred to as a “reach assist.” Further, in some implementations a single selection item is displayed to access both the insertion adjustment and port adjustment features.

[0129] FIG. 8B depicts an example alert 808 that can be displayed to a user while performing an insertion or port adjustment using the user input system. The alert 808 can provide information relating to the insertion or port adjustment or the state (e.g., control mode) of the repositionable assembly. The alert 808 can be provided at the same display as used for the first menu 802 or at another display. For example, in some implementations,alerts or other banner messages are provided at a display of the user input system at eye level with the operator (see display unit 254 of FIG. 2A).

[0130] FIG. 8C depicts an example second menu 810 that can be displayed in response to a selection by the operator to perform an insertion adjustment. In one or more implementations, the second menu 810 displays various items related to performing an insertion adjustment including a first button 812 to “insert” or move the distal end of the repositionable assembly down its insertion axis (e.g., toward an aperture) and a second button 814 to “retract” or move the distal end of the repositionable assembly up its insertion axis e.g., away from an aperture). See insertion and retraction directional arrows depicted in FIG.4A, where these directional arrows are applicable to performing an insertion adjustment using the proximal repositionable structure. The second menu 810 can further include a distance item 816. The distance item 816 can be configured to indicate an insertion state (e.g., location of a control point along the insertion axis of the repositionable assembly relative to a given datum (e.g., an initial location)) or indicate the distance that the distal end (or, for example, control point) will travel along the insertion axis given the reception of either an insert or retract command using the first and second buttons 812, 814, respectively. If indicative of an insertion state, the depicted distance in the distance item 816 can be updated or reset in view of a manual adjustment of the manipulator assembly (e.g., by a bed-side assistant). If indicative of travel distance, in some implementations, the travel distance can be selected by the operator by depressing the distance item 816. As depicted, the second menu 810 further includes, among other possible things, a close button 818 to exit the second menu 810. Exiting the second menu 810 can return to a previous menu, e.g., the first menu 802. In some implementations, the buttons of the second menu 810 are implemented as touch buttons on a touchscreen such that the display configured as the touchscreen is considered a user input device of the user input system. In some implementations, the buttons are selected and virtually depressed using a user input device (e.g., computer mouse).

[0131] Additional control functions can be added to the second menu 810 or implemented, for example, by function overloading the buttons. For example, a first function can be implemented by tapping a button and a second function can be implemented by depressing and holding a button in its depressed state. As another example, a first function can be implemented using a single click of a button and a second function can be implemented using a double click of the button. In the context of the depicted second menu 810 corresponding to an insertion adjustment, a tap of the first button 812 can cause an insertion motion to occur over a predefined distance (e.g., 0.5 cm) and a depression and holdof the first button 812 can cause an insertion motion to occur over the maximum available insertion distance.

[0132] FIG. 8D depicts another instance of the second menu 810. In FIG. 8D, the first button 812 has been disabled and is depicted as disabled using cross-hatching. Further, an additional alert or message 820 is displayed to the operator providing a rationale for why the first button 812 is disabled. In the example of FIG. 8D, the first button 812 is disabled because no further insertion is possible as stated in the message 820. In some implementations, additional information is provided in the message 820 or can be displayed (e.g., expanded or detailed message) by selecting the message 820. The additional information can include a detailed explanation related to the message 820 such as the reason for why insertion is not possible. Example reasons can include an indication of a range of motion limit of a joint used to perform the insertion adjustment and identification of the joint or degree of freedom, an anchored instrument (e.g., instrument cannot remain anchored if the disabled adjustment is applied), a budget (e.g., adjustment limit such as a travel distance limit) has been reached, etc. While FIG. 8D depicts the first button 812 as disabled, other buttons can be disabled without limitation. For example, the second button 814 can be disabled to prevent an insertion adjustment in the retraction direction. Further, the message 820 can indicate that retraction is not possible and provide a rationale, e.g., because retraction is not allowed as a first movement when performing and insertion adjustment.

[0133] In one or more embodiments, while performing a port or insertion adjustment, the computer-assisted system emits or generates an audible tone (e.g., a periodic beeping noise) to indicate to one or more users that the repositionable assembly is undergoing a reconfiguration.

[0134] While the preceding figures show various configurations of components, other configurations may be used without departing from the scope of the disclosure. For example, various components may be combined to create a single component. As another example, the functionality performed by a single component may be performed by two or more components. While instruments are described as being supported by a repositionable assembly similar to or configured as a robotic arm with an instrument holder, an instrument may be supported by any type of repositionable structure, without departing from the disclosure. Further, while components are often described in context of medical scenarios such as surgical scenarios, embodiments of the disclosure are equally applicable to other domains that involve robotic manipulation, e.g., non-surgical scenarios or systems, nonmedical scenarios or systems, and / or the like.

