CN117042715A

CN117042715A - Instrument shaft tensioning system and method

Info

Publication number: CN117042715A
Application number: CN202280015334.9A
Authority: CN
Inventors: 林佳艺; C·F·格雷策尔; J·杨
Original assignee: Auris Surgical Robotics Inc
Current assignee: Auris Health Inc
Priority date: 2021-02-17
Filing date: 2022-02-16
Publication date: 2023-11-10
Also published as: CN116963690A

Abstract

Systems, devices, and methods for assessing and/or removing slack in an elongate shaft of a medical instrument are discussed herein. For example, the instrument feeder device may be configured to engage the elongate shaft to facilitate axial movement of the elongate shaft. An amount of slack between the instrument feeder device and an instrument handle of the medical instrument may be determined. Further, slack in the elongate shaft may be removed by moving the instrument handle in a direction away from the instrument feeder apparatus and/or controlling the instrument feeder apparatus to insert the elongate shaft.

Description

Instrument shaft tensioning system and method

RELATED APPLICATIONS

The present application claims priority from U.S. provisional application No. 63/150,533 entitled "INSTRUMENT SHAFT TENSIONING SYSTEM AND METHOD" filed on month 2 of 2021 and U.S. provisional application No. 63/150,527 entitled "ENGAGEMENT CONTROL OF INSTRUMENT FEEDER DEVICES" filed on month 2 of 2021, the disclosures of which are incorporated herein by reference in their entireties.

Background

Technical Field

The present disclosure relates to the field of medical procedures and devices.

Prior Art

Various medical procedures involve the use of one or more medical devices to access a target anatomical site within a patient. In some cases, improper use of a particular device may adversely affect the health of the patient, the integrity of the medical device, and/or the efficacy of the procedure when accessing the site associated with the procedure.

Disclosure of Invention

In some implementations, the present disclosure relates to a system comprising: a first robotic arm configured to be coupled to an elongate shaft of a medical instrument; a second robotic arm configured to be coupled to an instrument base of a medical instrument; and a control circuit. The first robotic arm includes a drive output configured to control axial movement of the elongate shaft. The control circuit is configured to cause actuation of at least one of the drive output or the second robotic arm, and determine an amount of slack in the elongate shaft between the first robotic arm and the second robotic arm based at least in part on the actuation.

In some implementations, the control circuit is further configured to determine at least one of a first force associated with the drive output or a second force associated with the second robotic arm, and determine that at least one of the first force or the second force is greater than a threshold. The amount of slack in the elongate shaft may be determined based at least in part on determining that at least one of the first force or the second force is greater than a threshold. The amount of slack in the elongate shaft may be less than a predetermined amount.

In some embodiments, the control circuit is configured to cause actuation of the second robotic arm. Actuation of the second robotic arm may cause actuation of the second robotic arm in a direction away from the first robotic arm.

In some embodiments, the control circuit is configured to cause actuation of the drive output while enabling actuation of the second robotic arm by less than a threshold amount.

In some embodiments, the control circuit is further configured to receive an input signal indicative of insertion of the elongate shaft. The control circuit may be configured to cause actuation of the drive output in response to receiving the input signal. Actuation of the drive output may cause insertion of the elongate shaft.

In some embodiments, the first robotic arm is configured to be coupled to an instrument feeder device. The instrument feeder device may be configured to implement an engaged state in which the instrument feeder device is engaged with the elongate shaft and a disengaged state in which the instrument feeder device is disengaged from the elongate shaft.

In some embodiments, the control circuit is further configured to determine to transition the instrument feeder device from the engaged state to the disengaged state. The control circuit may be configured to cause actuation of the second robotic arm in response to determining to transition the instrument feeder device from the engaged state to the disengaged state. Actuation of the second robotic arm may cause actuation of the second robotic arm in a direction away from the first robotic arm.

In some embodiments, the control circuit is further configured to determine that the amount of slack in the elongate shaft is less than a predetermined amount, and cause the drive output and the second robotic arm to cooperatively actuate to axially move the elongate shaft based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount.

In some embodiments, the first robotic arm is configured to be coupled to an instrument feeder device. The control circuitry may be further configured to cause the instrument feeder device to apply a force to the elongate shaft to axially prevent movement of a portion of the elongate shaft positioned within the instrument feeder device. The control circuit may be configured to cause actuation of the second robotic arm. Actuation of the second robotic arm may cause actuation of the second robotic arm in a direction away from the first robotic arm.

In some implementations, the present disclosure relates to a method that includes causing, by a control circuit, actuation of at least one of a drive output of a first robotic arm or a second robotic arm. The first robot is coupled to an elongate shaft of the medical instrument and the second robot arm is coupled to an instrument base of the medical instrument. The drive output is configured to control axial movement of the elongate shaft. The method also includes determining, by the control circuit, an amount of slack in the elongate shaft between the first robotic arm and the second robotic arm based at least in part on the actuation.

In some embodiments, the method further comprises determining at least one of a first force applied by the drive output or a second force applied by the second robotic arm. Determining the amount of slack in the elongate shaft may be based on at least one of the first force or the second force.

In some embodiments, causing includes causing actuation of the second robotic arm in a direction away from the first robotic arm. Further, in some embodiments, causing includes causing the drive output to actuate while preventing the second robotic arm from actuating beyond a threshold amount.

In some embodiments, the method further comprises receiving an input signal indicative of insertion of the elongate shaft. Causing may include causing actuation of the drive output in response to receiving the input signal. Actuation of the drive output may cause insertion of the elongate shaft.

In some embodiments, the method further comprises determining to transition an instrument feeder device configured to engage the elongate shaft from an engaged state to a disengaged state. Causing may include causing actuation of the second robotic arm in a direction away from the first robotic arm in response to determining to transition the instrument feeder device from the engaged state to the disengaged state.

In some embodiments, the method further includes determining that the amount of slack in the elongate shaft is less than a predetermined amount, and causing the drive output and the second robotic arm to actuate in a coordinated manner to axially move the elongate shaft based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount.

In some embodiments, the method further comprises applying a force to the elongate shaft to prevent the elongate shaft from retracting from the patient. Causing may include causing actuation of the second robotic arm in a direction away from the first robotic arm.

In some implementations, the present disclosure relates to a system including an instrument feeder device configured to axially move an elongate shaft of a medical instrument and a control circuit. The medical device includes a device handle. The control circuit is configured to determine an amount of slack in the elongate shaft between the instrument handle and the instrument feeder device and to control the instrument feeder device based at least in part on the amount of slack in the elongate shaft.

In some embodiments, the control circuit is further configured to determine at least one of a first force applied by the drive output to control the instrument feeder device or a second force applied by the second robotic arm. The amount of slack in the elongate shaft may be determined based on at least one of the first force or the second force.

In some embodiments, the control circuitry is configured to control the instrument feeder device by causing the instrument feeder device to at least one of: axially move the elongate shaft, disengage from the elongate shaft, or remain engaged with the elongate shaft.

In some embodiments, the control circuit is configured to determine the amount of slack in the elongate shaft based on at least one of: a first force applied to the instrument feeder device, a second force applied by a robotic arm coupled to the instrument handle, shape sensing data indicative of a shape of the elongate shaft, or position sensor data indicative of a position of at least a portion of the elongate shaft.

In some embodiments, the control circuit is further configured to cause actuation of the second robotic arm in a direction away from the first robotic arm. The second robotic arm may be coupled to the instrument handle. The amount of slack may be determined based at least in part on actuation of the second robotic arm.

In some embodiments, the control circuitry is configured to cause actuation of the second robotic arm without controlling the instrument feeder device.

In some embodiments, the control circuit is further configured to determine that the second robotic arm has at least one of actuated beyond a threshold amount or actuated to a workspace boundary, and to generate a signal indicating that the second robotic arm has at least one of actuated beyond a threshold amount or actuated to a workspace boundary.

In some embodiments, the control circuit is further configured to determine that the amount of slack in the elongate shaft is less than a predetermined amount, and cause the instrument feeder device to disengage from the elongate shaft based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount.

In some embodiments, the control circuit is further configured to cause at least one of: moving the instrument feeder apparatus axially along the insertion direction or moving the instrument handle in a direction away from the instrument feeder apparatus, determining that the amount of slack in the elongate shaft is less than a predetermined amount, and causing at least one of the following to occur based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount: the instrument feeder device is moved axially in a retraction direction to the elongate shaft or the instrument handle is moved in a direction toward the instrument feeder device.

In some embodiments, the control circuit is further configured to cause the instrument feeder device to apply a force to the elongate shaft to axially prevent movement of a portion of the elongate shaft positioned within the instrument feeder device and to cause movement of the instrument handle in a direction away from the instrument feeder device. The amount of slack can be determined while moving the instrument handle.

In some implementations, the present disclosure relates to a system including an instrument feeder device and a control circuit. The instrument feeder device is configured to be coupled to the first robotic arm and configured to axially move an elongate shaft of the medical instrument. The medical device includes a device handle. The control circuitry is configured to determine that the elongate shaft is substantially free of slack between the instrument handle and the instrument feeder device, and to control the instrument feeder device based at least in part on the elongate shaft being substantially free of slack between the instrument handle and the instrument feeder device.

In some embodiments, the control circuit is further configured to cause actuation of the second robotic arm in a direction away from the first robotic arm. The second robotic arm may be coupled to the instrument handle. Determining that the elongate shaft is substantially free of slack may be based at least in part on actuation of the second robotic arm.

