SURGICAL INSTRUMENT WITH MAGNETIC SENSING

A sensor array can detect a position of a magnetic element. The sensor array can include a printed circuit board and a plurality of sensors. The printed circuit board is configured to rotate about a rotation axis and relative to the magnetic element. The plurality of sensors are disposed circumferentially about the rotation axis and coupled to the printed circuit board. At least one sensor is disposed at a selected circumferential position relative to the rotation axis. The sensor is configured to change between an open state and a closed state in response to a change in the position of the magnetic element relative to the rotation axis.

TECHNICAL FIELD

Systems and methods disclosed herein related to surgical instruments, and more particularly to magnetic input sensing for surgical instruments.

BACKGROUND

Minimally invasive procedures allow for access to a targeted site within a patient with minimal trauma to the patient. A medical robotic system can provide a mechanism through which one or more robotic arms are used to perform a surgical operation. For example, laparoscopic surgery can allow for surgical access to a patient's cavity through a small incision on the patient's abdomen.

In some applications, certain conventional laparoscopes for use with robotic systems may include an interface, such as a tool drive adapter, to couple the laparoscope to the robotic system and allow the robotic system to control operation of the laparoscope. In some applications, the tool drive adapter can couple to the robotic system and allow the instrument shaft of the laparoscope to pass through and rotate relative to the tool driver assembly. In some applications, certain electronics may be sealed, isolated, or otherwise disposed within the instrument shaft to allow the laparoscope to be sterilized.

In some applications, certain conventional laparoscopes may contain a separate user interface to allow a clinician to control operations or functions of the laparoscope or the robotic system. The user interface may include one or more buttons or other elements a clinician can interact with. In some applications, certain conventional laparoscopes can contain electronic components to detect actuation of the buttons or other elements by the clinicians. In some applications, an end of the instrument shaft can be coupled to an end of the user interface, allowing the instrument shaft to rotate relative to the end of the user interface.

In some applications, since certain conventional robotic laparoscopes or surgical instruments include a tool driver adapter and a separate user interface attached to the end of the instrument shaft, certain conventional robotic surgical instruments may have an overall longer length than surgical instruments configured for manual use.

SUMMARY

Some predicate systems can utilize laparoscopes or other surgical instruments that that are unwieldy to handle and may not be sterilized utilizing standardized processes due to the additional length of the instrument attributed to a separate user interface attached to an end of the instrument shaft.

In accordance with some embodiments disclosed herein is the realization that as robotic systems and surgical instruments developed by the present Applicant continue to evolve and provide functionality hitherto unavailable, important and unexpected changes to the structure and architecture of the robotic system and surgical instruments were discovered and found to provide surprisingly important and advantageous results in facilitating the effective and simple operations of the robotic system and surgical instruments. Further, in accordance with some embodiments disclosed herein is the realization that a reduced overall instrument length, while maintaining a desired operational length is desired. Additionally, in accordance with some embodiments disclosed herein is the realization that combining a user interface with a tool drive adapter that can withstand sterilization while providing accurate detection of user inputs is desired.

As such, the present disclosure addresses these and other challenges.

For example, due to the unique architecture of embodiments of the surgical instruments developed by the present Applicant, unique and innovative architecture has made it possible for overall length of the surgical instrument to be reduced, while maintaining a desired operational length. As a result, a robotic system can utilize the surgical instrument for a desired procedure, while allowing for the surgical instrument to be easily handled by a clinician and to be sterilized by utilizing standardized procedures and equipment. Further, the robotic system can utilize a surgical instrument that can provide accurate detection of user feedback, while allowing the components of the surgical instrument to withstand sterilization procedures.

Accordingly, embodiments disclosed herein provide a laparoscope or other surgical instrument can incorporate one or more user inputs (e.g. buttons) with the tool drive adapter, eliminating the need for a separate user interface, thereby reducing the overall length of the surgical instrument. The surgical instrument can include one or more sensors disposed, sealed, or isolated within an instrument shaft to detect the position or state of the user inputs, even as the instrument shaft rotates relative to the user inputs. The sensors can be arranged to provide reliable detection of the position or state of the user inputs.

Advantageously, some embodiments of the surgical instrument and sensor arrangement disclosed herein can reduce the overall length of the surgical instrument, while allowing for reliable detection of user inputs and withstanding sterilization processes. Such surgical instrument configurations and/or sensor arrangements can provide a solution to the above-noted challenges and have not been disclosed or implemented in predicate systems given that such systems did not implement or otherwise contemplate the unique improvements of Applicant's new technology until the discovery and development of embodiments of the instrument configurations and/or sensor arrangements described herein.

In accordance with some embodiments, a surgical instrument can include an instrument shaft and a tool drive adapter. The tool drive adapter can include a housing that is disposed around a portion of the instrument shaft. The instrument shaft can rotate about a rotation axis relative to the tool drive housing. In some embodiments, the surgical instrument is a laparoscope. Further, in some embodiments, the instrument shaft is a laparoscopic instrument.

In accordance with some embodiments, an actuator coupled to the tool drive housing can control a function of the surgical instrument. In some embodiments, a sensor array disposed within or otherwise coupled to the instrument shaft can detect a position of the actuator or any other suitable magnetic element. The sensor array can be disposed within or otherwise coupled to any suitable instrument, tool, or device.

The sensor array can include a printed circuit board configured to rotate about a rotation axis and relative to the magnetic element. In some embodiments, the printed circuit board can be round.

In accordance with some embodiments, a plurality of sensors can be disposed about the rotation axis and coupled to the printed circuit board. One or more sensors can be configured to change between an open state and a closed state in response to a change in position of the magnetic element relative to the rotation axis or provide a signal corresponding to the actuation of the actuator. The sensors can be equidistantly spaced apart. In some applications, the sensor array can include multiple groups of sensors. For example, in some embodiments, one group of sensors may be disposed on a first surface of a printed circuit board, and another group of sensors can be disposed on an opposite second surface of the printed circuit board. One group of sensors may be interposed between another group of sensors. In some applications, the sensors are reed switches.

In some embodiments, the printed circuit board can include a plurality of elongated slats disposed circumferentially about the rotation axis and configured to rotate about the rotation axis and relative to the magnetic element. In some embodiments, sensors can be coupled to a respective elongated slat of the plurality of elongated slats. In accordance with some embodiments, sensors can be disposed on the elongated slats. The sensors can be laterally spaced apart along the rotation axis.

DETAILED DESCRIPTION

Aspects of the present disclosure may be integrated into a robotically enabled medical system capable of performing a variety of medical procedures, including both minimally invasive, such as laparoscopy, and non-invasive, such as endoscopy, procedures. Among endoscopy procedures, the system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.

In addition to performing the breadth of procedures, the system may provide additional benefits, such as enhanced imaging and guidance to assist the physician. Additionally, the system may provide the physician with the ability to perform the procedure from an ergonomic position without the need for awkward arm motions and positions. Still further, the system may provide the physician with the ability to perform the procedure with improved case of use such that one or more of the instruments of the system can be controlled by a single user.

Various embodiments will be described below in conjunction with the drawings for purposes of illustration. It should be appreciated that many other implementations of the disclosed concepts are possible, and various advantages can be achieved with the disclosed implementations. Headings are included herein for reference and to aid in locating various sections. These headings are not intended to limit the scope of the concepts described with respect thereto. Such concepts may have applicability throughout the entire specification.

The robotically enabled medical system may be configured in a variety of ways depending on the particular procedure.FIG.1illustrates an embodiment of a cart-based robotically enabled system10arranged for a diagnostic and/or therapeutic bronchoscopy procedure. During a bronchoscopy, the system10may comprise a cart11having one or more robotic arms12to deliver a medical instrument, such as a steerable endoscope13, which may be a procedure-specific bronchoscope for bronchoscopy, to a natural orifice access point (i.e., the mouth of the patient positioned on a table in the present example) to deliver diagnostic and/or therapeutic tools. As shown, the cart11may be positioned proximate to the patient's upper torso in order to provide access to the access point. Similarly, the robotic arms12may be actuated to position the bronchoscope relative to the access point. The arrangement inFIG.1may also be utilized when performing a gastro-intestinal (GI) procedure with a gastroscope, a specialized endoscope for GI procedures.FIG.2depicts an example embodiment of the cart in greater detail.

With continued reference toFIG.1, once the cart11is properly positioned, the robotic arms12may insert the steerable endoscope13into the patient robotically, manually, or a combination thereof. As shown, the steerable endoscope13may comprise at least two telescoping parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument driver from the set of instrument drivers28, each instrument driver coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers28, which facilitates coaxially aligning the leader portion with the sheath portion, creates a “virtual rail”29that may be repositioned in space by manipulating the one or more robotic arms12into different angles and/or positions. The virtual rails described herein are depicted in the Figures using dashed lines, and accordingly the dashed lines do not depict any physical structure of the system. Translation of the instrument drivers28along the virtual rail29telescopes the inner leader portion relative to the outer sheath portion or advances or retracts the endoscope13from the patient. The angle of the virtual rail29may be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and position of the virtual rail29as shown represents a compromise between providing physician access to the endoscope13while minimizing friction that results from bending the endoscope13into the patient's mouth.