[0135] Commands to reconfigure the repositionable assembly, for example, to determine and perform a motion of a proximal repositionable structure to perform a port or insertion adjustment in response to a user input received at the user input system, can be executed on one or more processors of the control system of the computer-assisted system.

[0136] Determinations related to the reconfiguration of the repositionable assembly can concurrently, or jointly, consider constraints that may be imposed on the computer-assisted system. For example, range of motion limits of one or more instruments, e.g., anchored instruments, can constrain motion of a proximal repositionable structure. In one or more implementations, reconfiguration of the repositionable assembly is prevented if the associated motion is to violate an imposed constraint.

[0137] In one or more implementations, feedback is provided to a user of the computer-assisted system in response to reaching a constraint, such as a range of motion limit of an anchored instrument. Feedback can be provided in a variety of ways including, but not limited to: providing an audio and / or visual alert such as a tone or displayed warning message; and rendering haptic feedback on an associated input device. In one or more implementations, upon reaching an imposed constraint, a user can override an imposed limit or termination of the motion that violates (or will violate) the imposed constraint. In one example, during execution of a motion to reconfigure the repositionable assembly, as indicated by a user input received using an input device of the computer-assisted system, a range of motion limit of an anchored instrument is reached. In response, haptic feedback is provided at the input device indicating the prevention of further reconfiguration of the repositionable assembly to the user (at least with respect to a limited degree of freedom). Further, the user can select an option to continue with the reconfiguration in violation of the constraint (i.e., instrument is not anchored). Selection of the option can be realized by the user pressing a button (e.g., in response to a displayed message presenting the option), maintaining the user input to execute the violating motion (e.g., resisting haptic feedback at the input device for a predefined period), or other similar mechanism.

[0138] Turning to FIG. 9, a flowchart in accordance with one or more embodiments is shown. The flowchart of FIG. 9 depicts a method 900 for computer-assisted systems. The method 900 may be used reconfigure a repositionable assembly of a computer-assisted system to perform a port or insertion adjustment (e.g., move the reachable space of one or more supported instruments) in response to a user input received at an user input system of the computer-assisted system. One or more of the steps in FIG. 9 may be performed by various components of systems, previously described with reference to any of the precedingfigures. While these figures illustrate particular configurations of computer assisted systems, the method is equally applicable to other configurations. The method may be executed on one or more processors, e.g., of the control system of the computer-assisted system.

[0139] While the various steps in the flowchart are presented and described sequentially, one of ordinary skill will appreciate that some or all of the steps may be executed in different orders, may be combined or omitted, and some or all of the steps may be executed in parallel. Additional steps may further be performed. Furthermore, the steps may be performed actively or passively. For example, some steps may be performed using polling or be interrupt driven in accordance with one or more embodiments of the invention.

[0140] The subsequently described steps may be performed for repositionable assemblies as previously described or any other repositionable assemblies. In some embodiments, the repositionable assembly supports multiple instruments (e.g., two, three, or more instruments), each having multiple links. In some examples, a repositionable assembly may comprise a proximal repositionable structure and one or more distal repositionable structures. The one or more distal repositionable structures may each support or couple to one or more instruments. Examples of repositionable assemblies and instruments disposed on the repositionable assemblies include but are not limited to those previously discussed in reference to FIGS. 1, 2A-2B, and 3A-3B. For example, the repositionable assembly can include a proximal repositionable structure with a distal portion and a first distal repositionable structure attached to the distal portion. The first distal repositionable structure can be configured to support one or more instruments such as a first instrument. The subsequently described steps may be used to reconfigure the proximal repositionable structure to perform a port or insertion adjustment. The reconfiguration can move the reachable space of the first instrument.

[0141] Turning to FIG. 9, Step 902 of the method 900 indicates that the subsequent steps apply to a computer-assisted system that includes a control system, an input device configured to receive an input from a user, and a repositionable assembly that includes a proximal repositionable structure with a distal portion and a distal repositionable structure attached to the distal portion, where the distal repositionable structure is configured to support an instrument and to move a working portion of the instrument e.g., end effector) within a reachable space. In other words, the reachable space is defined, at least in part, by the movement of the working portion of the instrument provided by the distal repositionable structure. For example, in one or more implementations, the distal repositionable structure provides an insertion / retraction degree of freedom such that use of this degree of freedomretracts and inserts the instrument into a work site along an insertion axis of the distal repositionable structure. See insertion and retraction directional arrows depicted in FIG. 4A. Thus, the range of motion (or the motion between the fully retracted state and the fully inserted state) of the insertion / retraction degree of freedom defines boundaries of the reachable space of the instrument along the insertion axis of the distal repositionable structure (or the insertion axis of the instrument). Thus, the distal repositionable structure is configured to move the working portion of the instrument within the reachable space.

