Patent Description:
A common form of minimally invasive surgery is endoscopy. Endoscopic surgical instruments in minimally invasive medical techniques generally include an endoscope for viewing the surgical field, and working tools that include end effectors. Typical surgical end effectors include clamps, graspers, scissors, staplers, or needle holders, as examples. The working tools are similar to those used in conventional (open) surgery, except that the end effector of each tool is supported on the end of, for example, an approximately <NUM>-inch-long extension tube.

To manipulate end effectors, a human operator, typically a surgeon, manipulates or otherwise commands a locally-provided master manipulator. Commands from the master manipulator are translated as appropriate and sent to a remotely-deployed slave manipulator. The slave manipulator then manipulates the end effectors according to the operator's commands.

Force feedback may be included in minimally invasive robotic surgical systems. To provide such feedback, the remote slave manipulators typically provide force information to the master manipulator, and that force information is utilized to provide force feedback to the surgeon so that the surgeon is given the perception of feeling forces acting on a slave manipulator. In some force feedback implementations, haptic feedback may provide an artificial feel to the surgeon of tissue reactive forces on a working tool and its end effector.

Often, the master controls, which are typically located at a surgeon console, will include a clutch or other device for releasing one of the work tools at the patient site. This feature may be used, for example, in a system where there are more than two working tools. In such a system, the surgeon may release control of one working tool by one master and establish control over another working tool with that master.

The surgeon typically views an image of only the distal ends of the working tools that are within the endoscope's field of view. The surgeon cannot see portions of a tool, or an entire tool, that is outside the field of view. Accordingly, the surgeon cannot see if two or more tools are interfering with each other outside the field of view. Further, since the endoscope may be manipulated to be at various positions and orientations with reference to a surgical site and to the surgeon's body frame of reference, the surgeon may become confused about the general location of the tools. Consequently, the surgeon may not understand how to best move the master manipulators to avoid an inter-tool interference or to reorient one or more tools with reference to the surgical site.

<CIT>discloses in one embodiment of the invention, a method for a minimally invasive surgical system is disclosed. The method includes capturing and displaying camera images of a surgical site on at least one display device at a surgeon console; switching out of a following mode and into a masters-as-mice (MaM) mode; overlaying a graphical user interface (GUI) including an interactive graphical object onto the camera images; and rendering a pointer within the camera images for user interactive control. In the following mode, the input devices of the surgeon console may couple motion into surgical instruments. In the MaM mode, the input devices interact with the GUI and interactive graphical objects. The pointer is manipulated in three dimensions by input devices having at least three degrees of freedom. Interactive graphical objects are related to physical objects in the surgical site or a function thereof and are manipulatable by the input devices.

The following presents a simplified summary of some aspects and embodiments of the invention in order to provide a basic understanding of the invention. This summary is not an extensive overview of the invention. It is not intended to identify key/critical elements of the invention or to delineate the scope of the invention. Its sole purpose is to present some aspects and embodiments of the invention in a simplified form as a prelude to the more detailed description that is presented later. The invention is defined by the independent claims and optional features are defined by the dependent claims.

According to the invention, a robotic system according to claim <NUM> is provided.

According to the invention, a method according to claim <NUM> is provided.

In the following description, various aspects and embodiments of the present invention will be described. However, it will also be apparent to one skilled in the art that the present invention may be practiced without the specific details. Furthermore, well-known features may be omitted from this description or simplified in order not to obscure the embodiment being described.

Referring now to the drawings, in which like reference numerals represent like parts throughout several views, <FIG> shows a minimally invasive telesurgical system <NUM> having an operator station or surgeon console <NUM> in accordance with an embodiment. The surgeon console <NUM> includes a viewer <NUM> where an image of a surgical site is displayed to a surgeon S. As is known, a support (not shown) is provided on which the surgeon S can rest his or her forearms while gripping two master controls <NUM> (<FIG>), one in each hand. More controls may be provided if more end effectors are available, but typically a surgeon manipulates only two controls at a time and, if multiple tools are used, the surgeon releases one tool with a master control <NUM> and grasps another with same master control. When using the surgeon console <NUM>, the surgeon S typically sits in a chair in front of the surgeon console, positions his or her eyes in front of the viewer <NUM>, and grips the master controls <NUM>, one in each hand, while resting his or her forearms on the support.

A patient side cart <NUM> of the telesurgical system <NUM> is positioned adjacent to a patient P. In use, the patient side cart <NUM> is positioned close to the patient P requiring surgery. The patient side cart <NUM> typically is stationary during a surgical procedure, and includes wheels or castors to render it mobile. The surgeon console <NUM> is typically positioned remote from the patient side cart <NUM>, and it may be separated from the patient side cart by a great distance-even miles away-but will typically be used within the same operating room as the patient side cart.

The patient side cart <NUM>, shown in more detail in <FIG>, typically includes two or more robotic arm assemblies. In the embodiment shown in <FIG>, the patient side cart <NUM> includes four robotic arm assemblies <NUM>, <NUM>, <NUM>, <NUM>, but more or less may be provided. Each robotic arm assembly <NUM>, <NUM>, <NUM>, <NUM> is normally operatively connected to one of the master controls of the surgeon console <NUM>. Thus, movement of the manipulator portion of the robotic arm assemblies <NUM>, <NUM><NUM> is controlled by manipulation of the master controls.