In some embodiments, the control circuit is further configured to cause actuation of the drive output of the first robotic arm to control the instrument feeder device while preventing movement of the instrument handle. Determining that the elongate shaft is substantially free of slack may be based at least in part on actuation of the drive output.

In some embodiments, the control circuit is further configured to determine at least one of a first force applied by the drive output to control the instrument feeder device or a second force applied by a second robotic arm coupled to the instrument handle. Determining that the elongate shaft is substantially free of slack may be based on at least one of the first force or the second force.

In some embodiments, the control circuitry is configured to control the instrument feeder device by causing the instrument feeder device to at least one of: the elongate shaft is moved axially in the insertion direction or disengaged from the elongate shaft.

In some embodiments, the control circuit is configured to determine that the elongate shaft is substantially free of slack based on at least one of: a first force applied to the instrument feeder device, a second force applied by a second robotic arm coupled to the instrument handle, shape sensing data indicative of a shape of the elongate shaft, or position sensor data indicative of a position of at least a portion of the elongate shaft.

In some embodiments, the control circuit is further configured to cause the instrument feeder device to apply a force to the elongate shaft to axially prevent movement of a portion of the elongate shaft positioned within the instrument feeder device and to cause actuation of the second robotic arm in a direction away from the first robotic arm. The second robotic arm may be coupled to the instrument handle. Determining that the elongate shaft is substantially free of slack may be based at least in part on actuation of the second robotic arm.

To summarize the present disclosure, certain aspects, advantages, and features have been described. It will be appreciated that not necessarily all such advantages may be achieved in accordance with any particular embodiment. Thus, the disclosed embodiments may be carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.

Drawings

For purposes of illustration, various embodiments are depicted in the drawings and should in no way be construed to limit the scope of the disclosure. In addition, various features of the different disclosed embodiments can be combined to form additional embodiments that are part of the present disclosure. Throughout the drawings, reference numerals may be repeated to indicate corresponding relationships between reference elements.

Fig. 1 illustrates an example robotic medical system arranged for a diagnostic and/or therapeutic ureteroscopy procedure in accordance with one or more embodiments.

FIG. 2 illustrates the example robotic medical system of FIG. 1 arranged for a diagnostic and/or therapeutic bronchoscopy procedure in accordance with one or more embodiments.

Fig. 3 illustrates a tabletop-based robotic system configured to perform a medical procedure in accordance with one or more embodiments.

Fig. 4 illustrates medical system components that may be implemented in any of the medical systems discussed herein, in accordance with one or more embodiments.

Fig. 5 illustrates medical system components that may be implemented in any of the medical systems discussed herein, including a scope assembly/system and an instrument feeder assembly, according to one or more embodiments.

Fig. 6A illustrates a perspective view of an example instrument feeder device in accordance with one or more embodiments.

Fig. 6B illustrates an instrument feeder device according to one or more embodiments, with a portion of the housing removed to illustrate various features of the instrument feeder device.

Fig. 6C illustrates an instrument feeder device according to one or more embodiments, with a portion of a housing and a retention feature removed.

Fig. 6D illustrates a perspective view of an exemplary actuator/roller assembly that can be implemented within an instrument feeder device in accordance with one or more embodiments.

Fig. 6E illustrates a perspective view of a roller assembly with a portion of the roller and carrier plate removed to show an exemplary gear assembly, in accordance with one or more embodiments.

Fig. 6F illustrates a top view of an exemplary gear assembly in accordance with one or more embodiments.

Fig. 6G illustrates a bottom view of a roller assembly in accordance with one or more embodiments.

Fig. 7 illustrates an exploded view of an exemplary instrument device manipulator assembly associated with a robotic arm in accordance with one or more embodiments.

Fig. 8-1 and 8-2 illustrate a state in which rollers of an instrument feeder device are engaged and a cover is closed, in accordance with one or more embodiments.

Fig. 9-1 and 9-2 illustrate a state in which a roller of an instrument feeder device is engaged with an instrument shaft and a cover is closed, in accordance with one or more embodiments.

Fig. 10-1 and 10-2 illustrate a state in which the rollers of the instrument feeder device are disengaged and the cover is closed, in accordance with one or more embodiments.

Fig. 11-1 and 11-2 illustrate a state in which the rollers of the instrument feeder apparatus are disengaged and the cover is open, in accordance with one or more embodiments.

FIG. 12 illustrates an exemplary state of the engagement assembly when the instrument shaft is not disposed/loaded within the engagement assembly in accordance with one or more embodiments.

FIG. 13 illustrates an exemplary state of the engagement assembly when an instrument shaft is disposed/loaded within the engagement assembly in accordance with one or more embodiments.

Fig. 14 illustrates an exemplary process for determining the status of an engagement assembly of an instrument feeder device in accordance with one or more embodiments.

Fig. 15 illustrates an exemplary process for determining whether an elongate shaft of a medical instrument is loaded/properly loaded into an instrument feeder device in accordance with one or more embodiments.

Fig. 16-1 to 16-3 illustrate an exemplary process for determining and/or removing slack in an elongate shaft of a medical device according to one or more embodiments.

FIG. 17 illustrates an exemplary process of determining and/or removing slack in an elongate shaft of a medical device in the context of insertion of the elongate shaft, in accordance with one or more embodiments.

18-1 and 18-2 illustrate an exemplary process for determining and/or removing slack in an elongate shaft of a medical device in the context of enabling an admittance control mode and/or flipping the elongate shaft, in accordance with one or more embodiments.

Detailed Description

Although certain embodiments and examples are disclosed below, the subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses, and modifications and equivalents thereof. Accordingly, the scope of the present disclosure is not limited by any of the specific examples described below. For example, in any method or process disclosed herein, the acts or operations of the method or process may be performed in any suitable sequence and are not necessarily limited to any particular disclosed sequence. Various operations may then be described as multiple discrete operations, in a manner that may be helpful in understanding certain embodiments; however, the order of description should not be construed as to imply that these operations are order dependent. Additionally, the structures, systems, and/or devices described herein may be embodied as integrated components or as separate components. For purposes of comparing various embodiments, specific aspects and advantages of these embodiments are described. Not necessarily all such aspects or advantages may be achieved by any particular implementation. Thus, for example, various embodiments may be performed by way of accomplishing one advantage or a set of advantages taught herein without necessarily achieving other aspects or advantages as may be taught or suggested herein.

Although specific spatially relative terms such as "exterior," "interior," "upper," "lower," "below," "above," "vertical," "horizontal," "top," "bottom," and the like are used herein to describe the spatial relationship of one device/element or anatomical structure to another device/element or anatomical structure, it should be understood that these terms are used herein for convenience of description to describe the positional relationship between the elements/structures as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the elements/structures in use or operation in addition to the orientation depicted in the figures. For example, an element/structure described as being "above" another element/structure may represent a position below or beside such other element/structure relative to an alternative orientation of the subject patient or element/structure, and vice versa. It should be understood that spatially relative terms, including those listed above, may be understood with respect to the corresponding illustrated orientations with reference to the drawings.

To facilitate devices, components, systems, features, and/or modules having similar features in one or more aspects, specific reference numerals are repeated among different figures of the disclosed set of figures. However, repeated use of common reference numerals in the figures does not necessarily indicate that such features, devices, components, or modules are the same or similar in relation to any of the embodiments disclosed herein. Rather, one of ordinary skill in the art may be informed by context about the extent to which the use of common reference numerals may suggest similarity between the recited subject matter. The use of a particular reference number in the context of the description of a particular figure may be understood to refer to an identified device, component, aspect, feature, module or system in that particular figure, and not necessarily to any device, component, aspect, feature, module or system identified by the same reference number in another figure. Furthermore, aspects of the individual drawings identified with common reference numerals may be interpreted as sharing characteristics or being entirely independent of each other.

Although certain aspects of the disclosure are described in detail herein in the context of renal procedures, urinary procedures, and/or renal family procedures (such as kidney stone removal/treatment procedures), it is to be understood that such context is provided for convenience, and that the concepts disclosed herein are applicable to any suitable medical procedure (such as bronchoscopy). However, the following presents a description of the renal/urinary anatomy and associated medical problems and protocols to aid in describing the concepts disclosed herein.

Kidney lithiasis (also known as urolithiasis) is a medical condition that involves the formation of solid masses in the urinary tract, known as "kidney stones" (kidney stones, renal calculi, renal lithiasis or nepharolithitis) or "urinary stones" (uroliths stones). Urinary stones may be formed and/or found in the kidneys, ureters and bladder (referred to as "vesical stones"). Such urinary stones may form due to mineral concentrations in the urine and may cause significant abdominal pain once such stones reach a size sufficient to prevent urine flow through the ureters or urethra. Urinary stones may be formed from calcium, magnesium, ammonia, uric acid, cystine, and/or other compounds or combinations thereof.

There are several methods available for treating kidney stone patients, including observation, medical treatment (such as drainage therapy), non-invasive treatment (such as External Shock Wave Lithotripsy (ESWL)), minimally invasive or surgical treatment (such as ureteroscopy and percutaneous kidney stone extraction ("PCNL")), and the like. In some methods (e.g., ureteroscopy and PCNL), a physician may access the stone, break the stone into smaller pieces or fragments, and use a basket device and/or suction to remove relatively smaller pieces/particles of stone from the kidney.

In a ureteroscopy procedure, a physician may insert a ureteroscope into the urinary tract through the urethra to remove urinary stones from the bladder and ureter. Typically, a ureteroscope includes an imaging device at its distal end that is configured to enable visualization of the urinary tract. The ureteroscope may also include lithotripsy devices for capturing or breaking up urinary stones. During a ureteroscopy procedure, one physician/technician may control the position of the ureteroscope while another physician/technician may control the lithotripsy device.