The endoscope13may be directed down the patient's trachea and lungs after insertion using precise commands from the robotic system until reaching the target destination or operative site. In order to enhance navigation through the patient's lung network and/or reach the desired target, the endoscope13may be manipulated to telescopically extend the inner leader portion from the outer sheath portion to obtain enhanced articulation and greater bend radius. The use of separate instrument drivers28also allows the leader portion and sheath portion to be driven independent of each other.

For example, the endoscope13may be directed to deliver a biopsy needle to a target, such as, for example, a lesion or nodule within the lungs of a patient. The needle may be deployed down a working channel that runs the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathology results, additional tools may be deployed down the working channel of the endoscope for additional biopsies. After identifying a nodule to be malignant, the endoscope13may endoscopically deliver tools to resect the potentially cancerous tissue. In some instances, diagnostic and therapeutic treatments can be delivered in separate procedures. In those circumstances, the endoscope13may also be used to deliver a fiducial to “mark” the location of the target nodule as well. In other instances, diagnostic and therapeutic treatments may be delivered during the same procedure.

The system10may also include a movable tower30, which may be connected via support cables to the cart11to provide support for controls, electronics, fluidics, optics, sensors, and/or power to the cart11. Placing such functionality in the tower30allows for a smaller form factor cart11that may be more easily adjusted and/or re-positioned by an operating physician and his/her staff. Additionally, the division of functionality between the cart/table and the support tower30reduces operating room clutter and facilitates improving clinical workflow. While the cart11may be positioned close to the patient, the tower30may be stowed in a remote location to stay out of the way during a procedure.

In support of the robotic systems described above, the tower30may include component(s) of a computer-based control system that stores computer program instructions, for example, within a non-transitory computer-readable storage medium such as a persistent magnetic storage drive, solid state drive, etc. The execution of those instructions, whether the execution occurs in the tower30or the cart11, may control the entire system or sub-system(s) thereof. For example, when executed by a processor of the computer system, the instructions may cause the components of the robotics system to actuate the relevant carriages and arm mounts, actuate the robotics arms, and control the medical instruments. For example, in response to receiving the control signal, the motors in the joints of the robotics arms may position the arms into a certain posture.

The tower30may also include a pump, flow meter, valve control, and/or fluid access in order to provide controlled irrigation and aspiration capabilities to the system that may be deployed through the endoscope13. These components may also be controlled using the computer system of tower30. In some embodiments, irrigation and aspiration capabilities may be delivered directly to the endoscope13through separate cable(s).

The tower30may include a voltage and surge protector designed to provide filtered and protected electrical power to the cart11, thereby avoiding placement of a power transformer and other auxiliary power components in the cart11, resulting in a smaller, more moveable cart11.

The tower30may also include support equipment for the sensors deployed throughout the robotic system10. For example, the tower30may include opto-electronics equipment for detecting, receiving, and processing data received from the optical sensors or cameras throughout the robotic system10. In combination with the control system, such opto-electronics equipment may be used to generate real-time images for display in any number of consoles deployed throughout the system, including in the tower30. Similarly, the tower30may also include an electronic subsystem for receiving and processing signals received from deployed electromagnetic (EM) sensors. The tower30may also be used to house and position an EM field generator for detection by EM sensors in or on the medical instrument.

The tower30may also include a console31in addition to other consoles available in the rest of the system, e.g., console mounted on top of the cart. The console31may include a user interface and a display screen, such as a touchscreen, for the physician operator. Consoles in system10are generally designed to provide both robotic controls as well as pre-operative and real-time information of the procedure, such as navigational and localization information of the endoscope13. When the console31is not the only console available to the physician, it may be used by a second operator, such as a nurse, to monitor the health or vitals of the patient and the operation of system, as well as provide procedure-specific data, such as navigational and localization information. In other embodiments, the console30is housed in a body that is separate from the tower30.

The tower30may be coupled to the cart11and endoscope13through one or more cables or connections (not shown). In some embodiments, the support functionality from the tower30may be provided through a single cable to the cart11, simplifying and de-cluttering the operating room. In other embodiments, specific functionality may be coupled in separate cabling and connections. For example, while power may be provided through a single power cable to the cart, the support for controls, optics, fluidics, and/or navigation may be provided through a separate cable.

FIG.2provides a detailed illustration of an embodiment of the cart from the cart-based robotically enabled system shown inFIG.1. The cart11generally includes an elongated support structure14(often referred to as a “column”), a cart base15, and a console16at the top of the column14. The column14may include one or more carriages, such as a carriage17(alternatively “arm support”) for supporting the deployment of one or more robotic arms12(three shown in FIG.2). The carriage17may include individually configurable arm mounts that rotate along a perpendicular axis to adjust the base of the robotic arms12for better positioning relative to the patient. The carriage17also includes a carriage interface19that allows the carriage17to vertically translate along the column14.

The carriage interface19is connected to the column14through slots, such as slot20, that are positioned on opposite sides of the column14to guide the vertical translation of the carriage17. The slot20contains a vertical translation interface to position and hold the carriage at various vertical heights relative to the cart base15. Vertical translation of the carriage17allows the cart11to adjust the reach of the robotic arms12to meet a variety of table heights, patient sizes, and physician preferences. Similarly, the individually configurable arm mounts on the carriage17allow the robotic arm base21of robotic arms12to be angled in a variety of configurations.

In some embodiments, the slot20may be supplemented with slot covers that are flush and parallel to the slot surface to prevent dirt and fluid ingress into the internal chambers of the column14and the vertical translation interface as the carriage17vertically translates. The slot covers may be deployed through pairs of spring spools positioned near the vertical top and bottom of the slot20. The covers are coiled within the spools until deployed to extend and retract from their coiled state as the carriage17vertically translates up and down. The spring-loading of the spools provides force to retract the cover into a spool when carriage17translates towards the spool, while also maintaining a tight seal when the carriage17translates away from the spool. The covers may be connected to the carriage17using, for example, brackets in the carriage interface19to ensure proper extension and retraction of the cover as the carriage17translates.

The column14may internally comprise mechanisms, such as gears and motors, that are designed to use a vertically aligned lead screw to translate the carriage17in a mechanized fashion in response to control signals generated in response to user inputs, e.g., inputs from the console16.

The robotic arms12may generally comprise robotic arm bases21and end effectors22, separated by a series of linkages23that are connected by a series of joints24, each joint comprising an independent actuator, each actuator comprising an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm. Each of the arms12have seven joints, and thus provide seven degrees of freedom. A multitude of joints result in a multitude of degrees of freedom, allowing for “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arms12to position their respective end effectors22at a specific position, orientation, and trajectory in space using different linkage positions and joint angles. This allows for the system to position and direct a medical instrument from a desired point in space while allowing the physician to move the arm joints into a clinically advantageous position away from the patient to create greater access, while avoiding arm collisions.

The cart base15balances the weight of the column14, carriage17, and arms12over the floor. Accordingly, the cart base15houses heavier components, such as electronics, motors, power supply, as well as components that either enable movement and/or immobilize the cart. For example, the cart base15includes rollable wheel-shaped casters25that allow for the cart to easily move around the room prior to a procedure. After reaching the appropriate position, the casters25may be immobilized using wheel locks to hold the cart11in place during the procedure.

Positioned at the vertical end of column14, the console16allows for both a user interface for receiving user input and a display screen (or a dual-purpose device such as, for example, a touchscreen26) to provide the physician user with both pre-operative and intra-operative data. Potential pre-operative data on the touchscreen26may include pre-operative plans, navigation and mapping data derived from pre-operative computerized tomography (CT) scans, and/or notes from pre-operative patient interviews. Intra-operative data on display may include optical information provided from the tool, sensor and coordinate information from sensors, as well as vital patient statistics, such as respiration, heart rate, and/or pulse. The console16may be positioned and tilted to allow a physician to access the console from the side of the column14opposite carriage17. From this position, the physician may view the console16, robotic arms12, and patient while operating the console16from behind the cart11. As shown, the console16also includes a handle27to assist with maneuvering and stabilizing cart11.

FIG.3illustrates an embodiment of a robotically enabled system10arranged for ureteroscopy. In a ureteroscopic procedure, the cart11may be positioned to deliver a ureteroscope32, a procedure-specific endoscope designed to traverse a patient's urethra and ureter, to the lower abdominal area of the patient. In a ureteroscopy, it may be desirable for the ureteroscope32to be directly aligned with the patient's urethra to reduce friction and forces on the sensitive anatomy in the area. As shown, the cart11may be aligned at the foot of the table to allow the robotic arms12to position the ureteroscope32for direct linear access to the patient's urethra. From the foot of the table, the robotic arms12may insert the ureteroscope32along the virtual rail33directly into the patient's lower abdomen through the urethra.

After insertion into the urethra, using similar control techniques as in bronchoscopy, the ureteroscope32may be navigated into the bladder, ureters, and/or kidneys for diagnostic and/or therapeutic applications. For example, the ureteroscope32may be directed into the ureter and kidneys to break up kidney stone build up using a laser or ultrasonic lithotripsy device deployed down the working channel of the ureteroscope32. After lithotripsy is complete, the resulting stone fragments may be removed using baskets deployed down the ureteroscope32.