One of the robotic arm assemblies, indicated by the reference numeral <NUM>, is arranged to hold an image capture device <NUM>, e.g., an endoscope, or the like. The endoscope or image capture device <NUM> includes a viewing end <NUM> at a remote end of an elongated shaft <NUM>. The elongated shaft <NUM> permits the viewing end <NUM> to be inserted through a surgery entry port of the patient P. The image capture device <NUM> is operatively connected to the viewer <NUM> of the surgeon console <NUM> to display an image captured at its viewing end <NUM>.

Each of the other robotic arm assemblies <NUM>, <NUM>, <NUM> is a linkage that supports and includes a removable surgical instrument or tool <NUM>, <NUM>, <NUM>, respectively. The tools <NUM>, <NUM>, <NUM> of the robotic arm assemblies <NUM>, <NUM>, <NUM> include end effectors <NUM>, <NUM>, <NUM>, respectively. The end effectors <NUM>, <NUM>, <NUM> are mounted on wrist members which are mounted on distal ends of elongated shafts of the tools, as is known in the art. The tools <NUM>, <NUM>, <NUM> have elongated shafts to permit the end effectors <NUM>, <NUM>, <NUM> to be inserted through surgical entry ports of the patient P. Movement of the end effectors <NUM>, <NUM>, <NUM> relative to the ends of the shafts of the tools <NUM>, <NUM>, <NUM> is controlled by the master controls of the surgeon console <NUM>.

The depicted telesurgical system <NUM> includes a vision cart <NUM>, which contains equipment associated with the image capture device. In another embodiment, the vision cart <NUM> can be combined with other equipment that includes most of the computer equipment or other controls (the "core" data processing equipment) for operating the telesurgical system <NUM>. As an example, signals sent by the master controllers of the surgeon console <NUM> may be sent to the vision/core cart <NUM>, which in turn may interpret the signals and generate commands for the end effectors <NUM>, <NUM>, <NUM> and/or robotic arm assemblies <NUM>, <NUM>, <NUM>. In addition, video sent from the image capture device <NUM> to the viewer <NUM> may be processed by, or simply transferred by, the vision cart <NUM>.

<FIG> is a diagrammatic representation of the telesurgical system <NUM>. As can be seen, the system includes the surgeon console <NUM>, the patient side cart <NUM>, and the vision cart <NUM>. In addition, in accordance with an embodiment, an additional computer <NUM> and display <NUM> are provided. These components may be incorporated in one or more of the surgeon console <NUM>, the patient side cart <NUM>, and/or the vision cart <NUM>. For example, the features of the computer <NUM> may be incorporated into the vision cart <NUM>. In addition, the features of the display <NUM> may be incorporated into the surgeon console <NUM>, for example, in the viewer <NUM>, or maybe provided by a completely separate display at the surgeon console or on another location. In addition, in accordance with an embodiment, the computer <NUM> may generate information that may be utilized without a display, such as the display <NUM>.

Although described as a "computer," the computer <NUM> may be a component of a computer system or any other software or hardware that is capable of performing the functions described herein. Moreover, as described above, functions and features of the computer <NUM> may be distributed over several devices or software components. Thus, the computer <NUM> shown in the drawings is for the convenience of discussion, and it may be replaced by a controller or its functions may be provided by one or more other components.

<FIG> shows components of the computer <NUM> in accordance with an embodiment. A positional component is included in or is otherwise associated with the computer <NUM>. The positional component provides information about a position of an end effector, such as one of the end effectors <NUM>, <NUM>, <NUM>. In the embodiment shown in the drawings, a tool tracking component <NUM> is used for the positional component and provides information about a position of an end effector, such as the end effectors <NUM>, <NUM>, <NUM>. As used herein, "position" means at least one of the location and/or the orientation of the end effector. A variety of different technologies may be used to provide information about a position of an end effector, and such technologies may or may not be considered tool tracking devices. In a simple embodiment, the positional component utilizes video feed from the image capture device <NUM> to provide information about the position of an end effector, but other information may be used instead of, or in addition to, this visual information, including sensor information, kinematic information, any combination of these, or additional information that may provide the position and/or orientation of the end effectors <NUM>, <NUM>, <NUM>. Examples of systems that may be used for the tool tracking component <NUM> are disclosed in , <CIT>), <CIT>), U. No. <CIT>), and U. No. <CIT>). In accordance with an embodiment, the tool tracking component <NUM> utilizes the systems and methods described in commonly owned <CIT>). In general, the positional component maintains information about the actual position and orientation of end effectors. This information is updated depending upon when the information is available, and may be, for example, asynchronous information.