In the PCNL procedure (which can be used to remove relatively large stones), a physician can insert a nephroscope through the skin (i.e., percutaneously) and intermediate tissue to provide access to the treatment site in order to break up and/or remove the stones. During a PCNL procedure, a jet may be applied to clear stone dust, small debris, and/or thrombus from the treatment site and/or field of view. In some cases, a relatively straight and/or rigid nephroscope is used, wherein the physician positions the tip of the device in place within the kidney (e.g., the renal calyx) by pushing/leverage the nephroscope against the patient's body. Such movement may be detrimental to the patient (e.g., cause tissue damage).

In some of the procedures discussed herein, robotic tools may be implemented to enable a physician to access and/or treat a target anatomical site. For example, the medical system may be configured to engage with a medical instrument (such as a scope or another medical instrument) that includes an elongate shaft. The medical system may be configured to control the medical instrument to perform a procedure, such as to remove kidney stones from a patient and/or otherwise treat a target site. The medical system may include one or more robotic arms configured to be coupled to an instrument base/handle of the medical instrument and/or to an elongate shaft of the medical instrument.

In some cases, the medical system implements an instrument feeder device to help perform certain functions. The instrument feeder device may be selectively engageable with the elongate shaft of the medical instrument, control movement of the elongate shaft, and/or otherwise support the elongate shaft. For example, the instrument feeder device may facilitate axial movement of the elongate shaft (e.g., inserting/retracting the shaft), retaining the shaft during shaft flipping, retaining the shaft during manual movement of the robotic arm, and the like. To illustrate, the instrument feeder device can include one or more actuators configured to engage the elongate shaft to axially move the elongate shaft during actuation of the medical instrument. Further, the instrument feeder device may include a retention feature to retain the elongate shaft while still providing some freedom of movement of the elongate shaft, such as to flip the elongate shaft within the instrument feeder device, slide the elongate shaft through the instrument feeder device, and so forth. In many cases, the instrument feeder device can effectively/quickly control movement of the elongate shaft, such as to insert or retract the elongate shaft, and/or provide buckling-restrained support for the elongate shaft.

The instrument feeder device may generally be coupled to one robotic arm/component, while the instrument base of the medical instrument may generally be coupled to another robotic arm/component. In some examples, the instrument feeder device may be controlled in a manner related to movement of the instrument handle. For example, to insert a shaft, the instrument feeder device may cause axial movement of the shaft in an insertion direction, while a robotic arm coupled to the instrument handle moves closer to the robotic arm coupled to the instrument feeder device in a manner related to the speed of the axial movement. Similarly, to retract the shaft, the instrument feeder device may cause axial movement of the elongate shaft in a retraction direction, while the robotic arm coupled to the instrument handle moves farther away from the robotic arm coupled to the instrument feeder device in a manner related to the speed of the axial movement.

The present disclosure relates, inter alia, to devices, systems, and methods for controlling an instrument feeder device to intelligently engage and/or control medical instruments. This may assist the physician in using the instrument feeder device and/or the medical instrument in different ways/in different scenarios. For example, the medical system is configured to control the instrument feeder device to achieve various configurations/states for using the medical instrument, such as to load the medical instrument in the instrument feeder device, to control movement of an elongate shaft of the medical instrument, to enable adjustment of devices/components of the medical system, and so forth. For example, the medical system may cause the instrument feeder device to open/disengage at an appropriate time so that a physician may load an elongate shaft into the instrument feeder device. Further, the medical system may cause the instrument feeder device to engage the elongate shaft at an appropriate time such that the medical system may drive/navigate the medical instrument, such as by inserting or retracting the elongate shaft. Further, the medical system may cause the instrument feeder device to disengage from the elongate shaft at an appropriate time and retain the elongate shaft for certain actions, such as to turn the elongate shaft over, freely move the robotic arm without experiencing resistance due to engagement of the elongate shaft with the instrument feeder device, and the like.

Further, the present disclosure relates to devices, systems, and methods for determining a status of an instrument feeder device and/or a medical instrument relative to the instrument feeder device. For example, the robotic arm may include a drive output configured to couple to the instrument feeder device and provide an output to the instrument feeder device to control engagement with an elongate shaft of a medical instrument. The medical system may determine the state of engagement of the instrument feeder device with the elongate shaft and/or the state of the medical instrument based on the force applied by the drive output, the position of the drive output, the sensor on the instrument feeder device, and/or in another manner. The status of the instrument feeder device/medical instrument may indicate whether the medical instrument is loaded/properly loaded into the instrument feeder device, whether the instrument feeder device is engaged with the medical instrument, whether the instrument feeder device is configured to hold the medical instrument and allow freedom of movement of the medical instrument, and the like. This may allow the medical system to confirm/determine that the instrument feeder device is implemented in the proper configuration/state and/or that the medical instrument is loaded/properly loaded at the proper time. For example, if it is determined that the medical instrument is properly loaded into the instrument feeder device, the medical system may continue to drive/navigate the medical instrument. Further, if it is determined that the medical instrument is not loaded or not properly loaded (e.g., not placed in the proper position to facilitate actuation of the shaft), the medical system may provide a notification/signal to notify the user/component of such status and/or wait to actuate the medical instrument until the medical instrument is properly loaded.

Thus, in various examples, the medical systems discussed herein may be configured to control the instrument feeder device to intelligently engage and/or control the medical instrument. For example, the medical system may place the instrument feeder device in an appropriate state and/or confirm the state of the instrument feeder device/medical instrument at an appropriate time. This may help the physician use the instrument feeder device and/or the medical instrument in different ways/in different scenarios, such as by enabling a smooth workflow transition to load/unload the medical instrument, insert/retract the medical instrument, adjust the position of the robotic arm or another component of the medical system, flip the medical instrument, etc. In various examples, the instrument feeder device may be controlled without receiving a confirmation from the user regarding the status of the instrument feeder device/medical instrument. Further, by controlling and/or confirming the status of the instrument feeder device/medical instrument, the medical system may avoid/address issues associated with improperly loading the medical instrument (e.g., avoiding retention features/caps from gripping the elongate shaft (which may damage the elongate shaft), avoiding driving the elongate shaft in the event of improper loading of the elongate shaft (which may also damage the elongate shaft)), and/or the like.

Further, the present disclosure relates to devices, systems, and methods for assessing and/or removing slack in an elongate shaft of a medical instrument. For example, as described above, the instrument feeder device may be implemented to control an elongate shaft of a medical instrument. The instrument feeder device may generally be coupled to one robotic arm/component, while the instrument base of the medical instrument is generally coupled to another robotic arm/component. In some cases, the elongate shaft may include slack between the instrument base and the instrument feeder apparatus that may occur due to loading of the medical instrument, backlash/play in one or more components of the instrument feeder apparatus/robotic arm/handle/etc., mismatch between actual backlash and software configured backlash, slippage of the instrument feeder apparatus on the elongate shaft, etc. Such relaxation may cause undesirable problems. For example, if there is slack in the elongate shaft when the shaft is inserted, the slack curvature may increase as the instrument handle is moved closer to the instrument feeder device, which may potentially damage the elongate shaft and/or cause other problems. Further, if there is slack in the elongate shaft when the instrument feeder device is disengaged from the elongate shaft (e.g., to initiate flipping of the elongate shaft, to enable manual movement of the robotic arm, and/or for other reasons), the elongate shaft may move in the insertion direction with release of energy in the shaft. This may cause injury to the patient (e.g., due to the tip of the elongate shaft contacting tissue with relatively high force). To prevent such problems, the medical system may determine whether slack is present in the elongate shaft between the instrument handle and the instrument feeder device, and in some cases, remove/reduce the slack, if any, in the elongate shaft.

The medical system may determine the amount of slack in the elongate shaft in a number of ways. For example, the medical system may determine the magnitude of the arm force applied by a robotic arm coupled to an instrument base of the medical instrument and/or determine the magnitude of the drive output force applied by a drive output of the robotic arm coupled to the instrument feeder apparatus. The drive output may be configured to control axial movement of the elongate shaft. The magnitude of the arm force and/or the drive output force may be used to determine whether slack or tension is present in the elongate shaft. Additionally or alternatively, the medical system may determine an amount of slack in the elongate shaft based on shape sensing data indicative of a shape of the elongate shaft, position sensor data indicative of a position of at least a portion of the elongate shaft, and/or other data.

In various examples, the medical system may remove/reduce slack in the elongate shaft. For example, the medical system may cause the robotic arm coupled to the instrument handle to move in a direction away from the robotic arm coupled to the instrument feeder apparatus. This may occur without the use of an instrument feeder device to actively actuate the elongate shaft. Alternatively or additionally, the medical system may cause the instrument feeder device to move the elongate shaft in an insertion direction away from the instrument handle. This may occur without actively actuating a robotic arm coupled to the instrument handle. In some cases, the medical system may identify and/or remove slack in the elongate shaft prior to and/or as part of performing certain functions, such as prior to disengaging the instrument feeder device from the elongate shaft, prior to flipping the elongate shaft, as part of inserting the elongate shaft, and/or otherwise.