[0142] In Step 904, a user input is received at the input device. The received user input indicates a command to reconfigure the proximal repositionable structure such that the reachable space is moved. In particular, reconfiguration the proximal repositionable structure to move the reachable space will move the distal portion of the proximal repositionable structure. Or, in other words, the reachable space (or aperture portion, control point, distal end, port or entry guide) cannot be moved without moving the distal portion of the proximal repositionable structure (e.g., manipulator-supporting link). Thus, it may be said that the received user input indicates a command to reposition the distal portion of the proximal repositionable structure such that the reachable space is moved.

[0143] In Step 906, a motion to reconfigure the proximal repositionable structure is determined based on the user input. In one or more implementations the motion can be constrained, informed, or optimized according to other aspects of the computer-assisted system, repositionable assembly, supported instruments, or combinations thereof. For example, the motion can be constrained to use on a predefined subset of joints of the plurality of joints of the proximal repositionable structure. As another example, the motion can avoid placing the repositionable assembly in a predefined no-fly region and / or avoid pose singularities. As yet another example, the motion can be constrained based on available travel distances or adjustment limits where these adjustment limits, in turn, can be based on a type and / or a state of a supported instrument or entry guide. For example, in instances where the entry guide is an access port, the state (e.g., positions or locations of the first and second ports) of the access guide can be used to determine an adjustment limit for the travel distance used in an insertion adjustment in either a retraction or insertion direction. As yet another example, an insertion or port adjustment can be prohibited e.g., disabled on a user interface) based on a type of instrument or entry guide. For example, an insertion adjustment can be prohibited based on the use of a canula as an entry guide. As another example, a port adjustment can be prohibited based on the use of a stapler or its state (e.g., stapler fired, stapler clamped, etc.).

[0144] In Step 908, the motion to reconfigure the proximal repositionable to reposition its distal portion such the at the reachable space (or control point, interface portion, distal end, etc.) is moved is executed. In some implementations, the movement is monitored, tracked, and or displayed to a user using a camera of the computer-assisted system.

[0145] In summary, embodiments disclosed herein relate to a computer-assisted system including a repositionable assembly and a control system. The repositionable assembly includes a proximal repositionable structure having a distal portion and a distal repositionable structure attached to the distal portion. The distal repositionable structure is configured to support an instrument and to move a working portion of the instrument within a reachable space. The control system includes one or more processors and is communicatively coupled to the repositionable assembly. The control system is configured to receive a user input, the user input indicative of a command to reconfigure the proximal repositionable structure to move the reachable space. The control system is further configured to determine, based on the user input, a motion to reconfigure the proximal repositionable structure and execute the motion to reconfigure the proximal repositionable structure to move the reachable space. In one or more implementations, the reconfiguration of the proximal repositionable structure is a repositioning of the distal portion of the proximal repositionable structure. Further, in one or more implementations, the repositioning of the distal portion of the proximal repositionable structure is a movement of the distal portion along an insertion axis associated with the proximal repositionable structure. The proximal repositionable structure can be configured to pivot its distal portion about a remote center. In one or more implementations, such when performing an insertion adjustment, the location of the remote center is maintained in a world frame during the repositioning of the distal portion of the proximal repositionable structure along the insertion axis of the repositionable assembly. The motion to reconfigure the proximal repositionable structure can be constrained by one or more constraints. The computer-assisted system can include one or mor input devices. For example, a first input device can be used to receive the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space and a second input device can be used to control the instrument. As another example, a single input device can be used to receive the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space and to receive a second user input indicative of a second command to control the instrument. The command, or reception of the command (via user input), to reconfigure the proximal repositionable structure to move the reachable space can be enabled or disabled based on theone or more constraints or other factors of the computer-assisted system (e.g., the use of an instrument of a certain instrument type, the state of a procedure performed with the computer-assisted system, the use of a certain type of port or entry guide, etc.). In some implementations, enablement and disablement of the motion is effectuated by enabling or disabling an input device or element thereof such as a button provided on a touchscreen.