FIG.4illustrates an embodiment of a robotically enabled system similarly arranged for a vascular procedure. In a vascular procedure, the system10may be configured such that the cart11may deliver a medical instrument34, such as a steerable catheter, to an access point in the femoral artery in the patient's leg. The femoral artery presents both a larger diameter for navigation as well as a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in a ureteroscopic procedure, the cart11may be positioned towards the patient's legs and lower abdomen to allow the robotic arms12to provide a virtual rail35with direct linear access to the femoral artery access point in the patient's thigh/hip region. After insertion into the artery, the medical instrument34may be directed and inserted by translating the instrument drivers28. Alternatively, the cart may be positioned around the patient's upper abdomen in order to reach alternative vascular access points, such as, for example, the carotid and brachial arteries near the shoulder and wrist.

Embodiments of the robotically enabled medical system may also incorporate the patient's table. Incorporation of the table reduces the amount of capital equipment within the operating room by removing the cart, which allows greater access to the patient.FIG.5illustrates an embodiment of such a robotically enabled system arranged for a bronchoscopy procedure. System36includes a support structure or column37for supporting platform38(shown as a “table” or “bed”) over the floor. Much like in the cart-based systems, the end effectors of the robotic arms39of the system36comprise instrument drivers42that are designed to manipulate an elongated medical instrument, such as a bronchoscope40inFIG.5, through or along a virtual rail41formed from the linear alignment of the instrument drivers42. In practice, a C-arm for providing fluoroscopic imaging may be positioned over the patient's upper abdominal area by placing the emitter and detector around table38.

FIG.6provides an alternative view of the system36without the patient and medical instrument for discussion purposes. As shown, the column37may include one or more carriages43shown as ring-shaped in the system36, from which the one or more robotic arms39may be based. The carriages43may translate along a vertical column interface44that runs the length of the column37to provide different vantage points from which the robotic arms39may be positioned to reach the patient. The carriage(s)43may rotate around the column37using a mechanical motor positioned within the column37to allow the robotic arms39to have access to multiples sides of the table38, such as, for example, both sides of the patient. In embodiments with multiple carriages, the carriages may be individually positioned on the column and may translate and/or rotate independent of the other carriages. While carriages43need not surround the column37or even be circular, the ring-shape as shown facilitates rotation of the carriages43around the column37while maintaining structural balance. Rotation and translation of the carriages43allows the system to align the medical instruments, such as endoscopes and laparoscopes, into different access points on the patient. In other embodiments (not shown), the system36can include a patient table or bed with adjustable arm supports in the form of bars or rails extending alongside it. One or more robotic arms39(e.g., via a shoulder with an elbow joint) can be attached to the adjustable arm supports, which can be vertically adjusted. By providing vertical adjustment, the robotic arms39are advantageously capable of being stowed compactly beneath the patient table or bed, and subsequently raised during a procedure.

The arms39may be mounted on the carriages through a set of arm mounts45comprising a series of joints that may individually rotate and/or telescopically extend to provide additional configurability to the robotic arms39. Additionally, the arm mounts45may be positioned on the carriages43such that, when the carriages43are appropriately rotated, the arm mounts45may be positioned on either the same side of table38(as shown inFIG.6), on opposite sides of table38(as shown inFIG.9), or on adjacent sides of the table38(not shown).

The column37structurally provides support for the table38, and a path for vertical translation of the carriages. Internally, the column37may be equipped with lead screws for guiding vertical translation of the carriages, and motors to mechanize the translation of said carriages based the lead screws. The column37may also convey power and control signals to the carriage43and robotic arms39mounted thereon.

The table base46serves a similar function as the cart base15in cart11shown inFIG.2, housing heavier components to balance the table/bed38, the column37, the carriages43, and the robotic arms39. The table base46may also incorporate rigid casters to provide stability during procedures. Deployed from the bottom of the table base46, the casters may extend in opposite directions on both sides of the base46and retract when the system36needs to be moved.

Continuing withFIG.6, the system36may also include a tower (not shown) that divides the functionality of system36between table and tower to reduce the form factor and bulk of the table. As in earlier disclosed embodiments, the tower may provide a variety of support functionalities to table, such as processing, computing, and control capabilities, power, fluidics, and/or optical and sensor processing. The tower may also be movable to be positioned away from the patient to improve physician access and de-clutter the operating room. Additionally, placing components in the tower allows for more storage space in the table base for potential stowage of the robotic arms. The tower may also include a master controller or console that provides both a user interface for user input, such as keyboard and/or pendant, as well as a display screen (or touchscreen) for pre-operative and intra-operative information, such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also contain holders for gas tanks to be used for insufflation.

In some embodiments, a table base may stow and store the robotic arms when not in use.FIG.7illustrates a system47that stows robotic arms in an embodiment of the table-based system. In system47, carriages48may be vertically translated into base49to stow robotic arms50, arm mounts51, and the carriages48within the base49. Base covers52may be translated and retracted open to deploy the carriages48, arm mounts51, and arms50around column53, and closed to stow to protect them when not in use. The base covers52may be sealed with a membrane54along the edges of its opening to prevent dirt and fluid ingress when closed.

FIG.8illustrates an embodiment of a robotically enabled table-based system configured for a ureteroscopy procedure. In a ureteroscopy, the table38may include a swivel portion55for positioning a patient off-angle from the column37and table base46. The swivel portion55may rotate or pivot around a pivot point (e.g., located below the patient's head) in order to position the bottom portion of the swivel portion55away from the column37. For example, the pivoting of the swivel portion55allows a C-arm (not shown) to be positioned over the patient's lower abdomen without competing for space with the column (not shown) below table38. By rotating the carriage35(not shown) around the column37, the robotic arms39may directly insert a ureteroscope56along a virtual rail57into the patient's groin area to reach the urethra. In a ureteroscopy, stirrups58may also be fixed to the swivel portion55of the table38to support the position of the patient's legs during the procedure and allow clear access to the patient's groin area.

In a laparoscopic procedure, through small incision(s) in the patient's abdominal wall, minimally invasive instruments may be inserted into the patient's anatomy. In some embodiments, the minimally invasive instruments comprise an elongated rigid member, such as a shaft, which is used to access anatomy within the patient. After inflation of the patient's abdominal cavity, the instruments may be directed to perform surgical or medical tasks, such as grasping, cutting, ablating, suturing, etc. In some embodiments, the instruments can comprise a scope, such as a laparoscope.FIG.9illustrates an embodiment of a robotically enabled table-based system configured for a laparoscopic procedure. As shown inFIG.9, the carriages43of the system36may be rotated and vertically adjusted to position pairs of the robotic arms39on opposite sides of the table38, such that instrument59may be positioned using the arm mounts45to be passed through minimal incisions on both sides of the patient to reach his/her abdominal cavity.

To accommodate laparoscopic procedures, the robotically enabled table system may also tilt the platform to a desired angle.FIG.10illustrates an embodiment of the robotically enabled medical system with pitch or tilt adjustment. As shown inFIG.10, the system36may accommodate tilt of the table38to position one portion of the table at a greater distance from the floor than the other. Additionally, the arm mounts45may rotate to match the tilt such that the arms39maintain the same planar relationship with table38. To accommodate steeper angles, the column37may also include telescoping portions60that allow vertical extension of column37to keep the table38from touching the floor or colliding with base46.

FIG.11provides a detailed illustration of the interface between the table38and the column37. Pitch rotation mechanism61may be configured to alter the pitch angle of the table38relative to the column37in multiple degrees of freedom. The pitch rotation mechanism61may be enabled by the positioning of orthogonal axes1,2at the column-table interface, each axis actuated by a separate motor3,4responsive to an electrical pitch angle command. Rotation along one screw5would enable tilt adjustments in one axis1, while rotation along the other screw6would enable tilt adjustments along the other axis2. In some embodiments, a ball joint can be used to alter the pitch angle of the table38relative to the column37in multiple degrees of freedom.

For example, pitch adjustments are particularly useful when trying to position the table in a Trendelenburg position, i.e., position the patient's lower abdomen at a higher position from the floor than the patient's lower abdomen, for lower abdominal surgery. The Trendelenburg position causes the patient's internal organs to slide towards his/her upper abdomen through the force of gravity, clearing out the abdominal cavity for minimally invasive tools to enter and perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

FIGS.12and13illustrate isometric and end views of an alternative embodiment of a table-based surgical robotics system100. The surgical robotics system100includes one or more adjustable arm supports105that can be configured to support one or more robotic arms (see, for example,FIG.14) relative to a table101. In the illustrated embodiment, a single adjustable arm support105is shown, though an additional arm support can be provided on an opposite side of the table101. The adjustable arm support105can be configured so that it can move relative to the table101to adjust and/or vary the position of the adjustable arm support105and/or any robotic arms mounted thereto relative to the table101. For example, the adjustable arm support105may be adjusted one or more degrees of freedom relative to the table101. The adjustable arm support105provides high versatility to the system100, including the ability to easily stow the one or more adjustable arm supports105and any robotics arms attached thereto beneath the table101. The adjustable arm support105can be elevated from the stowed position to a position below an upper surface of the table101. In other embodiments, the adjustable arm support105can be elevated from the stowed position to a position above an upper surface of the table101.