The kinematic component <NUM> is generally any device that estimates a position, herein a "kinematic position," of an end effector utilizing information available through the telesurgical system <NUM>. In an embodiment, the kinematic component <NUM> utilizes kinematic position information from joint states of a linkage to the end effector. For example, the kinematic component <NUM> may utilize the master/slave architecture for the telesurgical system <NUM> to calculate intended Cartesian positions of the end effectors <NUM>, <NUM>, <NUM> based upon encoder signals for the joints in the linkage for each of the tools <NUM>, <NUM>, <NUM>. As examples, the kinematic component may utilize slave encoders <NUM> and/or master manipulator encoders to estimate the position of tool. An example of system utilizing an embodiment of a kinematic component is described in <CIT>, although others may be utilized. Kinematic position information for the end effector or any portion of the linkage and/or tool may also be provided in other ways, such as the use of optical fiber shape sensing, sensing the positions of components (e.g., electromagnetic components) embedded at various places along the linkage, tool, or end effector, various video tool tracking methods, etc..

In the embodiment shown in the drawings, an error correction component <NUM> is provided. In general, the error correction component calculates a difference between a location and/or orientation of a tool as provided by the tool tracking component <NUM> compared to the location and/or orientation of the tool as provided by the kinematic component <NUM>. Because of the large number of joints and movable parts, current kinematics measurement typically does not provide exact information for the location of a surgical end effector in space. A system with sufficient rigidity and sensing could theoretically provide near-exact kinetic information. In current minimally invasive robotic surgery systems, however, often the kinematic information may be inaccurate by up to an inch in any direction when taken in space. Thus, in accordance with an embodiment, an offset may be generated by the error correction component <NUM>. This offset provides information regarding the difference between the kinematic information provided by the kinematic component and the actual position information provided by the tool tracking component. Utilizing the offset, the kinematic information and the actual position information may be registered to the same location and/or orientation.

In accordance with an embodiment, a modeling component <NUM> is provided for generating a synthetic image <NUM> (<FIG>) of a patient side cart, such as the patient side cart <NUM>, or any portion thereof. In the embodiment shown in the drawings, the synthetic image <NUM> is of a different patient side cart configuration than the patient side cart <NUM> (an illustrative model of a da Vinci® Surgical System Model IS2000 patient side cart with three arms is shown), but the basic components of the two patient side carts are the same, except that the patient side cart <NUM> includes an additional robotic arm assembly and tool. In accordance with an embodiment, the synthetic image <NUM> may be displayed on the display <NUM> or the viewer <NUM>. To this end, modeling data <NUM> (<FIG>) may be provided that is associated with the vision cart <NUM> and/or the computer <NUM>. The modeling data <NUM> may be, for example, a two-dimensional (<NUM>-D) or three-dimensional (<NUM>-D) representation, such as an image, of the patient side cart <NUM>, or any portion thereof. In an embodiment, such a representation is a <NUM>-D model of the patient side cart <NUM>, or any portion thereof, and thus may represent an actual solid model of the patient side cart <NUM>, or any portion thereof. The modeling data <NUM> may be, for example, CAD data or other <NUM>-D solid model data representing components of the patient side cart <NUM>. In an embodiment, the <NUM>-D model is manipulatable at each joint of the patient side cart <NUM>, so that movements of the patient side cart may be mimicked by the synthetic image <NUM> of the patient side cart <NUM>. The modeling data may represent the entire patient side cart or any portion thereof, such as only the tools for the patient side cart.

Joint locations and orientations are generally known from kinematic data provided, for example, by the kinematic component <NUM>. Utilizing this information, each component of the patient side cart may be rendered in location so as to generate a image of the patient side cart that appears in <NUM>-D to the surgeon. Thus, in an embodiment, the modeling data <NUM> includes individualized information for each component or link of the patient side cart robot.

In accordance with an embodiment, the modeling component <NUM> constantly updates the location and/or orientation of the components of the synthetic image <NUM> in accordance with information provided by the tool tracking component <NUM> and/or the kinematic component <NUM>. For example, an initial state of the kinematic component <NUM> may be determined including a position of one or more end effectors for the patient side cart. These positions may be compared with position information provided by the tool tracking component <NUM>. As described above, the difference between the actual position as determined by the tool tracking component <NUM> and the estimated position of the end effectors provided by the kinematic component <NUM> may result in an offset, which may be stored in or otherwise used by the error correction component <NUM>. This offset may be used to register the position and orientation of an end effector as determined by the tool tracking component <NUM> to the position and orientation as estimated by the kinematic component <NUM>.

As data is available from the tool tracking component <NUM>, the actual position of the end effector may be tracked and registered with information provided by the kinematic component <NUM>. When tool tracking information is not available from the tool tracking component <NUM>, an assumption may be made that any change in kinematic information provided by the kinematic component <NUM> is an indication of actual movement by the end effector. That is, when tool tracking is not available, the position of an end effector may be accurately determined by the change in coordinate positions between the current position and the last known position, as calculated by the kinematic component <NUM>. The assumption here is that the change in position may be accurately calculated using only kinematic data, without tool tracking information. This assumption is reasonable, because although kinematic information is often not accurate for calculating a position of an end effector in space, it is typically accurate for calculating a change of position once a position is known, especially over a short period of time or for a small amount of movement. Thus, asynchronous data may be provided by the tool tracking component <NUM>, and synchronous data may be provided by the kinematic component <NUM>. The combination of this information provides data regarding the positions and orientations of the components of the patient side cart <NUM>.