Thus, in examples, the medical systems discussed herein may be configured to intelligently assess slack in medical instruments and/or remove such slack. This may prevent the elongate shaft from being inadvertently moved in the insertion direction (e.g., when the instrument feeder device is disengaged from the shaft), which may cause injury to the patient. Further, evaluating and/or removing slack in the elongate shaft may avoid damaging the medical instrument (e.g., due to excessive bending of the elongate shaft when too much slack is introduced between the instrument handle and the instrument feeder device). Further, interruptions in performing the procedure may be avoided (e.g., avoiding a user having to check for slack in the medical instrument, reloading the medical instrument, etc.). For example, the medical system may automatically evaluate and/or remove slack in the elongate shaft at some time before, during, or after a procedure. In some cases, these techniques can address an unknown source of introducing slack into the elongate shaft.

Although various techniques are discussed in the context of implementing two robotic arms as coupled to a medical instrument, these techniques may also be implemented with multiple components included on a single robotic arm. For example, the robotic arm may include a first coupling element/robotic component for coupling to an instrument feeder device and a second coupling element/robotic component for coupling to an instrument handle, wherein the feeder device and the handle are movable relative to one another, such as along a track or other feature.

Although some techniques are discussed in the context of robotic-assisted medical procedures, these techniques may also be applicable to other types of medical procedures, such as procedures that do not implement robotic tools or implement robotic tools for relatively few (e.g., less than a threshold number) operations. For example, these techniques may be applicable to procedures for performing manually operated medical instruments, such as manual catheters and/or scopes that are fully controlled by a physician.

Certain aspects of the disclosure are described herein in the context of renal, urinary, and/or renal procedures (such as a kidney stone removal/treatment procedure). However, it should be understood that such context is provided for convenience, and that the concepts disclosed herein are applicable to any suitable medical procedure. For example, the following description also applies to other surgical/medical procedures or medical procedures involving removal of a subject from a patient (including any subject that may be removed from a treatment site or patient lumen (e.g., esophagus, urinary tract, intestine, eye, etc.) via percutaneous and/or endoscopic access), such as, for example, cholecystolithiasis removal, lung (lung/transthoracic) tumor biopsy, cataract extraction, and the like. However, as mentioned, the following presents a description of the renal/urinary anatomy and associated medical problems and procedures to aid in describing the concepts disclosed herein.

Fig. 1 illustrates an exemplary robotic medical system 100 arranged for diagnostic and/or therapeutic ureteroscopy procedures in accordance with one or more embodiments. The medical system 100 includes a robotic system 110 configured to engage and/or control one or more medical instruments/devices to perform a procedure on a patient 120. In the example of fig. 1, robotic system 110 is coupled to scope 130 and Electromagnetic (EM) field generator 140. However, the robotic system 110 may be coupled to any type of device/instrument. The medical system 100 further includes a control system 150 configured to interact with the robotic system 110 and/or the physician 160, provide information about the procedure, and/or perform a variety of other operations. For example, the control system 150 may include a display 152 configured to present certain information and/or an input/output (I/O) device 154 (in this example, a controller) configured to receive input from a physician 160, such as to control the robotic system 110. The medical system 100 may include a table 170 (e.g., a hospital bed) configured to hold the patient 120. Various actions are described herein as being performed by physician 160. These actions may be performed directly by physician 160, a user under the direction of physician 160, another user (e.g., a technician), a combination thereof, and/or any other user. The devices/components of the medical system 100 may be arranged in a variety of ways depending on the type of procedure, the stage of the procedure, user preferences, etc.

The control system 150 is generally operable with the robotic system 110 to perform medical procedures. For example, the control system 150 may communicate with the robotic system 110 via a wireless or wired connection to control instruments/devices connected to the robotic system 110, receive images captured by medical instruments, and so forth. For example, control system 150 may receive image data from scope 130 (e.g., an imaging device associated with scope 130) and display the image data (and/or a representation generated from the image data) via display 152 to assist physician 160 in navigating scope 130 and/or another instrument within patient 120. Physician 160 may provide input via I/O device 154 or another I/O device, and control system 150 may send control signals to robotic system 110 to control movement of scope 130 coupled to robotic system 110. Scope 130 (and/or another medical instrument) may be configured to move in a variety of ways, such as to articulate, flip, etc.

In some embodiments, the control system 150 may provide power to the robotic system 110 via one or more electrical connections, optics to the robotic system 110 via one or more optical fibers or other components, and the like. In various examples, the control system 150 may communicate with the medical instrument to receive sensor data (via the robotic system 110 and/or directly from the medical instrument). The sensor data may indicate or may be used to determine a position and/or orientation of the medical instrument. Further, in examples, the control system 150 may communicate with the table top 170 to orient the table top 170 or otherwise control the table top 170. Further, in various examples, the control system 150 may be in communication with the EM field generator 140 to control the generation of EM fields around the patient 120.

The robotic system 110 may include one or more robotic arms 112 configured to engage and/or control medical instruments/devices. Each robotic arm 112 may include a plurality of arm segments coupled to joints, which may provide a plurality of degrees of movement. The distal end (e.g., end effector) of the robotic arm 112 may be configured to be coupled to an instrument/device. In the example of fig. 1, robotic arm 112 (a) is coupled to EM field generator 140. Second robotic arm 112 (B) is coupled to instrument feeder device 180, which may facilitate robotic control/advancement of scope 130. Further, third robotic arm 112 (C) is coupled to handle 132 of scope 130, which may be configured to facilitate advancement and/or manipulation of scope 130 and/or medical instruments deployable through scope 130, such as instruments deployed through a working channel of scope 130. In this example, second robotic arm 112 (B) and/or third robotic arm 112 (C) may control movement (e.g., articulation, tilting, etc.) of scope 130. Although three robotic arms are connected to a particular instrument/device in fig. 1, robotic system 110 may include any number of robotic arms configured to be connected to any medical instrument/medical device type.

The robotic system 110 is communicatively coupled to any component of the medical system 100. For example, the robotic system 110 may be communicatively coupled to the control system 150 to receive control signals from the control system 150 to perform operations, such as controlling the robotic arm 112, manipulating instruments/devices, etc., in a particular manner. Further, robotic system 110 may be configured to receive an image (also referred to as image data) depicting the internal anatomy of patient 120 from scope 130 and/or send the image to control system 150, which may then be displayed on display 152. Further, the robotic system 110 may be coupled to components of the medical system 100, such as the control system 150 and/or the fluid management system, in a manner that allows for receiving fluid, optics, power, etc. therefrom.

Medical instruments may include various types of instruments such as scopes (sometimes referred to as "endoscopes"), catheters, needles, guidewires, lithotripters, basket retrieval devices, forceps, vacuums, needles, scalpels, imaging probes, imaging devices, jaws, scissors, graspers, needle holders, microdissection knives, staplers, knockdown tackers, suction/irrigation tools, clip appliers, and the like. Medical devices may include direct access devices, percutaneous access devices, and/or other types of devices. In some embodiments, the medical device is a steerable device, while in other embodiments, the medical device is a non-steerable device. In some embodiments, a surgical tool refers to a device, such as a needle, scalpel, guidewire, or the like, configured to puncture or be inserted through a human anatomy. However, surgical tools may refer to other types of medical instruments.

The term "scope" or "endoscope" may refer to any type of elongate medical instrument having image generation, viewing, and/or capturing functions (or configured to provide such functions by an imaging device deployed through a working channel) and configured to be introduced into any type of organ, lumen, inner cavity, chamber, and/or space of the body. For example, a scope or endoscope (such as scope 130) may refer to a ureteroscope (e.g., for accessing the urinary tract), a laparoscope, a nephroscope (e.g., for accessing the kidney), a bronchoscope (e.g., for accessing an airway such as the bronchi), a colonoscope (e.g., for accessing the colon), an arthroscope (e.g., for accessing the joint), a cystoscope (e.g., for accessing the bladder), a borescope, and the like. In some cases, the scope/endoscope may include a rigid or flexible tube and/or may be sized to pass within an outer sheath, catheter, introducer, or other endoluminal device, or may be used without such a device. In some embodiments, the scope includes one or more working channels through which additional tools/medical instruments, such as lithotripters, basket devices, forceps, laser devices, imaging devices, etc., may be introduced into the treatment site.

The term "direct entry" or "direct access" may refer to any access of an instrument through a natural or artificial opening in the patient's body. For example, scope 130 may be referred to as a direct access instrument because scope 130 passes into the patient's urinary tract via the urethra.

The term "percutaneous access (percutaneous entry)" or "percutaneous access (percutaneous access)" may refer to access through the skin and any other body layers of a patient, such as through a puncture and/or small incision, necessary for the instrument to reach a target anatomical location associated with a procedure (e.g., a renal calendula network of a kidney). Thus, a percutaneous access device may refer to a medical device, apparatus, or component configured to pierce or insert through skin and/or other tissue/anatomy, such as a needle, scalpel, guidewire, sheath, shaft, scope, catheter, or the like. However, it should be understood that percutaneous access devices may refer to other types of medical devices in the context of the present disclosure. In some embodiments, a percutaneous access device refers to a device/apparatus that is inserted or implemented with a device that facilitates penetration and/or small incisions through the skin of a patient. For example, when a catheter is inserted through a sheath/shaft that has been inserted into the skin of a patient, the catheter may be referred to as a percutaneous access device.

In some embodiments, the medical device includes a sensor (also referred to as a "position sensor") configured to generate sensor data. In an example, the sensor data may indicate a position and/or orientation of the medical instrument and/or may be used to determine the position and/or orientation of the medical instrument. For example, the sensor data may indicate a position and/or orientation of the scope, which may indicate a tip over of the distal end of the scope. The position and orientation of the medical device may be referred to as the pose of the medical device. The sensor may be positioned at the distal end of the medical instrument and/or at any other location. In some embodiments, the sensors may provide sensor data to the control system 150, the robotic system 110, and/or another system/device to perform one or more positioning techniques to determine/track the position/orientation of the medical instrument.