The adjustable arm support105can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment ofFIGS.12and13, the arm support105is configured with four degrees of freedom, which are illustrated with arrows inFIG.12. A first degree of freedom allows for adjustment of the adjustable arm support105in the z-direction (“Z-lift”). For example, the adjustable arm support105can include a carriage109configured to move up or down along or relative to a column102supporting the table101. A second degree of freedom can allow the adjustable arm support105to tilt. For example, the adjustable arm support105can include a rotary joint, which can allow the adjustable arm support105to be aligned with the bed in a Trendelenburg position. A third degree of freedom can allow the adjustable arm support105to “pivot up,” which can be used to adjust a distance between a side of the table101and the adjustable arm support105. A fourth degree of freedom can permit translation of the adjustable arm support105along a longitudinal length of the table.

The surgical robotics system100inFIGS.12and13can comprise a table supported by a column102that is mounted to a base103. The base103and the column102support the table101relative to a support surface. A floor axis131and a support axis133are shown inFIG.13.

The adjustable arm support105can be mounted to the column102. In other embodiments, the arm support105can be mounted to the table101or base103. The adjustable arm support105can include a carriage109, a bar or rail connector111and a bar or rail107. In some embodiments, one or more robotic arms mounted to the rail107can translate and move relative to one another.

The carriage109can be attached to the column102by a first joint113, which allows the carriage109to move relative to the column102(e.g., such as up and down a first or vertical axis123). The first joint113can provide the first degree of freedom (“Z-lift”) to the adjustable arm support105. The adjustable arm support105can include a second joint115, which provides the second degree of freedom (tilt) for the adjustable arm support105. The adjustable arm support105can include a third joint117, which can provide the third degree of freedom (“pivot up”) for the adjustable arm support105. An additional joint119(shown inFIG.13) can be provided that mechanically constrains the third joint117to maintain an orientation of the rail107as the rail connector111is rotated about a third axis127. The adjustable arm support105can include a fourth joint121, which can provide a fourth degree of freedom (translation) for the adjustable arm support105along a fourth axis129.

FIG.14illustrates an end view of the surgical robotics system140A with two adjustable arm supports105A,105B mounted on opposite sides of a table101. A first robotic arm142A is attached to the bar or rail107A of the first adjustable arm support105B. The first robotic arm142A includes a base144A attached to the rail107A. The distal end of the first robotic arm142A includes an instrument drive mechanism146A that can attach to one or more robotic medical instruments or tools. Similarly, the second robotic arm142B includes a base144B attached to the rail107B. The distal end of the second robotic arm142B includes an instrument drive mechanism146B. The instrument drive mechanism146B can be configured to attach to one or more robotic medical instruments or tools.

In some embodiments, one or more of the robotic arms142A,142B comprises an arm with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms142A,142B can include eight degrees of freedom, including an insertion axis (one degree of freedom, including insertion), a wrist (three degrees of freedom, including wrist pitch, yaw, and roll), an elbow (one degree of freedom, including elbow pitch), a shoulder (two degrees of freedom, including shoulder pitch and yaw), and base144A,144B (one degree of freedom, including translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arm142A,142B, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.

The end effectors of the system's robotic arms comprise (i) an instrument driver (alternatively referred to as “instrument drive mechanism” or “instrument device manipulator”) that incorporate electro-mechanical means for actuating the medical instrument and (ii) a removable or detachable medical instrument, which may be devoid of any electro-mechanical components, such as motors. This dichotomy may be driven by the need to sterilize medical instruments used in medical procedures, and the inability to adequately sterilize expensive capital equipment due to their intricate mechanical assemblies and sensitive electronics. Accordingly, the medical instruments may be designed to be detached, removed, and interchanged from the instrument driver (and thus the system) for individual sterilization or disposal by the physician or the physician's staff. In contrast, the instrument drivers need not be changed or sterilized, and may be draped for protection.

FIG.15illustrates an example instrument driver. Positioned at the distal end of a robotic arm, instrument driver62comprises of one or more drive units63arranged with parallel axes to provide controlled torque to a medical instrument via drive shafts64. Each drive unit63comprises an individual drive shaft64for interacting with the instrument, a gear head65for converting the motor shaft rotation to a desired torque, a motor66for generating the drive torque, an encoder67to measure the speed of the motor shaft and provide feedback to the control circuitry, and control circuity68for receiving control signals and actuating the drive unit. Each drive unit63being independent controlled and motorized, the instrument driver62may provide multiple (four as shown inFIG.15) independent drive outputs to the medical instrument. In operation, the control circuitry68would receive a control signal, transmit a motor signal to the motor66, compare the resulting motor speed as measured by the encoder67with the desired speed, and modulate the motor signal to generate the desired torque.

For procedures that require a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile drape, that sits between the instrument driver and the medical instrument. The chief purpose of the sterile adapter is to transfer angular motion from the drive shafts of the instrument driver to the drive inputs of the instrument while maintaining physical separation, and thus sterility, between the drive shafts and drive inputs. Accordingly, an example sterile adapter may comprise of a series of rotational inputs and outputs intended to be mated with the drive shafts of the instrument driver and drive inputs on the instrument. Connected to the sterile adapter, the sterile drape, comprised of a thin, flexible material such as transparent or translucent plastic, is designed to cover the capital equipment, such as the instrument driver, robotic arm, and cart (in a cart-based system) or table (in a table-based system). Use of the drape would allow the capital equipment to be positioned proximate to the patient while still being located in an area not requiring sterilization (i.e., non-sterile field). On the other side of the sterile drape, the medical instrument may interface with the patient in an area requiring sterilization (i.e., sterile field).

D. Medical Instrument

FIG.16illustrates an example medical instrument with a paired instrument driver. Like other instruments designed for use with a robotic system, medical instrument70comprises an elongated shaft71(or elongate body) and an instrument base72. The instrument base72, also referred to as an “instrument handle” due to its intended design for manual interaction by the physician, may generally comprise rotatable drive inputs73, e.g., receptacles, pulleys or spools, that are designed to be mated with drive outputs74that extend through a drive interface on instrument driver75at the distal end of robotic arm76. When physically connected, latched, and/or coupled, the mated drive inputs73of instrument base72may share axes of rotation with the drive outputs74in the instrument driver75to allow the transfer of torque from drive outputs74to drive inputs73. In some embodiments, the drive outputs74may comprise splines that are designed to mate with receptacles on the drive inputs73.

The elongated shaft71is designed to be delivered through either an anatomical opening or lumen, e.g., as in endoscopy, or a minimally invasive incision, e.g., as in laparoscopy. The elongated shaft71may be either flexible (e.g., having properties similar to an endoscope) or rigid (e.g., having properties similar to a laparoscope) or contain a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of a rigid elongated shaft may be connected to an end effector extending from a jointed wrist formed from a clevis with at least one degree of freedom and a surgical tool or medical instrument, such as, for example, a grasper or scissors, that may be actuated based on force from the tendons as the drive inputs rotate in response to torque received from the drive outputs74of the instrument driver75. When designed for endoscopy, the distal end of a flexible elongated shaft may include a steerable or controllable bending section that may be articulated and bent based on torque received from the drive outputs74of the instrument driver75.

Torque from the instrument driver75is transmitted down the elongated shaft71using tendons along the shaft71. These individual tendons, such as pull wires, may be individually anchored to individual drive inputs73within the instrument handle72. From the handle72, the tendons are directed down one or more pull lumens along the elongated shaft71and anchored at the distal portion of the elongated shaft71, or in the wrist at the distal portion of the elongated shaft. During a surgical procedure, such as a laparoscopic, endoscopic or hybrid procedure, these tendons may be coupled to a distally mounted end effector, such as a wrist, grasper, or scissor. Under such an arrangement, torque exerted on drive inputs73would transfer tension to the tendon, thereby causing the end effector to actuate in some way. In some embodiments, during a surgical procedure, the tendon may cause a joint to rotate about an axis, thereby causing the end effector to move in one direction or another. Alternatively, the tendon may be connected to one or more jaws of a grasper at distal end of the elongated shaft71, where tension from the tendon cause the grasper to close.

In endoscopy, the tendons may be coupled to a bending or articulating section positioned along the elongated shaft71(e.g., at the distal end) via adhesive, control ring, or other mechanical fixation. When fixedly attached to the distal end of a bending section, torque exerted on drive inputs73would be transmitted down the tendons, causing the softer, bending section (sometimes referred to as the articulable section or region) to bend or articulate. Along the non-bending sections, it may be advantageous to spiral or helix the individual pull lumens that direct the individual tendons along (or inside) the walls of the endoscope shaft to balance the radial forces that result from tension in the pull wires. The angle of the spiraling and/or spacing there between may be altered or engineered for specific purposes, wherein tighter spiraling exhibits lesser shaft compression under load forces, while lower amounts of spiraling results in greater shaft compression under load forces, but also exhibits limits bending. On the other end of the spectrum, the pull lumens may be directed parallel to the longitudinal axis of the elongated shaft71to allow for controlled articulation in the desired bending or articulable sections.