The positions of the components of a robotic arm assembly may be determined by utilizing the joint states provided by the kinematic component. These joint states are calculated backwards from the end effector, the position of which is known, as described above. In addition, because the slave encoders <NUM> at the joints of robotic arm assemblies <NUM> for the patient side cart provide change in state information for each joint, the relative position of each section of the robotic arm assemblies may be accurately estimated and tracked. Thus, information can be provided to the modeling component <NUM> that is sufficient so that modeling component <NUM> may generate the synthetic image <NUM> by utilizing the modeling data <NUM>, with the position of each of the segments of the robotic arm assemblies <NUM>, including tools <NUM> at the end of the robotic arm assemblies, or an endoscope <NUM> at the end of one of the robotic arm assemblies.

Referring again to <FIG>, in an embodiment, in addition to the synthetic image <NUM> for the patient side cart, a view volume <NUM> for the endoscope is provided. The view volume <NUM> represents a projection of the field of view of the endoscope <NUM>. The field of view is the view visible by the endoscope, and the view volume is a projection of the boundaries of the field of view. That is, the view volume <NUM> represents a <NUM>-D space that is visible by the endoscope <NUM>. If desired, as shown in <FIG>, camera information <NUM> may be provided to the modeling component <NUM>. The camera information includes a calibrated set of intrinsic and extrinsic parameters about the camera. The intrinsic parameters include, e.g., focal length and principle point, which model the perspective mapping of the optics. Additionally, the intrinsic parameters may account for lens distortion. The extrinsic parameters may account for, e.g., relative position and orientation between the stereo endoscopic views. As can be understood, changing the parameters, such as zoom, of the endoscope will change the view volume for the endoscope, such as making the view volume narrower or wider. In addition, as the endoscope <NUM> is moved, the view volume <NUM> will move accordingly. The camera information permits the creation of a <NUM>-D stereo rendering that may be superimposed on the stereo view of the end effector from the image capture device, as described below.

<FIG> is a flowchart representing a process for updating a rendering of a synthetic image <NUM> in accordance with an embodiment. Beginning at <NUM>, the position and orientation of the patient side cart, or any portion thereof, is sensed. This sensing may occur, for example, via the tool tracking component <NUM> and/or the kinematic component <NUM>, as described above.

At <NUM>, the position and orientation information from <NUM> is used to generate a model (e.g., the synthetic image <NUM>). As described above, the modeling component <NUM> uses the modeling data <NUM> to generate the model. The position and orientation information provided from <NUM> is utilized to correctly arrange the position and orientation of the synthetic model to match that of the patient side cart.

At <NUM>, as a result of the patient side cart moving, information is received. The movement may be, for example, movement of one of the robotic arm assemblies, movement of the endoscope, change in the focus of the endoscope, or movement by one of the end effectors. The movement of the end effector may be a change in location or orientation, including, for example, closing of pinchers or other operational movement of the end effectors.

At <NUM>, a determination is made whether tool tracking information is available. In the embodiment show in <FIG>, the determination is whether an image is available so that the actual position of the end effector or any portion of the tool that is in a field of view (e.g., the view volume <NUM>) of the endoscope <NUM> may be found using the tool tracking component <NUM>. In one aspect, if tool tracking is available, then <NUM> branches to <NUM> where the tool tracking information is utilized to update information about the position and orientation of the tool and/or end effector.

At <NUM>, the kinematic information is used to update information about the location and orientation of the joints of each linkage of the robot for the patient side cart. At <NUM>, the offset is updated, if desired. At <NUM>, the display of the synthetic image <NUM> is updated, and the process branches back to <NUM>.

At <NUM>, if the tool tracking information is not available, then the process branches to <NUM>, where the kinematic information provided by the kinematic component <NUM> is utilized to determine the position of the end effector. The process then proceeds to <NUM>, and then on through the process, although since the tool tracking information was not available on this loop, the offset will likely not be updated, skipping <NUM>.

Utilizing the method shown in <FIG>, a <NUM>-D rendering of the synthetic image <NUM> is generated, and the synthetic image accurately represents the physical configuration of the patient side cart at any point in time throughout a surgical procedure. This information can be utilized and viewed by the surgeon S, or by someone else, to evaluate the state of the patient side cart. As described below, the viewer <NUM> or the display <NUM> may show the synthetic image <NUM>, either from a point of view that is the same as the point of view from the endoscope, or from another angle or distance. The synthetic image <NUM> enables observation of all parts of the patient view cart via the viewer <NUM>, thus permitting the surgeon S to monitor movements of the robot and tools. In addition, in accordance with an embodiment, viewing of these components is available in connection with the view volume <NUM>, permitting a surgeon to have a good perspective of where the endoscope's field of view is with respect to space. The view volume <NUM> provides a three dimensional representation of what is being seen by the surgeon S when looking in the viewer <NUM>.