[0146] Although only a few example embodiments have been described in detail above, those skilled in the art will readily appreciate that many modifications are possible in the example embodiments without materially departing from this invention. Accordingly, all such modifications are intended to be included within the scope of this disclosure as defined in the following claims.

Claims

1. CLAIMSWhat is claimed is:

1. A computer-assisted system comprising:a repositionable assembly comprising:a proximal repositionable structure comprising a distal portion, anda distal repositionable structure attached to the distal portion, the distal repositionable structure configured to support an instrument and to move a working portion of the instrument within a reachable space; and a control system comprising one or more processors and communicatively coupled to the repositionable assembly, the control system configured to:receive a user input, the user input indicative of a command to reconfigure the proximal repositionable structure to move the reachable space, determine, based on the user input, a motion to reconfigure the proximal repositionable structure, andexecute the motion to reconfigure the proximal repositionable structure to move the reachable space.

2. The computer-assisted system of claim 1, wherein the reconfiguration of the proximal repositionable structure is a repositioning of the distal portion of the proximal repositionable structure.

3. The computer-assisted system of claim 2, wherein the repositioning of the distal portion of the proximal repositionable structure is a movement of the distal portion along an insertion axis associated with the proximal repositionable structure.

4. The computer-assisted system of claim 3, wherein the proximal repositionable structure is configured to pivot its distal portion about a remote center and wherein a location of the remote center is maintained in a world frame during the repositioning of the distal portion of the proximal repositionable structure along the insertion axis of the repositionable assembly.

5. The computer-assisted system of any of claims 1-4, wherein the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints.

6. The computer-assisted system of claim 5, wherein the one or more constraints comprise a first constraint that reconfiguration of the proximal repositionable structure is performed using a subset of a plurality of joints of the proximal repositionable structure.

7. The computer-assisted system of claim 5, wherein the control system is further configured to generate an alert or message in response to reaching at least one of the one or more constraints.

8. The computer-assisted system of claim 5, wherein the one or more constraints comprise a first constraint based on a state of the instrument.

9. The computer-assisted system of claim 5, wherein:the motion to reconfigure the proximal repositionable structure comprises a repositioning of the distal portion of the proximal repositionable structure along an insertion axis associated with the proximal repositionable structure; and the one more constraints comprise an adjustment limit that specifies an available travel distance for the distal portion.

10. The computer-assisted system of claim 9, wherein:the computer-assisted system further comprises an entry guide; andthe adjustment limit is based on the entry guide.

11. The computer-assisted system of claim 10, wherein the repositioning of the distal portion of the proximal repositionable structure is less than the adjustment limit.

12. The computer-assisted system of any of claims 1-4, wherein the control system is configured to enable or disable the receiving of the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space based, at least in part, on one or more of:a first instrument of a first instrument type being attached to the repositionable assembly,a second instrument of a second instrument type not being attached to the repositionable assembly,a first entry guide of a first entry guide type being attached to the repositionable assembly,a software remote center being configured for the repositionable assembly, orthe software remote center being offset from a hardware remote center of the repositionable assembly by at least a threshold distance.

13. The computer-assisted system of any of claims 1-4, wherein the computer-assisted system further comprises:a first input device to receive the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space; and a second input device to receive a second user input indicative of a second command to control the instrument.

14. The computer-assisted system of claim 13, wherein the first input device is a touchscreen input device.

15. The computer-assisted system of claim 14, wherein the touchscreen input device is configured to display a graphical user interface for receiving the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space.

16. The computer-assisted system of claim 15, wherein:the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints; andan element of the graphical user interface is disabled based on a configuration of the proximal repositionable assembly and the one or more constraints.

17. The computer-assisted system of claim 15, wherein:the motion to reconfigure the proximal repositionable structure comprises a repositioning of the distal portion of the proximal repositionable structure along an insertion axis associated with the proximal repositionable structure; the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints comprising:an insertion adjustment limit that specifies an available travel distance for the distal portion in an insertion direction, anda retraction adjustment limit that specifies an available travel distance for the distal portion in a retraction direction; andthe control system is further configured to:disable an insertion element of the graphical user interface in response to travel of the distal portion in the insertion direction being greater than or equal to the insertion adjustment limit, anddisable a retraction element of the graphical user interface in response to travel of the distal portion in the retraction direction being greater than or equal to the retraction adjustment limit.

18. The computer-assisted system of any of claims 1-4, wherein the computer-assisted system further comprises:an input device to receive the user input indicative of the command to reconfigure the proximal repositionable structure to move the reachable space and to receive a second user input indicative of a second command to control the instrument.