In endoscopy, the elongated shaft71houses a number of components to assist with the robotic procedure. The shaft may comprise of a working channel for deploying surgical tools (or medical instruments), irrigation, and/or aspiration to the operative region at the distal end of the shaft71. The shaft71may also accommodate wires and/or optical fibers to transfer signals to/from an optical assembly at the distal tip, which may include of an optical camera. The shaft71may also accommodate optical fibers to carry light from proximally located light sources, such as light emitting diodes, to the distal end of the shaft.

At the distal end of the instrument70, the distal tip may also comprise the opening of a working channel for delivering tools for diagnostic and/or therapy, irrigation, and aspiration to an operative site. The distal tip may also include a port for a camera, such as a fiberscope or a digital camera, to capture images of an internal anatomical space. Relatedly, the distal tip may also include ports for light sources for illuminating the anatomical space when using the camera.

In the example ofFIG.16, the drive shaft axes, and thus the drive input axes, are orthogonal to the axis of the elongated shaft. This arrangement, however, complicates roll capabilities for the elongated shaft71. Rolling the elongated shaft71along its axis while keeping the drive inputs73static results in undesirable tangling of the tendons as they extend off the drive inputs73and enter pull lumens within the elongated shaft71. The resulting entanglement of such tendons may disrupt any control algorithms intended to predict movement of the flexible elongated shaft during an endoscopic procedure.

FIG.17illustrates an alternative design for an instrument driver and instrument where the axes of the drive units are parallel to the axis of the elongated shaft of the instrument. As shown, a circular instrument driver80comprises four drive units with their drive outputs81aligned in parallel at the end of a robotic arm82. The drive units, and their respective drive outputs81, are housed in a rotational assembly83of the instrument driver80that is driven by one of the drive units within the assembly83. In response to torque provided by the rotational drive unit, the rotational assembly83rotates along a circular bearing that connects the rotational assembly83to the non-rotational portion84of the instrument driver. Power and controls signals may be communicated from the non-rotational portion84of the instrument driver80to the rotational assembly83through electrical contacts may be maintained through rotation by a brushed slip ring connection (not shown). In other embodiments, the rotational assembly83may be responsive to a separate drive unit that is integrated into the non-rotatable portion84, and thus not in parallel to the other drive units. The rotational mechanism83allows the instrument driver80to rotate the drive units, and their respective drive outputs81, as a single unit around an instrument driver axis85.

Like earlier disclosed embodiments, an instrument86may comprise an elongated shaft portion88and an instrument base87(shown with a transparent external skin for discussion purposes) comprising a plurality of drive inputs89(such as receptacles, pulleys, and spools) that are configured to receive the drive outputs81in the instrument driver80. Unlike prior disclosed embodiments, instrument shaft88extends from the center of instrument base87with an axis substantially parallel to the axes of the drive inputs89, rather than orthogonal as in the design ofFIG.16.

When coupled to the rotational assembly83of the instrument driver80, the medical instrument86, comprising instrument base87and instrument shaft88, rotates in combination with the rotational assembly83about the instrument driver axis85. Since the instrument shaft88is positioned at the center of instrument base87, the instrument shaft88is coaxial with instrument driver axis85when attached. Thus, rotation of the rotational assembly83causes the instrument shaft88to rotate about its own longitudinal axis. Moreover, as the instrument base87rotates with the instrument shaft88, any tendons connected to the drive inputs89in the instrument base87are not tangled during rotation. Accordingly, the parallelism of the axes of the drive outputs81, drive inputs89, and instrument shaft88allows for the shaft rotation without tangling any control tendons.

FIG.18illustrates an instrument having an instrument based insertion architecture in accordance with some embodiments. The instrument150can be coupled to any of the instrument drivers discussed above. The instrument150comprises an elongated shaft152, an end effector162connected to the shaft152, and a handle170coupled to the shaft152. The elongated shaft152comprises a tubular member having a proximal portion154and a distal portion156. The elongated shaft152comprises one or more channels or grooves158along its outer surface. The grooves158are configured to receive one or more wires or cables180therethrough. One or more cables180thus run along an outer surface of the elongated shaft152. In other embodiments, cables180can also run through the elongated shaft152. Manipulation of the one or more cables180(e.g., via an instrument driver) results in actuation of the end effector162.

The instrument handle170, which may also be referred to as an instrument base, may generally comprise an attachment interface172having one or more mechanical inputs174, e.g., receptacles, pulleys or spools, that are designed to be reciprocally mated with one or more torque couplers on an attachment surface of an instrument driver.

In some embodiments, the instrument150comprises a series of pulleys or cables that enable the elongated shaft152to translate relative to the handle170. In other words, the instrument150itself comprises an instrument-based insertion architecture that accommodates insertion of the instrument, thereby minimizing the reliance on a robot arm to provide insertion of the instrument150. In other embodiments, a robotic arm can be largely responsible for instrument insertion.

Any of the robotic systems described herein can include an input device or controller for manipulating an instrument attached to a robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electronically, electrically, wirelessly and/or mechanically) with an instrument such that manipulation of the controller causes a corresponding manipulation of the instrument e.g., via master slave control.

FIG.19is a perspective view of an embodiment of a controller182. In the present embodiment, the controller182comprises a hybrid controller that can have both impedance and admittance control. In other embodiments, the controller182can utilize just impedance or passive control. In other embodiments, the controller182can utilize just admittance control. By being a hybrid controller, the controller182advantageously can have a lower perceived inertia while in use.

In the illustrated embodiment, the controller182is configured to allow manipulation of two medical instruments, and includes two handles184. Each of the handles184is connected to a gimbal186. Each gimbal186is connected to a positioning platform188.

As shown inFIG.19, each positioning platform188includes a SCARA arm (selective compliance assembly robot arm)198coupled to a column194by a prismatic joint196. The prismatic joints196are configured to translate along the column194(e.g., along rails197) to allow each of the handles184to be translated in the z-direction, providing a first degree of freedom. The SCARA arm198is configured to allow motion of the handle184in an x-y plane, providing two additional degrees of freedom.

In some embodiments, one or more load cells are positioned in the controller. For example, in some embodiments, a load cell (not shown) is positioned in the body of each of the gimbals186. By providing a load cell, portions of the controller182are capable of operating under admittance control, thereby advantageously reducing the perceived inertia of the controller while in use. In some embodiments, the positioning platform188is configured for admittance control, while the gimbal186is configured for impedance control. In other embodiments, the gimbal186is configured for admittance control, while the positioning platform188is configured for impedance control. Accordingly, for some embodiments, the translational or positional degrees of freedom of the positioning platform188can rely on admittance control, while the rotational degrees of freedom of the gimbal186rely on impedance control.

F. Navigation and Control

Traditional endoscopy may involve the use of fluoroscopy (e.g., as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide endoluminal guidance to an operator physician. In contrast, the robotic systems contemplated by this disclosure can provide for non-radiation-based navigational and localization means to reduce physician exposure to radiation and reduce the amount of equipment within the operating room. As used herein, the term “localization” may refer to determining and/or monitoring the position of objects in a reference coordinate system. Technologies such as pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to achieve a radiation-free operating environment. In other cases, where radiation-based imaging modalities are still used, the pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to improve upon the information obtained solely through radiation-based imaging modalities.

FIG.20is a block diagram illustrating a localization system90that estimates a location of one or more elements of the robotic system, such as the location of the instrument, in accordance to an example embodiment. The localization system90may be a set of one or more computer devices configured to execute one or more instructions. The computer devices may be embodied by a processor (or processors) and computer-readable memory in one or more components discussed above. By way of example and not limitation, the computer devices may be in the tower30shown inFIG.1, the cart shown inFIGS.1-4, the beds shown inFIGS.5-14, etc.

As shown inFIG.20, the localization system90may include a localization module95that processes input data91-94to generate location data96for the distal tip of a medical instrument. The location data96may be data or logic that represents a location and/or orientation of the distal end of the instrument relative to a frame of reference. The frame of reference can be a frame of reference relative to the anatomy of the patient or to a known object, such as an EM field generator (see discussion below for the EM field generator).

The various input data91-94are now described in greater detail. Pre-operative mapping may be accomplished through the use of the collection of low dose CT scans. Pre-operative CT scans are reconstructed into three-dimensional images, which are visualized, e.g. as “slices” of a cutaway view of the patient's internal anatomy. When analyzed in the aggregate, image-based models for anatomical cavities, spaces and structures of the patient's anatomy, such as a patient lung network, may be generated. Techniques such as center-line geometry may be determined and approximated from the CT images to develop a three-dimensional volume of the patient's anatomy, referred to as model data91(also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of center-line geometry is discussed in U.S. patent application Ser. No. 14/523,760, the contents of which are herein incorporated in its entirety. Network topological models may also be derived from the CT-images, and are particularly appropriate for bronchoscopy.