If desired, a single display may be provided for showing both the field of view of the endoscope and the synthetic image <NUM>. For example, as shown in <FIG>, a view <NUM> provided by the viewer <NUM> or the display <NUM> provides both an actual field of view image <NUM> for the endoscope <NUM> and the synthetic image <NUM>. The synthetic image <NUM> is shown in a separate tile window <NUM>. In the embodiment shown in <FIG>, the tile <NUM> is approximately the same size as the field of view <NUM>, but if desired, the tile window may be smaller or larger than the field of view <NUM>. Also, if desired, a toggle or other feature may be provided so that the surgeon may switch back and forth between a larger presentation of the synthetic image <NUM> or the field of view <NUM>. In addition, the synthetic image <NUM> and/or the tile window <NUM> may be partially superimposed over a portion of the field of view, either on a continuous basis or upon request.

As an example of toggling back and forth between a larger presentation of the synthetic image <NUM> or the field of view <NUM>, a camera control may be provided that is connected to the master manipulators. For example, a user may start looking at the endoscopic view and may pull the endoscope back by pulling the his hands towards himself while in a camera control mode. At some point, the endoscope cannot be pulled back any farther, and the field of view encompasses a maximum area. Continuing to pull back on the master controls (with or without a haptic detent or other indication) can expose a view showing sections of a synthetic image <NUM> along the borders of the real image (e.g., the image captured in field of view <NUM>). Pulling back even farther on the master controls (with or without haptic detent or other indication) may provide a view where the image captured in field of view <NUM> is only the middle section of the screen. Pulling back still farther on the controls (with or without haptic detent or other indication) may provide the entire synthetic image <NUM>. Reversing the master control direction can be used to reverse such a real-to-synthetic zoom out function and control a synthetic-to-real zoom in function. As an alternative to camera control using master manipulator movement, the system may be configured to use another control input (e.g., a foot pedal, a finger button on a manipulator, the roll of the master manipulator grip, and the like) to control the zoom functions.

<FIG> shows a tile window <NUM> displaying an alternate angle for viewing a portion of the synthetic image <NUM>. In the embodiment shown, the view volume <NUM> is slightly tilted from the actual field of view of the endoscope, but the particular angle of view of the view volume <NUM> shows relevant information regarding the configuration of the tools <NUM> with respect to the view volume.

The features of the synthetic image <NUM> provide another number of benefits to a user of the minimally invasive telesurgical system <NUM>. Some of these advantages are set forth below.

Typically, in a minimally invasive telesurgical system, only the most distal portions of the surgical tools, such as the tools <NUM>, may be visible to the surgeon in the field of view of the endoscope <NUM> at any time. Depending upon the configuration of the patient side cart, it is possible that collisions between moving parts of the robot assembly may occur which are not visible to the surgeon in the field of view. Some of these collisions ("outer collisions" because they are outside of the field of view for the endoscope <NUM>) may occur between the linkages of robotic arm assemblies leading to the tools, the collisions may occur between two tools, or may occur between a tool and a linkage. Such outer collisions may occur outside the body or inside the body but not within the field of view. In addition, an outer collision may occur between one tool that is in the field of view and another tool that is slightly outside the field of view. Collisions occurring inside the body and in the field of view of the endoscope are "inner collisions".

In accordance with an embodiment, the synthetic image <NUM> and/or the information generated by the modeling component <NUM> may be utilized for collision detection. As an example, a surgeon viewing the viewer <NUM>, or another individual viewing the display <NUM>, may view the synthetic image <NUM> to see an indication of an imminent or actual collision.

Collision detection may involve more than just a visual image of a collision. Information about relative locations of robot linkages and tools is maintained by the modeling component <NUM>, and this information may be used to generate a signal if two components are sensed to be too close to one another. For example, each tool may be treated like a capsule or cylinder, having a particular radius or buffer zone outside the tool's surface. Using the actual position information from the tool tracking component and/or the kinematic information from the kinematic component <NUM>, the modeling component <NUM> may predict or warn of a collision. For example, if two tools <NUM> are presumed to have a radius of one half inch each, then if the center line for one of the tools comes within an inch of the center line for a second tool, then the modeling component <NUM> may assume that a collision has occurred. A separate signal may be generated if the two tools are calculated to be close, but not in contact, with each other. For the above example, this distance may be, e.g., a center line distance between the tools of <NUM> inches.

<FIG> shows at the bottom a display tile window in which a real field of view image <NUM> shows two tools <NUM>, <NUM> colliding. Although the collision in <FIG> is within the field of view <NUM>, as described above, the collision may take place outside the field of view or even outside the body of the patient. Even if inside the field of view, the tools <NUM>, <NUM> are not necessarily visible, because they may be blocked by cauterization smoke, blood, or an organ, as examples. In <FIG>, the inner collision is seen in the field of view <NUM>, but it is also detected by the modeling component <NUM>.

At the top of <FIG> is a display tile window <NUM> representing the synthetic image <NUM>. In the embodiment shown in <FIG>, the tile window <NUM> is taken from the same point of view as the field of view <NUM>, but a different point of view may be provided as described above. In addition, as described above, outer collisions, as well as inner collisions, may be detected.