19. A method for controlling a computer-assisted system, the method performed by a control system of the computer-assisted system and comprising:receiving a user input, the user input indicative of a command to reconfigure a repositionable assembly comprised computer-assisted system to move a reachable space, wherein:the repositionable assembly comprises a proximal repositionable structure comprising a distal portion and a distal repositionable structure attached to the distal portion, andthe distal repositionable structure is configured to support an instrument and to move a working portion of the instrument in the reachable space; determining, based on the user input, a motion to reconfigure the proximal repositionable structure; andexecuting the motion to reconfigure the proximal repositionable structure to move the reachable space.

20. The method of claim 19, wherein the reconfiguration of the proximal repositionable structure is a repositioning of the distal portion of the proximal repositionable structure.

21. The method of claim 20, wherein the repositioning of the distal portion of the proximal repositionable structure is a movement of the distal portion along an insertion axis associated with the proximal repositionable structure.

22. The method of claim 21, wherein the proximal repositionable structure is configured to pivot its distal portion about a remote center and wherein a location of the remote center is maintained in a world frame during the repositioning of the distal portion of the proximal repositionable structure along the insertion axis of the repositionable assembly.

23. The method of any of claims 19-22, wherein the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints.

24. The method of claim 23, wherein the one or more constraints comprise a first constraint that reconfiguration of the proximal repositionable structure is performed using a subset of a plurality of joints of the proximal repositionable structure.

25. The method of claim 23, further comprising generating an alert or message in response to reaching at least one of the one or more constraints.

26. The method of claim 23, wherein the one or more constraints comprise a first constraint based on a state of the instrument.

27. The method of claim 23, wherein:the motion to reconfigure the proximal repositionable structure comprises a repositioning of the distal portion of the proximal repositionable structure along an insertion axis associated with the proximal repositionable structure; and the one more constraints comprise an adjustment limit that specifies an available travel distance for the distal portion.

28. The method of claim 27, wherein:the computer-assisted system further comprises an entry guide; andthe adjustment limit is based on the entry guide.

29. The method of claim 28, wherein the repositioning of the distal portion of the proximal repositionable structure is less than the adjustment limit.

30. The method of any of claims 19-22, wherein the control system is configured to enable or disable the receiving of the user input indicative of the command to reconfigure the repositionable assembly to move the reachable space based, at least in part, on one or more of:a first instrument of a first instrument type being attached to the repositionable assembly,a second instrument of a second instrument type not being attached to the repositionable assembly,a first entry guide of a first entry guide type being attached to the repositionable assembly,a software remote center being configured for the repositionable assembly, or the software remote center being offset from a hardware remote center of the repositionable assembly by at least a threshold distance.

31. The method of any of claims 19-22, wherein the computer-assisted system further comprises:a first input device to receive the user input indicative of the command to reconfigure the repositionable assembly to move the reachable space; anda second input device to receive a second user input indicative of a second command to control the instrument.

32. The method of claim 31, wherein the first input device is a touchscreen input device.

33. The method of claim 32, wherein the touchscreen input device is configured to display a graphical user interface for receiving the user input indicative of the command to reconfigure the repositionable assembly to move the reachable space.

34. The method of claim 33, wherein:the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints; andthe method further comprises disabling an element of the graphical user interface based on a configuration of the proximal repositionable assembly and the one or more constraints.

35. The method of claim 33, wherein:the motion to reconfigure the proximal repositionable structure comprises a repositioning of the distal portion of the proximal repositionable structure along an insertion axis associated with the proximal repositionable structure; the motion to reconfigure the proximal repositionable structure is constrained by one or more constraints comprising:an insertion adjustment limit that specifies an available travel distance for the distal portion in an insertion direction, anda retraction adjustment limit that specifies an available travel distance for the distal portion in a retraction direction; andthe method further comprises:disabling an insertion element of the graphical user interface in response to travel of the distal portion in the insertion direction being greater than or equal to the insertion adjustment limit, anddisabling a retraction element of the graphical user interface in response to travel of the distal portion in the retraction direction being greater than or equal to the retraction adjustment limit.

36. The method of any of claims 19-22, wherein the computer-assisted system further comprises:an input device to receive the user input indicative of the command to reconfigure the repositionable assembly to move the reachable space and to receive a second user input indicative of a second command to control the instrument.

37. A non-transitory machine-readable medium comprising a plurality of machine-readable instructions executed by one or more processors associated with a computer-assisted system, the plurality of machine-readable instructions causing the one or more processors to perform the method of any of claims 19 to 36.

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