In some embodiments, the instrument may be equipped with a camera to provide vision data92. The localization module95may process the vision data to enable one or more vision-based location tracking. For example, the preoperative model data may be used in conjunction with the vision data92to enable computer vision-based tracking of the medical instrument (e.g., an endoscope or an instrument advance through a working channel of the endoscope). For example, using the preoperative model data91, the robotic system may generate a library of expected endoscopic images from the model based on the expected path of travel of the endoscope, each image linked to a location within the model. Intra-operatively, this library may be referenced by the robotic system in order to compare real-time images captured at the camera (e.g., a camera at a distal end of the endoscope) to those in the image library to assist localization.

Other computer vision-based tracking techniques use feature tracking to determine motion of the camera, and thus the endoscope. Some features of the localization module95may identify circular geometries in the preoperative model data91that correspond to anatomical lumens and track the change of those geometries to determine which anatomical lumen was selected, as well as the relative rotational and/or translational motion of the camera. Use of a topological map may further enhance vision-based algorithms or techniques.

Optical flow, another computer vision-based technique, may analyze the displacement and translation of image pixels in a video sequence in the vision data92to infer camera movement. Examples of optical flow techniques may include motion detection, object segmentation calculations, luminance, motion compensated encoding, stereo disparity measurement, etc. Through the comparison of multiple frames over multiple iterations, movement and location of the camera (and thus the endoscope) may be determined.

The localization module95may use real-time EM tracking to generate a real-time location of the endoscope in a global coordinate system that may be registered to the patient's anatomy, represented by the preoperative model. In EM tracking, an EM sensor (or tracker) comprising of one or more sensor coils embedded in one or more locations and orientations in a medical instrument (e.g., an endoscopic tool) measures the variation in the EM field created by one or more static EM field generators positioned at a known location. The location information detected by the EM sensors is stored as EM data93. The EM field generator (or transmitter), may be placed close to the patient to create a low intensity magnetic field that the embedded sensor may detect. The magnetic field induces small currents in the sensor coils of the EM sensor, which may be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations may be intra-operatively “registered” to the patient anatomy (e.g., the preoperative model) in order to determine the geometric transformation that aligns a single location in the coordinate system with a position in the pre-operative model of the patient's anatomy. Once registered, an embedded EM tracker in one or more positions of the medical instrument (e.g., the distal tip of an endoscope) may provide real-time indications of the progression of the medical instrument through the patient's anatomy.

Robotic command and kinematics data94may also be used by the localization module95to provide localization data96for the robotic system. Device pitch and yaw resulting from articulation commands may be determined during pre-operative calibration. Intra-operatively, these calibration measurements may be used in combination with known insertion depth information to estimate the position of the instrument. Alternatively, these calculations may be analyzed in combination with EM, vision, and/or topological modeling to estimate the position of the medical instrument within the network.

AsFIG.20shows, a number of other input data can be used by the localization module95. For example, although not shown inFIG.20, an instrument utilizing shape-sensing fiber can provide shape data that the localization module95can use to determine the location and shape of the instrument.

The localization module95may use the input data91-94in combination(s). In some cases, such a combination may use a probabilistic approach where the localization module95assigns a confidence weight to the location determined from each of the input data91-94. Thus, where the EM data may not be reliable (as may be the case where there is EM interference) the confidence of the location determined by the EM data93can be decrease and the localization module95may rely more heavily on the vision data92and/or the robotic command and kinematics data94.

As discussed above, the robotic systems discussed herein may be designed to incorporate a combination of one or more of the technologies above. The robotic system's computer-based control system, based in the tower, bed and/or cart, may store computer program instructions, for example, within a non-transitory computer-readable storage medium such as a persistent magnetic storage drive, solid state drive, or the like, that, upon execution, cause the system to receive and analyze sensor data and user commands, generate control signals throughout the system, and display the navigational and localization data, such as the position of the instrument within the global coordinate system, anatomical map, etc.

2. Surgical Instruments

As described above, certain conventional laparoscopes or other surgical instruments include a tool driver adapter to allow the instrument to interface with a robotic system and a separate user interface to allow a clinician to control functions of the surgical instrument and/or robotic system. Therefore, in certain applications, certain conventional laparoscopes or surgical instruments may be longer than instruments configured to manual use. In some applications, certain laparoscopes or other surgical instruments that are relatively longer may be unwieldy for a clinician to handle and may not fit into standardized trays or compartments for sterilization processes.

Therefore, it may be desirable to reduce the overall length of the laparoscope or surgical instrument while maintaining the operational length of the instrument shaft, to allow for case of handling and permit sterilization using standardized processes. In accordance with some embodiments described herein, by removing the additional length of a separate user interface attached to an end of the instrument shaft, the overall length of the surgical instrument can be shortened without reducing the operational length of the instrument. In accordance with some embodiments described herein, the user interface can be combined with the tool drive adapter, eliminating the separate user interface, reducing overall instrument length while maintaining a desired operational or shaft length.

However, in certain applications, it may be challenging to accurately detect user inputs (e.g. button presses) when the user interface is moved to or combined with the tool drive adapter. In certain applications, since the tool drive adapter is configured to withstand sterilization procedures, certain conventional electronic arrangements for detecting user inputs may not be suitable for use within the tool drive adapter. For example, certain conventional electronic arrangements for detecting user inputs may not withstand sterilization procedures or function across sealed or isolated portions of the tool drive adapter.

Therefore, in accordance with certain embodiments described herein, it may be desired to utilize components, such as buttons or other user inputs, that can withstand sterilization and place electrical components for detecting user inputs (e.g. button presses) within a sealed compartment, such as the sealed instrument shaft. In certain applications, since the instrument shaft can rotate relative to the tool drive adapter and the buttons (or other user inputs), it may be challenging to reliably detect user inputs (e.g. state of the buttons on the tool drive adapter), as the instrument shaft rotates.

Advantageously, embodiments described herein address the challenges described herein and provide a laparoscope or other surgical instrument for use with a robotic system that provides a reduced overall length, while maintaining a desired operational length, while allowing for reliable detection of user inputs.

FIG.21illustrates a partial perspective view of a laparoscope200, in accordance with some embodiments. As described herein, a laparoscope200facilitates therapeutic interventions by providing an view of an internal surgical site during a surgical procedure. In the depicted example, the laparoscope200includes a camera or other suitable optical device to view a site disposed at the end of the instrument shaft204. During operation, the instrument shaft204can be advanced, manipulated, and/or rotated to position the camera and instrument shaft204in a desired position relative to the patient. In some embodiments, the laparoscope200may include surgical tools or instruments to perform a surgical procedure. Optionally, the instrument shaft204can be manipulated or rotated to perform a surgical procedure. The instrument shaft204may be formed at least partially from stainless steel.

In some embodiments, the laparoscope200can be coupled to a robotic surgical system, such as the systems described herein, by attaching the tool drive adapter210to a mating portion of the robotic surgical system. As illustrated, the housing202of the tool drive adapter210can be configured to mate with a complementary portion of the robotic surgical system. During operation, the instrument shaft204may rotate relative to the tool drive adapter210and the robotic surgical system.

In the depicted example, the laparoscope200can include one or more user interface elements or buttons212a,212b,212cto allow a clinician to control the operation of the laparoscope and/or functions of the attached robotic system. During operation, electronic components of the laparoscope200can detect when a button212a,212b,212cis pressed or released and provide a corresponding signal to other portions of the laparoscope200or the connected robotic system. Optionally, the laparoscope200can include more or fewer user interface elements or buttons.

As illustrated, the user interface elements or buttons212a,212b,212ccan be disposed on or otherwise integrated with the housing202of the tool drive adapter210. In some applications, by combining or integrating the buttons212a,212b,212cwith the tool drive adapter210, embodiments of the laparoscope200may eliminate the need for a separate user interface portion attached to the end of the instrument shaft204, reducing the overall length of the laparoscope200, while maintaining the effective operational length of the instrument shaft204. Advantageously, by reducing the overall length of the laparoscope200compared to certain conventional laparoscopes, the laparoscope200may be easier to handle and allow for sterilization using standardized procedures.

In some embodiments, signals from the buttons212a,212b,212ccan be provided to portions of the laparoscope200and/or the robotic system via a connector206. In some embodiments, video signals and/or control signals can be sent to or from the laparoscope200via the connector206.

FIG.22illustrates a partial perspective view of the laparoscope200ofFIG.21with a housing202shown in hidden lines.FIG.23illustrates a perspective view of a sensor array220of the laparoscope ofFIG.21. With reference toFIGS.22and23, as illustrated, the laparoscope200includes a sensor array220to detect the position or state of one or more buttons212a,212b,212c.

In the depicted example, the sensor array220can wirelessly detect the position, actuation, or state of the buttons212a,212b,212c.In some embodiments, the sensor array220can detect changes in magnetic field to determine the state of the buttons212a,212b,212c.In the depicted example, the buttons212a,212b,212ccan include or be coupled to magnetic elements214a,214b,214csuch that the magnetic field experienced by the sensor array220changes as the buttons212a,212b,212care pressed, released, or otherwise actuated. Advantageously, since the buttons212a,212b,212cdo not contain any active electronic elements (i.e. passive elements), the buttons212a,212b,212ccan withstand sterilization processes, allowing the tool drive adapter210to be sterilized. In certain applications, certain conventional electronic or active user interface elements may not withstand sterilization procedures.