<FIG> is a flowchart showing an illustrative process for providing collision information in accordance with an embodiment. The process begins at <NUM>. At <NUM>, a model, such as the synthetic image <NUM>, is generated. This generation process is described with reference to <FIG>. At <NUM>, the robot for the patient side cart is moved. At <NUM>, the proximity of linkages and/or tools of the robotic arm assemblies <NUM> are computed. At <NUM>, a determination is made whether the proximities are within a high threshold. The high threshold represents spacing between tools or linkages at which a warning of a collision is given. For example, as described above, if two tools are assumed to have a radius of a half an inch, the high threshold may be a centerline separation of <NUM> inches. If the components of the patient side cart are not within the high threshold, <NUM> branches back to <NUM>, and the robot continues to move.

If two components of the patient side cart are within the high threshold, then <NUM> branches to <NUM>, where a warning is generated. This warning may be an audible warning, a visual warning (e.g., provided within the viewer <NUM> or on the display <NUM>), or another suitable indication of collision proximity. If visual, the warning may be presented, for example, in the field of view <NUM> (<FIG>). In the embodiment shown in <FIG>, the words "inner collision error" are shown, indicating an actual collision. Alternatively, for a warning message, a message stating that tools are too close or similar may be provided. In addition, for the view of the synthetic image <NUM>, the color of the tools <NUM> may change to provide the warning, such as changing from a metal color to yellow for a warning.

A surgeon may or may not elect to rearrange the robot after the warning is generated at <NUM>. In either event, the process proceeds to <NUM>, where the robot has moved again. At <NUM>, a determination is made whether the robot is within a low threshold. In an embodiment, the low threshold represents a distance, such as a center line distance, at which a collision is assumed. If the low threshold is not met, the process branches back to <NUM> and continues to loop, likely continuing to generate the warning message unless the components of the patient side cart are moved to outside the high threshold in <NUM>.

If the components are within the low threshold, then <NUM> branches to <NUM>, where collision information is generated, such as a collision warning or message. As an example, in <FIG>, the collision error warning is provided in the field of view <NUM>. (Both near and actual collision warnings may use the same or different indications. ) A similar collision error warning may be provided in the tile window <NUM>, and the tools <NUM> may change colors, such as to red, to show a collision error. The process then loops back to <NUM>.

As stated above, for collision detection, the components need not be in the field of view of the viewer <NUM>. Thus, when components of the patient side cart are improperly aligned and are approaching a collision or actually have a collision, information may be provided, either in visual form or in the form of a warning or error message. The warning may be particularly helpful where a user is not familiar with operation of the robot and may put the tools or robotic arm assemblies in an awkward position. The person viewing the viewer <NUM> may select a different synthetic view angle and distance of the robot so as to determine the near collision or actual collision point between two robotic manipulators. Once the operator views the collision point, he or she may adjust one or more of the robot's kinematic arms (either the passive, "set up" portions or the actively controlled, manipulator portions) to cure the actual or near collision condition and avoid further collisions. In one aspect, if the operator is viewing a synthetic view that corresponds to the endoscope's field of view, the synthetic view may be automatically changed to show a collision point if a collision warning or actual collision is occurring.

In an embodiment, the location of a patient and/or portions of the patient's tissue structures (e.g., from preoperative imaging or by other suitable method of registering tissue structure locations) may be provided to the system, and registered patient location data may be to detect, warn, and display actual or potential collisions between the robot and the patient or designated tissue structures in the patient. Collisions may be detected as described above.

Also, in an embodiment, a visual, audio, or other indicator may be provided to assist in reducing or correcting a collision state. For example, for the warning situation described above, information may be provided to a surgeon to aid the surgeon in avoiding a collision. For example, a visual indicator may provide information about a movement direction in which a collision might occur, or may indicate a movement direction for the surgeon to make in order to avoid or cure a collision.

In minimally invasive surgery, it is possible for instruments to be positioned outside the endoscopic camera's view volume. This possibility can result in situations where the tool is effectively lost, since the surgeon does not necessarily know how to move the endoscope to bring the instrument back into view, or how to move the instrument into the endoscope's field of view. Moreover, the situation may compromise patient safety, since the surgeon is able to move an instrument which cannot be observed.

The synthetic image <NUM> provides a solution to this problem by presenting the surgeon with a broader view of the endoscope's view volume <NUM>, along with an accurate depiction of the position of each tool <NUM>. Such a broader view and tool depiction may be provided from various points of view. In an embodiment, the broad view and tool depictions are provided from the same point of view or direction as the endoscope field of view. By providing a broad view in this direction, the surgeon will be able to retain the intuitive tool control movement he or she normally experiences when viewing the real endoscopic image while moving tools into the proper position so that the tool is back in the view volume <NUM>. Alternatively, the view volume <NUM> may be viewed from other angles, allowing a surgeon to have a different perspective of what the endoscope <NUM> is viewing. As examples, <FIG> and <FIG> show three different views, taken at different angles and pans, of views that may be shown for the synthetic image <NUM>. Although the lower part of <FIG> shows an actual image, a synthetic image <NUM> may be provided from the same direction, and would look similar except that synthetic tools would be shown instead of video feed of the actual tools. The view established by the field of view is shown in the lower part of <FIG>, and a view taken from a front side of the synthetic image-zoomed outward to show much of the patient side cart-is shown in the top of <FIG>. A view taken slightly rearward and upward of the direction of the field of view of the endoscope, and zoomed outward to show the view volume <NUM>, is shown in <FIG>. This slight variation in view provides a good perspective of where the tools <NUM> are with respect to the view volume <NUM>. A surgeon may toggle between a view consistent with the field of view and one just off from the field of view, such as shown in <FIG>. To this end, a controller or other device may be provided for allowing a surgeon to toggle between different views of the synthetic image <NUM>. Alternatively, a separate controller or the master controller may be utilized to allow infinite positioning (e.g., various pan, tilt, roll, dolly, truck, crane, and zoom image movements) of the synthetic image <NUM>.