In some implementations, the sensor may include an Electromagnetic (EM) sensor having a coil of conductive material. Here, the EM field generator may provide an EM field that is detected by an EM sensor on the medical instrument. The magnetic field may induce a small current in the coil of the M sensor, which may be analyzed to determine the distance and/or angle/orientation between the EM sensor and the EM field generator. Further, the sensor may include another type of sensor, such as a camera, a distance sensor (e.g., a depth sensor), a radar device, a shape sensing fiber optic, an accelerometer, a gyroscope, an accelerometer, a satellite-based positioning sensor (e.g., a Global Positioning System (GPS)), a radio frequency transceiver, and so forth.

In some embodiments, the medical system 100 may further include an imaging device (not shown in fig. 1) that may be integrated into the C-arm and/or configured to provide imaging during a procedure, such as a fluoroscopic procedure. The imaging device may be configured to capture/generate one or more images of the patient 120, such as one or more x-ray or CT images, during a procedure. In an example, images from the imaging device may be provided in real-time to view anatomical structures and/or medical instruments within the patient 120 to assist the physician 160 in performing a procedure. The imaging device may be used to perform fluoroscopy (e.g., using contrast dye within the patient 120) or another type of imaging technique.

Furthermore, in some embodiments, medical system 100 may also include a fluid management system (sometimes referred to as an "aspiration system" or "irrigation system") configured to provide aspiration and/or irrigation to a target site, such as via a catheter, scope 130, an instrument/device associated with the catheter/scope (e.g., one or more access sheaths), and/or another instrument/device. The fluid management system may be configured to hold one or more fluid bags/containers and/or to control fluid flow thereto/therefrom. In various examples, the fluid management system includes certain electronic components, such as a display, a flow control mechanism, and/or a control circuit. The fluid management system may comprise a stand-alone tower/cart. The fluid management system may include a pump with which aspiration fluid may be drawn into the collection container/cartridge via an aspiration channel/tube coupled to the catheter/scope.

The various components of the medical system 100 may be communicatively coupled to one another by a network, which may include wireless and/or wired networks. Exemplary networks include one or more Personal Area Networks (PANs), local Area Networks (LANs), wide Area Networks (WANs), internet local area networks (IAN), body Area Networks (BANs), cellular networks, the internet, and the like. Further, in some embodiments, the components of the medical system 100 are connected via one or more support cables, tubes, etc. for data communications, fluid/gas exchange, power exchange, etc.

In some examples, the medical system 100 is implemented to perform a medical procedure related to kidney anatomy, such as to treat kidney stones. For example, a robot-assisted percutaneous procedure may be implemented in which a robotic tool (e.g., one or more components of medical system 100) may enable a physician/urologist to perform endoscopic (e.g., ureteroscopy) target access as well as percutaneous access/treatment. However, the present disclosure is not limited to kidney stone removal and/or robot-assisted procedures. In some implementations, the robotic medical solution may provide relatively higher precision, more excellent control, and/or more excellent hand-eye coordination relative to certain instruments than a strict manual protocol. For example, robot-assisted percutaneous access to the kidney according to some procedures may enable a urologist to perform both direct access endoscopic kidney access and percutaneous kidney access. While some embodiments of the present disclosure are presented in the context of catheters, kidney scopes, ureteroscopes, and/or human kidney anatomy, it should be understood that the principles disclosed herein may be implemented in any type of endoscopic/percutaneous procedure or another type of procedure.

In one exemplary, non-limiting procedure, the medical system 100 can be used to examine the kidney 190 and/or remove kidney stones 191. During the setup of the procedure, the physician 160 may position the robotic arm 112 of the robotic system 110 in a desired configuration and/or with the appropriate medical instrument attached. For example, physician 160 may position first robotic arm 112 (a) near the treatment site and attach EM field generator 140, which may assist in tracking the position of scope 130 and/or other instruments/devices during the procedure. In addition, physician 160 may position second robotic arm 112 (B) between the legs of patient 120 and attach instrument feeder device 180, which may facilitate robotic control/advancement of scope 130. In some cases, physician 160 can insert sheath/access instrument 134 into urethra 192 of patient 120, through bladder 193, and/or up to ureter 194. The physician 160 may connect the sheath/access instrument 134 to the instrument feeder device 180. Sheath/access instrument 134 may include a lumen-type device configured to receive scope 130, thereby assisting in inserting scope 130 into the anatomy of patient 120. However, in some embodiments, sheath/access instrument 134 is not used (e.g., scope 130 is inserted directly into urethra 192). Physician 160 may then insert scope 130 into sheath/access instrument 134 manually, robotically, or a combination thereof. Physician 160 may attach handle 132 of scope 130 to third robotic arm 112 (C), which may be configured to facilitate movement of handle 132, operation of a basket device/laser device/another medical instrument deployed through scope 130, and/or to facilitate other actions.

Physician 160 may interact with control system 150 to cause robotic system 110 to advance and/or navigate scope 130 into kidney 190. For example, physician 160 may use controller 154 or another I/O device to navigate scope 130 to locate kidney stones 191. Control system 150 may provide information about scope 130 via display 152, such as to assist physician 160 in navigating scope 130, such as to view an image representation (e.g., a real-time image captured by scope 130). In some embodiments, control system 150 may use positioning techniques to determine the position and/or orientation of scope 130, which may be viewed by physician 160 via display 152. In addition, other types of information may also be presented via display 152 to assist physician 160 in controlling scope 130, such as an x-ray image or other image of the internal anatomy of patient 120.

Once at the site of kidney stone 191 (e.g., within the calyx of kidney 190), scope 130 may be used to appoint/mark the percutaneous passage of a catheter into the target site of kidney 190. To minimize damage to the kidney 190 and/or surrounding anatomy, the physician 160 may designate the nipple as a target site for percutaneous access to the kidney 190. However, other target locations may be specified or determined. In some embodiments that specify a nipple, physician 160 may navigate scope 130 to contact the nipple, control system 150 may use a positioning technique to determine the position of scope 130 (e.g., the position of the distal end of scope 130), and control system 150 may correlate the position of scope 130 with the target position. Furthermore, in some embodiments, physician 160 may navigate scope 130 within a specific distance of the nipple (e.g., park in front of the nipple) and provide input indicating that the target location is within the field of view of scope 130. The control system 150 may perform image analysis and/or other positioning techniques to determine the location of the target location. Furthermore, in some embodiments, scope 130 may provide a fiducial point to mark the nipple as a target location.

Once the target site is specified, a catheter or other instrument may be inserted into patient 120 through a percutaneous access path to reach the target site (e.g., meet scope 130). For example, EM field generator 140 may be removed and a catheter (not shown) may be connected to first robotic arm 112 (a). The physician 160 may interact with the control system 150 to advance and/or navigate the catheter with its robotic system 110. Alternatively or additionally, the catheter may be manually inserted and/or controlled, such as when the catheter is implemented as a manually controllable catheter. The control system 150 may provide information about the catheter via the display 152 to assist the physician 160 in navigating the catheter. For example, display 152 may provide image data from the perspective of scope 130, where the image data may depict a catheter (e.g., when within the field of view of the imaging device of scope 130). In some embodiments, a needle or another medical device is inserted into the patient 120 to create a percutaneous access path for catheter access. Further, in some embodiments, a percutaneous access device/assembly (e.g., one or more sheaths and/or shafts) is inserted into a path created by a needle or another instrument to provide an access path for a catheter to a target site. Here, the catheter may be inserted into a percutaneous access device. The percutaneous access device can provide irrigation to the target anatomy, while the catheter can provide aspiration (e.g., via a lumen in the catheter).

When scope 130 and/or the catheter are positioned at the target site, physician 160 may use scope 130 to break up kidney stones 191 and/or use the catheter to remove fragments of kidney stones 191 from patient 120. For example, scope 130 may deploy a tool (e.g., a laser, cutting instrument, etc.) through the working channel to fragment kidney stones 191, and the catheter may aspirate fragments in kidney 190 through the percutaneous access path. The catheter may provide suction to maintain/retain the kidney stones 191 at the distal end of the catheter and/or at a relatively fixed location, while scope 130 disintegrates the kidney stones 191 using a tool (e.g., a laser), as shown in fig. 1. The fluid management system may provide irrigation to the target site via a percutaneous access device/assembly associated with the catheter and/or aspiration to the target site via the catheter (e.g., a lumen in catheter 140).

Although various examples are discussed in the context of providing irrigation/aspiration via a catheter and/or percutaneous access device/assembly, in some cases, irrigation fluid and/or aspiration may be provided to a treatment site (e.g., a kidney) by another device, such as scope 130. Furthermore, irrigation and aspiration may or may not be provided by the same instrument. Where one or more of the instruments provide irrigation and/or aspiration functions, one or more other of the instruments may be used for other functions, such as breaking up the object to be removed.

Furthermore, while various exemplary protocols are discussed in the context of a catheter implementing robotic control, the protocols may be implemented using a manually controllable catheter. For example, the catheter may include a manually controllable handle configured to be held/manipulated by the physician 160. The physician 160 may navigate the catheter by moving the handle and/or manipulating the manual actuator, which may cause the distal portion of the catheter to articulate.