In the depicted example, the sensor array220includes one or more array components230a,230b,230cto detect the actuation or change of state of a respective button212a,212b,212cby detecting the change in magnetic field of the respective magnetic elements214a,214b,214c. As illustrated, each array component230a,230b,230ccan be aligned with a respective magnetic element214a,214b,214cto detect the state of the respective button212a,212b,212c.For example, each array component230a,230b,230ccan be aligned along the axis of rotation of the instrument shaft204with a respective magnetic element214a,214b,214cto detect the state of the button212a,212b,212c.Optionally, the sensor array can include more or fewer array components corresponding to the number of user interface elements or buttons.

Optionally, the array components230a,230b,230ccan be coupled together to maintain alignment between the array components230a,230b230cand the respective magnetic elements214a,214b,214cand/or between the other array components. For example, the array components230a,230b,230ccan be coupled together with bolts or shafts224and secured with fasteners226. In some embodiments, the array components230a,230b,230ccan be electrically coupled together via connectors or wires222.

As illustrated, the sensor array220is disposed within the instrument shaft204. In some embodiments, the sensor array220is sealed, isolated, or otherwise enclosed within the instrument shaft204without compromising the integrity or otherwise breaching the instrument shaft204. Advantageously, since the components of the sensor array220are disposed or otherwise isolated within the instrument shaft204, sensitive electronic components are protected from certain conditions that may be present during sterilization procedures, allowing the instrument shaft204to be sterilized. As described herein, certain conventional electronic components or arrangements for detecting user inputs may not withstand sterilization procedures or function across sealed or isolated portions of the tool drive adapter.

In the depicted example, the sensor array220can rotate with the instrument shaft204, permitting the sensor array220to rotate relative to the housing202and the buttons212a,212b,212c.As described herein, embodiments of the sensor array220can detect changes in magnetic field to determine the state of the buttons212a,212b,212cas the sensor array220rotates relative to the buttons212a,212b,212c.

FIG.24illustrates a partial exploded view of the sensor array220ofFIG.23.FIG.25illustrates a front elevation view of an array component230of the sensor array220ofFIG.23.FIG.26illustrates a side elevation view of the array component230ofFIG.25. With reference toFIGS.24-26, in some embodiments, each array component230a,230b,230c,generally referred to as array component230, includes one or more sensor240to detect a state of a respective button212a,212b,212c.In some embodiments, the sensors240may include reed switches, hall effect sensors, and/or capacitive touch sensors.

In the depicted example, the array component230can include one or more sensors240to detect a change in magnetic field of a magnetic element (e.g. magnetic elements214a,214b214c,generally referred to as magnetic element214) to detect the position of a user input or button (e.g. buttons212a,212b,212c,generally referred to as button212). During operation, one or more sensors240can change in state (e.g. from an open state to a closed state) in response to a user input or button212press to provide a corresponding signal to the laparoscope200or the connected robotic system. For example, one or more sensors240may change from an open state to a closed state when a corresponding button212is pressed, and may change from a closed state to an open state when the corresponding button212is released. In some applications, an open state may correspond to an open circuit and a closed state may correspond to a closed circuit.

In some embodiments, the sensors240can be reed switches that are configured to move between a first state, such as an open state (i.e. open circuit) and a second state, such as a closed state (i. e. closed circuit), in response to an applied magnetic field or magnetomotive force. In some embodiments, the reed switch sensor240may have a magnetomotive force threshold wherein the sensor240moves from an open state to a closed state in response to the magnetomotive force experienced by the sensor240. For example, a reed switch sensor240can move or change to a closed state when the button212and the corresponding magnetic element214are pressed or actuated, such that the magnetic element214provides sufficient magnetic field or magnetomotive force to actuate or affect the reed switch sensor240to a closed state or position. Further, the reed switch sensor240can be configured to be in an open state when a button212and corresponding magnetic clement214is in a resting position, such that the magnetic element214does not provide sufficient magnetic field or magnetomotive force to actuate or affect the reed switch sensor240to the closed state or position. Advantageously, the use of reed switches does not require any standby power to detect a button press.

In some applications, the magnetomotive force threshold of the reed switch sensor240can be adjusted such that the sensor240is in an open state when the button212and the corresponding magnetic element214is in a resting position and the sensor240is in a closed state when the button212and the corresponding magnetic element214are in a depressed or actuated position. In some embodiments, the magnetomotive force threshold of the reed switch sensor240can be adjusted by altering or specifying parameters of the reed switch sensor240. In some embodiments, the size or strength of the magnetic elements214can be configured to provide a magnetomotive force below the magnetomotive force threshold when the button212is in a resting position and above the magnetomotive force threshold when the button212is in the actuated position. In some embodiments, the spacing and/or orientation of the magnetic elements214and/or the sensor240can be adjusted or modified such that the effective magnetomotive force applied to the sensor240is below the magnetomotive force threshold when the button212is in the resting position and the effective magnetomotive force applied to the sensor240is above the magnetomotive force threshold when the button212is in the actuated position. In some embodiments, the sensor240may be placed in on its side, lengthwise, widthwise, rotated, and/or an inverted orientation relative to the printed circuit board232.

In the depicted example, each array component230can include multiple sensors240in an arrangement242to allow the array component230to detect the state of a respective button212as the array components230of the sensor array220rotate with the instrument shaft204and relative to the respective button212. In some embodiments, the sensors240of the array component230and/or a corresponding magnetic element214can be configured such that at least one sensor240accurately detects and indicates the state of the respective button212as the array components230of the sensor array220rotate with the instrument shaft204and relative to the respective button212.

As illustrated, the array component230may include multiple sensors240in an arrangement242, such that at least one sensor240adjacent to the magnetic element214during the course of rotation experiences sufficient magnetic field or magnetomotive force to exceed the magnetomotive force threshold of the sensor240and move or change to a closed state when the button212and the corresponding magnetic element214are pressed or actuated. In some embodiments, multiple sensors240adjacent to the magnetic element214during the course of rotation of the array component230may exceed the magnetomotive force threshold and move to a closed state when the button212is pressed or actuated. During operation, the one or more sensors240in a closed state when the button212is pressed or actuated may change as the instrument shaft204rotates.

In some embodiments, the arrangement242can be configured such that at least one sensor240does not experience sufficient magnetomotive force to exceed the magnetomotive force threshold of the sensor240to be in an open state when the button212and the corresponding magnetic element214are in a resting or unactuated position. In some applications, the arrangement242of the sensors240may prevent all the sensors240from being placed in a closed position when a respective button212is in an resting or unactuated position. During operation, the one or more sensors240in an open state when the button212is resting position may change as the instrument shaft204rotates. Therefore, in accordance with some embodiments, at least one sensor240may be changed to a closed state when a button212is pressed and at least one sensor240may be changed to an open state when a button212is in a resting position.

As illustrated, the sensors240may be placed in an arrangement242on a printed circuit board232. In some embodiments, the sensors240are disposed in a circular arrangement242. In some embodiments, the sensors240can be equidistantly spaced around the circumference of the printed circuit board232. Optionally, a first set of sensors240can be disposed in an arrangement242on a first surface231of the printed circuit board232. In some embodiments, a second set of sensors240can be disposed in an arrangement242′ on the second surface233of the printed circuit board232. In some embodiments, the second arrangement242′ of sensors240are interposed between the first arrangement242of sensors240. In some embodiments, the sensors240are disposed between an edge236and a cavity or opening234of the printed circuit board232. The printed circuit board232may have a generally circular, annular, or ring shape. Optionally, the printed circuit board232can define channels238to allow shafts226to pass through and fasten the printed circuit boards232of the array component230.

In some embodiments, the arrangement242can include six sensors240and the arrangement242′ can include five sensors240. Optionally, the eleven sensors240can be evenly spaced (approximately every 32 degrees) to minimize angular spacing between the sensors240, maximizing the number of sensors240capable of detecting the magnetomotive force of a respective magnetic element214when the button212is actuated. In some embodiments, the array component230may include additional sensors240to further minimize the angular spacing between the sensors240. Optionally, the number of sensors240utilized by the array component230may vary.

In some embodiments, other aspects of the array component230and/or the corresponding magnetic element214can be configured such that at least one sensor240accurately detects and indicates the state of the respective button212as the array components230of the sensor array220rotate with the instrument shaft204and relative to the respective button212. For example, the parameters of the sensor240may be altered or specified to adjust the magnetomotive force threshold of the sensor240such that at least one sensor240accurately detects and indicates the state of the respective button212during rotation of the array components230. In another example, the size, strength, or other parameters of the magnetic elements214may be altered or specified to adjust the magnetomotive force applied to the sensor240such that at least one sensor240accurately detects and indicates the state of the respective button212during rotation of the array components230. In some embodiments, the spacing and/or orientation of the magnetic elements214and/or the sensor240can be adjusted or modified to adjust the magnetomotive force applied to the sensor240such that at least one sensor240accurately detects and indicates the state of the respective button212during rotation of the array components230.