<FIG> is a flow chart representing a process for lost tool recovery in accordance with an embodiment. The process begins at <NUM>. At <NUM>, the synthetic image <NUM> is generated as described above. At <NUM>, the patient side cart, or the robot, is moved.

At <NUM>, a determination is made whether one or more of the tools is outside of the field of view. If not, the process loops back to <NUM>. If one or more of the tools is outside of the field of view, then the process may move to <NUM>, where a synthetic image is shown. The synthetic image may or may not be automatically shown; the synthetic image display may be selected by a surgeon. To this end, <NUM> may be done as a result of a request by the surgeon or another operator, and may or may not be triggered by a tool being out of the field of view. If desired, however, a synthetic image may be automatically shown as a result of a loss of an image of the tool. In such an embodiment, however, it may be desirable to show the synthetic image in a tile window in addition to the field of view, instead of taking the field of view away from the surgeon.

If the missing tool display option is available, the synthetic view <NUM> may be requested or otherwise provided in <NUM>. The synthetic image provided in <NUM> may be, as described above, substantially the same as the field of view of the endoscope <NUM> or any number of perspectives of the modeled system. If a desired angle is not shown, then a surgeon may elect at <NUM> to show a different view. If the surgeon elects to show a different view, then <NUM> branches to <NUM>, where the synthetic image <NUM> is, e.g., rotated to show a different view. If desired, as part of this movement, the synthetic image may rotate in space so that the surgeon may get an idea of the position from which the view started relative to the position where the view is going. In addition, in accordance with an embodiment, when a view of the synthetic image <NUM> is inconsistent with the same point of view as the field of view, a warning message or other indicator may be provided to the surgeon so that the surgeon may understand that he or she is looking at the view volume <NUM> from a direction that is different than the direction of the field of view.

If the surgeon did not request a different view in <NUM>, then the process loops back to <NUM>.

As described above, the synthetic image <NUM> provides an image of the patient side cart that is larger than and outside of the view volume <NUM>. Thus, even if taken along the same point of view as the field of the view of the endoscope <NUM>, the surgeon may zoom outward so that tools that are just outside the view volume <NUM> may be seen. The surgeon may then move these tools or the endoscope to the desired position so that they are within the field of view.

As described above, there are a number of ways in which the system may present the synthetic image <NUM> of the robot to the surgeon. A first option, described with respect to <FIG>, includes a tile window <NUM> showing a synthetic view above the field of view image <NUM>, with both shown at the same time. Another option, shown in <FIG>, shows only the synthetic image <NUM>.

In accordance with an embodiment, a third option is provided in which a video display from an endoscope is superimposed over the synthetic image <NUM>, with the positions matched, so that the video image is rendered in the context of the synthetic image <NUM> of the entire patient side cart. This view provides relative positions of the components of the patient cart for the surgeon, and allows the surgeon to understand where the surgeon is with respect to space. The view is also well suited when transitioning between a pure video display and a pure synthetic image <NUM>. During the transition, the surgeon can relate respective positions of the robot and the video image from the endoscope.

A simplified version of this feature is shown in <FIG>, where an image within the field of view <NUM> is projected over a window tile <NUM> that includes the synthetic image <NUM>. The field of view image <NUM> includes two tools <NUM>, <NUM> performing an operation. The window tile <NUM> extends the view provided by the field of view <NUM>, and additional sections of the tools <NUM>,<NUM>-indicated by the reference numerals <NUM>,<NUM>, respectively-are provided. The surgeon may zoom in and out to provide additional information about the location of the tools with respect to other parts of the patient side cart. In addition, the features described with respect to the embodiment shown in <FIG> may be utilized to find the lost tool that is just outside the field of view, for example, in the window tile <NUM>, but not in the field of view <NUM>.

In accordance with the invention, in addition to the synthetic image <NUM>, the modeling data <NUM> may be utilized to project a image other than a visual representation of portions of the patient side cart. According to the invention, using the position information provided by the tool tracking component <NUM> and/or the kinematic component <NUM>, the modeling component <NUM> is configured to display text on a portion of the synthetic image. According to the invention, the text is superimposed over the actual tools in a field of view within an outer perimeter of the image of the distal end of the actual tools so as to focus attention on that tool or to provide other information. As an example, for the tool <NUM> in <FIG>, the modeling component <NUM> may be utilized to display a text message "closed" <NUM> collocated over the video image of the tool <NUM> to indicate that the clamp for the tool is closed. The camera information, described above, permits the creation of a <NUM>-D stereo rendering that may be superimposed on the stereo view of the tool <NUM> from the image capture device. Error messages may also be provided.