The medical system 100 (and/or other medical systems discussed herein) may provide a variety of benefits, such as providing guidance to assist a physician in performing a procedure (e.g., instrument tracking, instrument navigation, instrument calibration, etc.), enabling a physician to perform a procedure from an ergonomic position without clumsy arm movements and/or positions, enabling a single physician to perform a procedure using one or more medical instruments, avoiding radiation exposure (e.g., associated with fluoroscopy techniques), enabling a procedure to be performed in a single surgical environment, providing continuous aspiration/irrigation to more effectively remove an object (e.g., remove kidney stones), and so forth. For example, the medical system 100 may provide instructional information to assist a physician in accessing a target anatomical feature using various medical instruments while minimizing bleeding and/or damage to anatomical structures (e.g., critical organs, blood vessels, etc.). Furthermore, the medical system 100 may provide non-radiation-based navigation and/or positioning techniques to reduce radiation exposure of physicians and patients and/or to reduce the number of devices in the operating room. Furthermore, the medical system 100 may provide functionality distributed between at least the control system 150 and the robotic system 110, which may be capable of independent movement. Such distribution of functionality and/or mobility may enable the control system 150 and/or robotic system 110 to be placed at a location optimal for a particular medical procedure, which may maximize the work area around the patient and/or provide an optimal location for a physician to perform the procedure.

Although various techniques/systems are discussed as being implemented as robotic-assisted procedures (e.g., procedures that use, at least in part, the medical system 100), these techniques/systems may be implemented in other procedures, such as in a fully robotic medical procedure, a purely human procedure (e.g., an inorganic robotic system), and so forth. For example, the medical system 100 may be used to perform a procedure without requiring a physician to hold/manipulate the medical instrument and without requiring the physician to control movement of the robotic system/arm (e.g., a full robotic procedure that relies on relatively few inputs to guide the procedure). That is, the medical instruments used during the procedure may each be held/controlled by a component of the medical system 100, such as the robotic arm 112 of the robotic system 110.

Fig. 2 illustrates an exemplary robotic medical system 100 arranged for diagnostic and/or therapeutic bronchoscopy procedures in accordance with one or more embodiments. During bronchoscopy, the arm 112 of the robotic system 110 can be configured to deliver a medical instrument, such as a steerable endoscope 210 (also referred to as a "bronchoscope 210") (which can be a procedure-specific bronchoscope for bronchoscopy), to a natural orifice entry point (i.e., the mouth of the patient 120 positioned on the table 170 in this example) to deliver a diagnostic and/or therapeutic tool. As shown, a robotic system 110 (e.g., a cart) may be positioned proximate to the upper torso of the patient in order to provide access to the access point. Similarly, the robotic arm 112 may be actuated to position the bronchoscope 210 relative to the entry point. The arrangement in fig. 2 may also be utilized when performing a Gastrointestinal (GI) procedure using a gastroscope (a dedicated endoscope for the GI procedure).

Once the robotic system 110 is properly positioned, the robotic arm 112 may robotically, manually, or a combination thereof insert the steerable endoscope 210 into the patient. Steerable endoscope 210 may include at least two telescoping portions, such as an inner guide portion and an outer sheath portion, wherein each portion is coupled to a separate instrument driver from a set of instrument drivers, and/or wherein each instrument driver is coupled to a distal end of a respective robotic arm 112. This linear arrangement of instrument drivers creates a "virtual track" 220 that can be repositioned in space by maneuvering one or more robotic arms 112 to different angles and/or positions. The virtual tracks/paths described herein are depicted in the figures using dashed lines that generally do not depict any physical structure of the system. Translation of one or more of the instrument drivers along the virtual track 220 may advance or retract the endoscope 210 from the patient 120.

After insertion, endoscope 210 may be directed down the patient's trachea and lungs using precise commands from robotic system 110 until the target surgical site is reached. The use of a separate instrument driver may allow separate portions of the endoscope/assembly 210 to be driven independently. For example, the endoscope 210 may be guided to deliver a biopsy needle to a target, such as, for example, a lesion or nodule within a patient's lung. The needle may be deployed down a working channel that extends the length of the endoscope 210 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 endoscope 210 for additional biopsies. For example, when a nodule is identified as malignant, the endoscope 210 may be passed through an endoscopic delivery tool to resect potentially cancerous tissue. In some cases, the diagnostic and therapeutic treatments may be delivered in separate protocols. In these cases, the endoscope 210 may also be used to deliver fiducials to "mark" the location of the target nodule. In other cases, the diagnostic and therapeutic treatments may be delivered during the same protocol.

In the arrangement of system 100 in fig. 2, patient guide 230 is attached to patient 120 via a port (not shown; e.g., a surgical tube). Patient guide 230 may be secured to table top 170 (e.g., via a patient guide holder configured to support guide 230 and to fix the position of patient guide 230 relative to table top 170 or other structure). In some embodiments, the patient guide 230 may include a proximal end, a distal end, and an guide tube between the proximal end and the distal end. The proximal end of the patient guide 230 may provide an opening/aperture that may be configured to receive the instrument 210 (e.g., a bronchoscope), and the distal end of the patient guide 230 may provide a second opening that may be configured to guide the instrument 210 into the patient access port. The curved tube member of the introducer 230 may connect the proximal and distal ends of the introducer and guide the instrument 210 through the introducer 230.

The curvature of the guide 230 may enable the robotic system 110 to maneuver the instrument 210 from a position that is not directly axially aligned with the patient access port, allowing for more flexibility in placement of the robotic system 110 within the room. Furthermore, the curvature of the guide 230 may allow the robotic arm 112 of the robotic system 110 to be substantially horizontally aligned with the patient guide 230, which may facilitate manual movement of the robotic arm 112 (if desired).

In some embodiments, one or more of the instrument feeder devices discussed herein may be implemented in a bronchoscopy procedure, such as shown in fig. 2. For example, instrument feeder device may be implemented in cooperation with endoscope 210 to at least partially control movement of scope 210.

Fig. 3 illustrates a tabletop-based robotic system 300 configured to perform a medical procedure in accordance with one or more embodiments. Here, one or more of the robotic components of robotic medical system 100 may be incorporated into table top 302, which may reduce the amount of capital equipment in the operating room and/or allow more access to patient 120 than a cart-based robotic system. For example, the system 300 may include one or more components of the control system 150 and/or the robotic system 110.

As shown, the table top 302 may include/incorporate one or more robotic arms 304 configured to engage and/or control a medical instrument/medical device. Each robotic arm 304 may include a plurality of arm segments coupled to joints, which may provide a plurality of degrees of movement. The distal end (i.e., end effector) of the robotic arm 304 may be configured to be coupled to an instrument/device, which may include any of the medical instruments/devices discussed herein, such as catheters, needles, scopes, and the like. For example, robotic arm 304 (B) may be coupled to instrument feeder device 180 and/or robotic arm 304 (C) may be coupled to handle 132 of scope 130, as shown in fig. 3. Each robotic arm 304 may be similar to or different from robotic arm 112 of system 100 of fig. 1 and 2. Further, each end effector may be similar to or different from the end effector of robotic system 110.

As shown, the robot-enabled tabletop system 300 may include a column 310 coupled to one or more carriages 312 (e.g., annular movable structures) from which one or more robotic arms 304 may protrude. The carriage 312 may translate along a vertical column interface that extends along at least a portion of the length of the column 310 to provide different vantage points from which the robotic arm 304 may be positioned to reach the patient 120. In some embodiments, the carriage 312 may be rotated about the post 310 using a mechanical motor positioned within the post 310 to allow the robotic arm 304 to access multiple sides of the table 302. Rotation and/or translation of the carriage 312 may allow the system 300 to align medical instruments, such as an endoscope and/or a catheter, into different access points on the patient 120. By providing vertical adjustment, the robotic arm 304 may be configured to be compactly stored under the platform of the tabletop system 300 and then raised during a procedure. The robotic arm 304 may be mounted on the bracket 312 by one or more arm mounts 314 that may include a series of joints that may be individually rotated and/or telescopically extended to provide additional configurability to the robotic arm 304. The post 310 structurally provides support for the tabletop platform and provides a path for vertical translation of the carriage 312. The post 310 may also transmit power and control signals to the carriage 312 and the robotic arm 304 mounted thereon.

In some embodiments, the table-based robotic system 300 may include or be associated with a control system similar to the control system 150 to interact with a physician and/or provide information about a medical procedure. For example, the control system may include input components to enable a physician to control one or more robotic arms 304 and/or medical instruments attached to one or more robotic arms 304. In some implementations, the input component enables the physician to provide inputs to control the medical device in a manner similar to how the physician physically holds/manipulates the medical device.

Fig. 4 illustrates medical system components that may be implemented in any of the medical systems of fig. 1-3, according to one or more embodiments of the present disclosure. Although certain components are shown in fig. 4, it should be understood that additional components not shown may be included in embodiments according to the present disclosure. Moreover, any of the illustrated components may be omitted, interchanged, and/or integrated into other devices/systems, such as the table 170, medical instruments, etc.

The control system 150 may include one or more of the following components, devices, modules, and/or units (referred to herein as "components"), individually/individually and/or in combination/collectively: control circuitry 401, one or more communication interfaces 402, one or more power supply units 403, one or more I/O components 404, one or more mobile components 405 (e.g., casters or other types of wheels), and/or memory/data storage 406. In some embodiments, the control system 150 may include a housing/casing configured and/or sized to house or contain at least a portion of one or more components of the control system 150. In this example, the control system 150 is shown as a cart-based system that is movable by one or more moving components 405. In some cases, after the proper position is reached, a wheel lock may be used to immobilize one or more moving components 405 to hold control system 150 in place. However, the control system 150 may be implemented as a fixed system, integrated into another system/device, or the like.