Further, in some applications, the range of motion of the buttons212and/or the magnetic elements214can be adjusted to modify the magnetomotive force applied at one or more sensor240when the button212is in a resting position and the magnetomotive force applied at one or more switch when the button212is actuated, such that at least one sensor240accurately detects and indicates the state of the respective button212during rotation of the array components230. In some embodiments, the range of motion of the magnetic elements214can be adjusted relative to the axis of rotation of the instrument shaft204to increase a difference between the applied magnetomotive force applied to a sensor240when the button212is in an unactuated state and the applied magnetomotive force applied to the sensor240when the button212is in an actuated state. In some embodiments, the range of motion of the buttons212may be reduced to provide a desired system response.

In some embodiments, the laparoscope200includes a controller to determine the state of the buttons212a,212b,212c.In some embodiments, the controller analyzes the state of the sensors240of each of the array components230a,230b,230c,to determine the state of each of the respective buttons212a,212b,212c.In some applications, the controller utilizes a table lookup or algorithmic approach to compare the state of each of the sensors240to determine the state of a respective button212. In some applications, the controller may monitor for a single sensor240of a array component230to move to a closed state to determine that a respective button212has been pressed. Optionally, the controller may monitor for multiple or a certain number of sensors240to move to a closed state to determine that a respective button212has been pressed. In some applications, the controller may monitor for changes in sensor240states to determine if a respective button212has been pressed or released. In some applications, the controller may filter sensors240that may be in a closed state when a button212is in a resting position. For example, the controller may determine a “baseline” status for each sensor240of a respective array component230(e.g. during an initialization process) to determine if any sensors240are in a closed state when a button212is in a resting position, and monitor sensors240identified in an initial open state that change to a closed state to determine when the button212is pressed.

FIG.27illustrates a perspective view of a sensor array420, in accordance with some embodiments.FIG.28illustrates a perspective view of a partial sensor array420ofFIG.27.FIG.29illustrates a front elevation view of a printed circuit board472of the sensor array420ofFIG.27.FIG.30illustrates a side elevation view of the printed circuit board472ofFIG.27. With reference toFIGS.27-30, in some embodiments, a laparoscope can utilize a sensor array420to detect the position or state of one or more buttons. In some embodiments, certain features of the sensor array420may be similar to features of the sensor array220and may be referenced with similar reference numerals.

In the depicted example, the sensor array420can wirelessly detect the position, actuation, or state of the buttons of a laparoscope or other surgical instrument. In some embodiments, the sensor array420can detect changes in magnetic field to determine the state of the buttons. In the depicted example, the sensor array420includes one or more sensor sets430a,430b,430cto detect the actuation or change of state of a respective button by detecting the change in magnetic field of the respective magnetic elements. As illustrated, each sensor set430a,430b,430ccan be aligned with a respective magnetic element to detect the state of the respective button. For example, each sensor set430a,430b,430ccan be aligned along the axis of rotation of the instrument shaft with a respective magnetic element to detect the state of the respective button. Optionally, the sensor array420can include more or fewer sets of sensors corresponding to the number of user interface elements or buttons.

Similar to sensor array220, the sensor array420can be disposed within an instrument shaft, such as instrument shaft204described herein. In some embodiments, the sensor array420is sealed, isolated, or otherwise enclosed within the instrument shaft without compromising the integrity or otherwise breaching the instrument shaft. In the depicted example, the sensor array420can rotate with the instrument shaft, permitting the sensor array420to rotate relative to the buttons. As described herein, embodiments of the sensor array420can detect changes in magnetic field to determine the state of the buttons as the sensor array420rotates relative to the buttons.

In some embodiments, each sensor set430a,430b,430cincludes one or more sensors440a,440b440cto detect a state of a respective button. In some embodiments, the sensors440a,440b440cmay include reed switches, hall effect sensors, and/or capacitive touch sensors.

In the depicted example, each sensor set430a,430b,430cis configured to detect a change in magnetic field of a magnetic element (e.g. magnetic elements214a,214b214c) to detect the position of a user input or button (e.g. buttons212a,212b,212c). During operation, one or more sensors440a,440b440cin each sensor set430a,430b,430ccan change in state (e.g. from an open state to a closed state) in response to a user input or button press to provide a corresponding signal to the laparoscope or the connected robotic system. As described with respect to sensor array220, the sensors440a,440b440ccan be reed switches that are configured to move between a first state, such as an open state (i.e. open circuit) and a second state, such as a closed state (i. e. closed circuit), in response to an applied magnetic field or magnetomotive force.

In the depicted example, each sensor set430a,430b,430ccan include multiple sensors440a,440b,440cto allow the each sensor set430a,430b,430cto detect the state of a respective button as the sensor sets430a,430b,430crotate with the instrument shaft and relative to the respective buttons. In some embodiments, the sensors440a,440b,440cof the sensor sets430a,430b,430cand/or the corresponding magnetic elements can be configured such that at least one sensor440a,440b,440cfrom each sensor set430a,430b,430caccurately detects and indicates the state of the respective button as the sensor sets430a,430b,430cof the sensor array420rotate with the instrument shaft and relative to the respective buttons.

Similar to the embodiment described with respect to sensor array220, each sensor set430a,430b,430cmay include multiple sensors440a,440b,440cin an arrangement, such that at least one sensor440a,440b,440cfrom each sensor set430a,430b,430cis adjacent to the respective magnetic element during the course of rotation experiences sufficient magnetic field or magnetomotive force to exceed the magnetomotive force threshold of the sensor440a,440b,440cand move or change to a closed state when the button and the corresponding magnetic element are pressed or actuated.

As illustrated, the sensors440a,440b,440cof each sensor set430a,430b,430cmay be placed in an arrangement around the central axis of rotation. In some embodiments, the sensors440a,440b,440cof each sensor set430a,430b,430care disposed circumferentially around the central axis of rotation. As illustrated, each sensor set430a,430b,430cis axially spaced apart along the central axis of rotation.

In the depicted example, the sensors440a,440b,440cof each sensor set430a,430b,430care disposed on multiple printed circuit boards472. In some embodiments, as illustrated, one sensor440a,440b,440c,from each respective sensor set430a,430b,430cis disposed on a single printed circuit board472. In other words, sensors440a,440b,440c,from different sensor sets are disposed on a common printed circuit board472and share a common angular alignment relative to the axis of rotation. In some embodiments, sensors440a,440b,440ccan be disposed on a radial surface of the printed circuit board472. The printed circuit board472may have a generally elongated or slat shape. In the depicted example, printed circuit boards472are circumferentially disposed around the central axis of rotation.

As illustrated, the printed circuit boards472can be coupled to backplanes460. In the depicted example, the printed circuit boards472can include connectors450to mechanically couple to mating connectors454of the backplanes460. As illustrated, the connectors450can further facilitate electrical communication between the sensors440a,440b,440cdisposed on the printed circuit board472and the backplanes460via the connectors454. The printed circuit board472can include traces or conductors452to facilitate an electrical connection between the sensors440a,440b,440cvia the printed circuit board472and the connector450. In some embodiments, the backplanes460include or define a central cavity464and/or channels468to facilitate the passage of wiring and/or hardware.

In some embodiments, the each sensor set430a,430b,430ccan include nine sensors440a,440b,440cdisposed on nine printed circuit boards472. In some embodiments, the sensors440a,440b,440cof each sensor set430a,430b,430ccan be equidistantly spaced around the rotational axis (approximately every 40 degrees) to minimize angular spacing between the sensors440a,440b,440c,and maximizing the number of sensors440a,440b,440ccapable of detecting the magnetomotive force of a respective magnetic element when the button is actuated. In some embodiments, the sensor sets430a,430b,430cmay include additional sensors440a,440b,440c, to further minimize the angular spacing between the sensors440a,440b,440c.Optionally, the number of sensors440a,440b,440cutilized by each sensor set430a,430b,430cmay vary. Therefore, in some embodiments, the number of corresponding printed circuit boards472and backplane connectors454may vary accordingly.

As described herein, other aspects of the sensor sets430a,430b,430cand/or the corresponding magnetic elements can be configured such that at least one sensor440a,440b,440caccurately detects and indicates the state of the respective button as the sensor sets430a,430b,430cof the sensor array420rotate with the instrument shaft and relative to the respective buttons.

3. Implementing Systems and Terminology

Implementations disclosed herein can advantageously provide systems, methods and apparatus for provide an added level of safety to a robot that interacts with humans, by allowing joints to be completely unlocked and repositioned even under complete electrical or software failure of the robot.

It should be noted that the terms “couple,” “coupling,” “coupled” or other variations of the word couple as used herein may indicate either an indirect connection or a direct connection. For example, if a first component is “coupled” to a second component, the first component may be either indirectly connected to the second component via another component or directly connected to the second component.

The previous description of the disclosed implementations is provided to enable any person skilled in the art to make or use the present inventions. Various modifications to these implementations will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other implementations without departing from the scope of the inventions. For example, it will be appreciated that one of ordinary skill in the art will be able to employ a number corresponding alternative and equivalent structural details, such as equivalent ways of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for producing particular actuation motions, and equivalent mechanisms for delivering electrical energy. Thus, the present inventions are not intended to be limited to the implementations shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.