<FIG> is a flow chart representing a process for displaying information utilizing the modeling component <NUM> in accordance with an embodiment. Beginning at <NUM>, the location of the components of the patient side cart is determined, for example, the location of the tools <NUM>. At <NUM>, the modeling component <NUM> is aligned with the tool as described above. At <NUM>, the desired information is displayed over the tool. For example, as described above, words may be displayed over the tool. In addition, if desired, information may be displayed around or adjacent to a tool or other feature.

As can be understood, to superimpose a message over actual tools in the field of view, the modeling data <NUM> need only include information about the outer perimeter of the tools. The other components of the patient side cart are not needed for this embodiment.

The synthetic image <NUM> may be useful in providing a remote image of the operation of the patient side cart. For example, in some situations, an individual remote from the patient side cart may desire to view operation of the patient side cart. In such a situation, the synthetic image <NUM> may be rendered at both the viewer <NUM> and a remote display (e.g., the display <NUM>). In such a situation, in accordance with one embodiment, the modeling data may be maintained all at one location, with the synthetic image <NUM> sent to a remote location for display at the remote location.

In an alternate embodiment, position and orientation information provided by the tool tracking component <NUM> and/or the kinematic component <NUM> may be sent to a remote computer. The remote computer, in turn, includes a modeling component <NUM> and the modeling data <NUM>. In this embodiment, the synthetic image <NUM> is generated at the remote location in a separate operation from producing the synthetic image <NUM> for the viewer <NUM>.

Being able to provide a synthetic image <NUM> in remote locations permits an operating surgeon viewing the surgeon's console to communicate with a surgical assistant viewing an assistant monitor. In addition, a student surgeon at one surgeon console may communicate with a remote proctor at another surgeon console.

In accordance with another embodiment, a remote user or proctor may have controls for movement of a synthetic image, such as a synthetic image <NUM>. The movement of the synthetic image may be watched by a surgeon or student at the surgeon console, permitting the user to learn surgical procedures and motions, and to mimic those motions with the surgeon or student's controls (and thus the tools).

The linkages for the robotic arm assemblies of the patient side cart have a limited range of movement, limiting the movement of the tools supported by each arm or linkage. When the robot for a patient encounters range of motion limits, it is not always obvious to a surgeon (new or experienced) why the robot is not able to continue moving. In a telesurgical system, there are typically two sources of range of motion limits: joint limits of the master manipulator and joint limits of the slave manipulator.

In accordance with an embodiment, the modeling component <NUM> generates a signal to indicate that a limit of the range of movement for a tool is approaching. The signal may be used, for example, to generate a visual cue to the surgeon, such as color coding of the part(s) that have reached a limit. Alternatively, the limit may be represented with synthetic geometry as a virtual wall <NUM> (<FIG>), which may be shown with the synthetic model <NUM>, or may alternately be superimposed over the field of view. The virtual wall <NUM> is for the right-most tool <NUM>, and it may be shown as concave, flat, or otherwise shaped to match the curvature of a range of motion. The virtual wall <NUM> is displayed in a position and direction that is perpendicular to the impeded motion direction of the instrument tip.

Thus, while the invention is susceptible to various modifications and alternative constructions, a certain illustrated embodiment thereof is shown in the drawings and has been described above in detail.

The use of the terms "a" and "an" and "the" and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The term "connected" is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. The use of any and all examples, or exemplary language (e.g., "such as") provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed.

Claim 1:
A robotic system comprising:
a patient side cart (<NUM>) including two or more robotic arm assemblies(<NUM>, <NUM>, <NUM>), wherein the two or more robotic arm assemblies (<NUM>, <NUM>, <NUM>) include: a first robotic arm assembly (<NUM>, <NUM>, <NUM>) operatively couplable to a first tool (<NUM>, <NUM>, <NUM>), the first tool having a distal end; and
a second robotic arm assembly;
an image capture device (<NUM>) having a field of view, wherein the second robotic arm assembly is arranged to hold the image capture device;
a display(<NUM>); and
a processor configured to:
cause an image of the field of view captured by the image capture device, to be displayed on the display, the image of the field of view including an image of the first tool; and
generate a synthetic image, including information about the first robotic arm assembly or the first tool, to be rendered on the image of the first tool in the image of the field of view being displayed on the display, by:
determining a location of the first tool;
aligning the synthetic image, including the information about the first robotic arm assembly or first tool, with the first tool in the image of the first tool by using the location of the first tool; and
rendering the synthetic image, including the information about the first robotic arm assembly or the first tool, over the first tool on the image of the first tool in the image of the field of view being displayed on the display, wherein a portion of the synthetic image includes a text message, wherein the portion of the synthetic image including the text message is superimposed over the first tool within an outer perimeter of the image of the first tool, and wherein both the portion of the synthetic image including the text message and the image of the first tool are displayed in the image of the field of view being displayed on the display when the synthetic image is rendered over the first tool.