The various components of the control system 150 may be electrically and/or communicatively coupled using some connection circuitry/devices/features that may or may not be part of the control circuitry. For example, the connection features may include one or more printed circuit boards configured to facilitate the mounting and/or interconnection of at least some of the various components/circuits of the control system 150. In some embodiments, two or more of the components of the control system 150 may be electrically and/or communicatively coupled to each other.

The one or more communication interfaces 402 may be configured to communicate with one or more devices/sensors/systems. For example, one or more communication interfaces 402 may transmit/receive data wirelessly and/or in a wired manner over a network. In some implementations, one or more of the communication interfaces 402 may implement wireless technologies such as bluetooth, wi-Fi, near Field Communication (NFC), and the like.

The one or more power supply units 403 may be configured to manage and/or provide power for the control system 150 (and/or the robotic system 110, in some cases). In some embodiments, the one or more power supply units 403 include one or more batteries, such as lithium-based batteries, lead-acid batteries, alkaline batteries, and/or other types of batteries. That is, the one or more power supply units 403 may include one or more devices and/or circuits configured to provide power and/or provide power management functionality. Further, in some embodiments, one or more power supply units 403 include a main power connector configured to couple to an Alternating Current (AC) or Direct Current (DC) main power source.

One or more of the I/O components/devices 404 may include a variety of components to receive input and/or provide output, such as to interact with a user to facilitate performance of a medical procedure. One or more I/O components 404 may be configured to receive touch, voice, gestures, or any other type of input. In various examples, one or more I/O components 404 may be used to provide inputs regarding control of the device/system, such as to control robotic system 110, navigate a scope/catheter or other medical instrument attached to robotic system 110 and/or deployed through a scope, control table 170, control a fluoroscopy device, and the like. For example, a physician (not shown) may provide input via the I/O component 404, and in response, the control system 150 may send control signals to the robotic system 110 to manipulate the medical instrument. In various examples, a physician may use the same I/O device to control multiple medical instruments (e.g., switch control between instruments).

As shown, the one or more I/O components 404 may include one or more displays 152 (sometimes referred to as "one or more display devices 152") configured to display data. The one or more displays 152 may include one or more Liquid Crystal Displays (LCDs), light Emitting Diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and/or any other type of technology. In some embodiments, the one or more displays 152 include one or more touch screens configured to receive input and/or display data. Further, one or more I/O components 404 may include one or more I/O devices/controls 407, which may include: a controller 154 (e.g., a handheld controller, a video game type controller, a finger type control that enables finger-like movement, etc.), a touchpad, a mouse, a keyboard, a wearable device (e.g., an optical head-mounted display), a virtual or augmented reality device (e.g., a head-mounted display), a pedal (e.g., a button at the user's foot), etc. In addition, the one or more I/O components 404 may include: one or more speakers configured to output sound based on the audio signal; and/or one or more microphones configured to receive sound and generate an audio signal. In some implementations, the one or more I/O components 404 include or are implemented as a console.

In some implementations, one or more I/O components 404 can output information related to a procedure. For example, control system 150 may receive a real-time image captured by the scope and display the real-time image and/or a visual/image representation of the real-time image via display 152. Display 152 may present an interface that may include image data from a scope and/or another medical instrument. Additionally or alternatively, the control system 150 may receive signals (e.g., analog signals, digital signals, electrical signals, acoustic/sonic signals, pneumatic signals, tactile signals, hydraulic signals, etc.) from medical monitors and/or sensors associated with the patient, and the display 152 may present information regarding the health or environment of the patient. Such information may include information displayed via a medical monitor, including, for example, heart rate (e.g., ECG, HRV, etc.), blood pressure/blood rate, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., spO) ₂ )、CO ₂ Brain waves (e.g., EEG), environmental and/or local or core body temperature, etc.

In some embodiments, the control system 150 may be coupled to the robotic system 110, the table 170, or another table and/or medical instrument by one or more cables or connectors (not shown). In some implementations, the support functionality from the control system 150 may be provided through a single cable, thereby simplifying and eliminating the confusion of the operating room. In other implementations, specific functions may be coupled in separate cables and connectors. For example, while power may be provided through a single power cable, support for control, optical, fluid, and/or navigation may be provided through separate cables for control.

The robotic system 110 generally includes an elongated support structure 410 (also referred to as a "column"), a robotic system base 411, and a console 412 at the top of the column 410. The column 410 may include one or more brackets 413 (also referred to as "arm supports 413") for supporting deployment of one or more robotic arms 112. The bracket 413 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arm 112 for positioning relative to the patient. Bracket 413 also includes a bracket interface 414 that allows bracket 413 to translate vertically along post 410. The bracket interface 414 may be connected to the post 410 by a slot (such as slot 415) positioned on opposite sides of the post 410 to guide vertical translation of the bracket 413. The slot 415 may include a vertical translation interface to position and maintain the bracket 413 at various vertical heights relative to the base 411. The vertical translation of the carriage 413 allows the robotic system 110 to adjust the reach of the robotic arm 112 to meet various table heights, patient sizes, physician preferences, and the like. Similarly, the individually configurable arm mounts on the carriage 413 allow the robotic arm base 416 of the robotic arm 112 to be angled in a variety of configurations. The column 410 may internally include mechanisms (such as gears and/or motors) designed to mechanically translate the carriage 413 using vertically aligned lead screws in response to control signals generated in response to user inputs (such as inputs from an I/O device).

The base 411 may balance the weight of the column 410, the bracket 413, and/or the robotic arm 112 on a surface such as a floor. Thus, the base 411 may house heavier components, such as one or more electronics, motors, power supplies, etc., as well as components that enable the robotic system 110 to move and/or be stationary. For example, the base 411 may include reversible wheels 417 (also referred to as "casters 417" or "moving parts" 417) that allow the robotic system 110 to move within a room for a procedure. After reaching the proper position, the casters 417 may be immobilized using a wheel lock to hold the robotic system 110 in place during the procedure. As shown, the robotic system 110 also includes a handle 418 to assist in maneuvering and/or stabilizing the robotic system 110. In this example, the robotic system 110 is shown as a mobile cart-based system. However, the robotic system 110 may be implemented as a stationary system, integrated into a table top, or the like.

The robotic arm 112 may generally include a robotic arm base 416 and an end effector 419 separated by a series of links 420 (also referred to as "arm segments 420") connected by a series of joints 421. Each joint 421 may comprise an independent actuator, and each actuator may comprise an independently controllable motor. Each of the individually controllable joints 421 represents an independent degree of freedom available to the robotic arm 112. For example, each arm 112 may have seven joints, providing seven degrees of freedom. However, any number of joints may be implemented with any degree of freedom. In an example, multiple joints may produce multiple degrees of freedom, allowing for "redundant" degrees of freedom. The redundant degrees of freedom allow the robotic arms 112 to position their respective end effectors 419 at a particular position, orientation, and/or trajectory in space using different link positions and/or joint angles. In some embodiments, the end effector 419 may be configured to engage and/or control a medical instrument, device, subject, or the like. The freedom of movement of the arm 112 may allow the robotic system 110 to position and/or guide medical instruments from a desired point in space, and/or allow a physician to move the arm 112 to a clinically advantageous position away from a patient to form a passageway while avoiding arm collisions.

The end effector 419 of each of the robotic arms 112 may include an Instrument Device Manipulator (IDM). In some embodiments, the IDM may be removed and replaced with a different type of IDM. For example, a first type of IDM may steer an endoscope, a second type of IDM may steer a catheter, a third type of IDM may hold an EM field generator, and so on. However, the same IDM may also be used. In some cases, the IDM may include connectors to transfer pneumatic pressure, electrical power, electrical signals, and/or optical signals to/from the robotic arm 112. IDMs may be configured to manipulate medical devices using techniques including, for example, direct drive, harmonic drive, gear drive, belt/pulley, magnetic drive, and the like. In some embodiments, the IDMs may be attached to respective ones of the robotic arms 112, wherein the robotic arms 112 are configured to insert or withdraw respective coupled medical instruments into or from the treatment site.

In some embodiments, the robotic arm 112 may be configured to control the position, orientation, and/or articulation of a medical instrument attached thereto. For example, robotic arm 112 may be configured/configurable to be able to manipulate a scope/catheter using an elongate moving member. The elongate moving member may include one or more pull wires, cables, optical fibers, and/or flexible shafts. To illustrate, robotic arm 112 may be configured to actuate a plurality of pull wires of the scope/catheter to deflect the tip of the scope/catheter. The pull wire may comprise any suitable or desired material, such as metallic and/or non-metallic materials, such as stainless steel, kevlar (Kevlar), tungsten, carbon fiber, etc. In some embodiments, the scope/catheter is configured to exhibit non-linear behavior in response to forces applied by the elongate moving member. The non-linear behavior may be based on the stiffness and/or compressibility of the scope/catheter, as well as the variability of slack or stiffness between different elongate moving members.

As shown, the console 412 is positioned at the upper end of the column 410 of the robotic system 110. The console 412 may include a display to provide a user interface (e.g., a dual purpose device such as a touch screen) for receiving user input and/or providing output, such as to provide pre-operative data, intra-operative data, information for configuring the robotic system 110, etc. to a physician/user. Potential preoperative data may include preoperative planning, navigation and mapping data derived from preoperative Computed Tomography (CT) scans, and/or records from preoperative patient interviews. The intraoperative data may include optical information provided from the tool, sensors, and/or coordinate information from the sensors, as well as important patient statistics such as respiration, heart rate, and/or pulse. The console 412 may be positioned and tilted to allow a physician to access the console 412 from the side of the column 410 opposite the arm base 416. From this position, the physician can view the console 412, the robotic arm 112, and the patient while manipulating the console 412 from behind the robotic system 110.

The robotic system 110 may also include control circuitry 422, one or more communication interfaces 423, one or more power supply units 424, one or more input/output components 425, one or more actuators/hardware 426, and/or memory/data storage 427. The one or more communication interfaces 423 may be configured to communicate with one or more devices/sensors/systems. For example, one or more communication interfaces 423 may transmit/receive data wirelessly and/or by wire via a network.

The one or more power supply units 424 may be configured to manage and/or provide power for the robotic system 110. In some embodiments, the one or more power supply units 424 include one or more batteries, such as lithium-based batteries, lead-acid batteries, alkaline batteries, and/or other types of batteries. That is, the one or more power supply units 424 may include one or more devices and/or circuits configured to provide power and/or provide power management functionality. Further, in some embodiments, the one or more power supply units 424 include a main power connector configured to couple to an Alternating Current (AC) or Direct Current (DC) main power source. Further, in some embodiments, the one or more power supply units 424 include a connector configured to be coupled to the control system 150 to receive power from the control system 150.

The one or more I/O components/devices 425 may be configured to receive input and/or provide output, such as to interact with a user. One or more I/O components 425 may be configured to receive touch, voice, gestures, or any other type of input. In various examples, one or more I/O components 425 may be used to provide input regarding control of the device/system, such as to control/configure the robotic system 110. The one or more I/O components 425 may include one or more displays configured to display data. The one or more displays may include one or more Liquid Crystal Displays (LCDs), light Emitting Diode (LED) displays, organic LED displays, plasma displays, electronic paper displays, and/or any other type of technology. In some embodiments, the one or more displays include one or more touch screens configured to receive input and/or display data. Further, the one or more I/O components 425 may include a touch pad, controller, mouse, keyboard, wearable device (e.g., optical head mounted display), virtual or augmented reality device (e.g., head mounted display), and the like. Additionally, the one or more I/O components 425 may include: one or more speakers configured to output sound based on the audio signal; and/or one or more microphones configured to receive sound and generate an audio signal. In some embodiments, one or more I/O components 425 include or are implemented as a console 412. Further, the one or more I/O components 425 may include one or more buttons that may be physically pressed, such as buttons on the distal end of the robotic arm 112 (which may enable/disable admittance control modes of the robotic arm 112 for manual operation/movement of the robotic arm 112).

The one or more actuators/hardware 426 may be configured to facilitate movement of the robotic arm 112. Each actuator 426 may include a motor that may be implemented at a joint or elsewhere within the robotic arm 112 to facilitate movement of the joint and/or connected arm segments/links. In some implementations, the user can manually manipulate the robotic arm 112 without using electronic user controls. For example, during setup in a surgical operating room or at any point during a procedure, a user may select a button on the distal end of the robotic arm 112 to enable the admittance control mode, and then manually move the robotic arm 112 to a particular orientation/position.

The various components of the robotic system 110 may be electrically and/or communicatively coupled using some connection circuits/devices/features that may or may not be part of the control circuit 422. For example, the connection features may include one or more printed circuit boards configured to facilitate installation and/or interconnection of at least some of the various components/circuits of the robotic system 110. In some embodiments, two or more of the components of robotic system 110 may be electrically and/or communicatively coupled to each other.

As mentioned above, systems 150 and 110 may include control circuits 401 and 422, respectively, configured to perform certain functions described herein. The term "control circuit" may refer to one or more processors, processing circuits, processing modules/units, chips, dies (e.g., semiconductor die, including one or more active and/or passive devices and/or connection circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, graphics processing units, field programmable gate arrays, application specific integrated circuits, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and/or any devices that manipulate signals (analog and/or digital) based on hard coding of circuit and/or operational instructions. The control circuitry may also include one or more memory devices, which may be embodied in a single memory device, multiple memory devices, and/or embedded circuitry of the device. Such data storage devices may include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, data storage registers, and/or any device that stores digital information. It should be noted that in embodiments where the control circuitry includes a hardware state machine (and/or implements a software state machine), analog circuitry, digital circuitry, and/or logic circuitry, the data storage/registers storing any associated operational instructions may be embedded within, or external to, the circuitry comprising the state machine, analog circuitry, digital circuitry, and/or logic circuitry.

Although the control circuitry is shown as a separate component from the other components of the control system 150/robotic system 110, any or all of the other components of the control system 150/robotic system 110 may be at least partially embodied in the control circuitry. For example, the control circuitry may include various devices (active and/or passive), semiconductor materials and/or regions, layers, regions and/or portions thereof, conductors, leads, vias, connections, etc., wherein one or more other components of the control system 150/robotic system 110 and/or portions thereof may be at least partially formed and/or implemented in/by such circuit components/devices.

In addition, the memory/data storage 406/427 may be configured to store data/instructions. For example, the data storage/memory 406/427 may store instructions that are executable by the control circuitry to perform certain functions/operations. The term "memory" may refer to any suitable or desired type of computer-readable medium. For example, one or more computer-readable media may include one or more volatile data storage devices, nonvolatile data storage devices, removable data storage devices, and/or non-removable data storage devices implemented using any technology, layout, and/or data structure/protocol, including any suitable or desired computer-readable instructions, data structures, program modules, or other types of data. One or more computer-readable media that may be implemented in accordance with embodiments of the disclosure include, but are not limited to, phase change memory, static Random Access Memory (SRAM), dynamic Random Access Memory (DRAM), other types of Random Access Memory (RAM), read Only Memory (ROM), electrically Erasable Programmable Read Only Memory (EEPROM), flash memory or other memory technology, compact disc read only memory (CD-ROM), digital Versatile Disks (DVD) or other optical storage devices, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other non-transitory medium that can be used to store information for access by a computing device. As used in some contexts herein, one or more computer-readable media may not generally include communication media such as modulated data signals and carrier waves. Accordingly, one or more computer-readable media should be generally understood to refer to non-transitory media.

In some cases, the control system 150 and/or the robotic system 110 are configured to implement one or more localization techniques to determine/track the orientation/position of the object/medical instrument. For example, one or more positioning techniques may process the input data to generate position/orientation data for the medical instrument. The position/orientation data of the object/medical instrument may indicate a position/orientation of the object/medical instrument with respect to the frame of reference. The frame of reference may be a frame of reference relative to the anatomy of the patient, a known object (e.g., EM field generator, system, etc.), a coordinate system/space, etc. In some implementations, the position/orientation data may indicate a position/orientation of a distal end (and/or in some cases a proximal end) of the medical instrument. For example, the position/orientation data of the scope may indicate the position and orientation of the distal end of the scope, including the amount of eversion of the distal end of the scope. The position and orientation of an object may be referred to as the pose of the object.

Exemplary input data that may be used to generate position/orientation data for an object/medical instrument may include: sensor data from sensors associated with the medical instrument (e.g., EM field sensor data, vision/image data captured by imaging/depth/radar devices on the medical instrument, accelerometer data from accelerometers on the medical instrument, gyroscope data from gyroscopes on the medical instrument, satellite-based positioning data from satellite-based sensors (e.g., global Positioning System (GPS)), etc.); feedback data (also referred to as "kinematic data") from the robotic arm/component (e.g., data indicating how the robotic arm/component is moved/actuated); robot command data for the robotic arm/component (e.g., control signals sent to the robotic system 110/robotic arm 112 to control movement of the robotic arm 112/medical instrument); shape sensing data (which may provide information about the position/shape of the medical device) from the shape sensing fiber; model data about the patient anatomy (e.g., a model of an interior/exterior portion of the patient anatomy); patient position data (e.g., data indicating how the patient is positioned on the table); preoperative data; etc.

Fig. 5 illustrates medical system components that may be implemented in any of the medical systems discussed herein, including scope assembly/system 502 and instrument feeder assembly 504, according to one or more embodiments. Scope system 502 and/or feeder assembly 504 may include various hardware and control components. In various examples, scope system 502 may represent/include scope 130 and/or other scopes discussed herein. Further, instrument feeder assembly 504 may include instrument feeder device 180 and/or any other instrument feeder device described herein.

As shown in fig. 5, scope system 502 includes a handle/instrument base 506 coupled to an elongate shaft 508. The handle 506 may be configured to be coupled to a robotic arm for robotic manipulation and/or may be configured to be held and manually manipulated by a user (in some cases). For example, the handle 506 may be configured to control actuation of the elongate shaft 508. The elongate shaft 508 can include a rigid or flexible tube or another element. In some cases, elongate shaft 508 and/or other components of scope system 502 are sized to pass within an outer sheath, catheter, introducer, or other endoluminal device.

As shown, scope system 502 may include one or more lights 510 at least partially disposed at a distal end of elongate shaft 508 to provide light at the distal end. In various examples, scope system 502 may be configured to house optical fibers to carry light from a proximally located light source (such as a light emitting diode) to the distal end of elongate shaft 508. The distal end of the elongate shaft 508 can include a port for a light source to illuminate the anatomical space that may be useful when the imaging device/camera 512 is in use. Scope system 502 may be implemented with any number of light sources.

Scope system 502 may also include a camera/imaging device 512 configured to capture image data, such as image data representing the internal anatomy of a patient. In various examples, imaging device 512 may include optical fibers, an array of optical fibers, and/or lenses. One or more optical components of imaging device 512 may move with the tip of scope system 502 such that movement of the tip causes a change in the image captured by imaging device 512. Thus, the imaging device 512 can capture data from the distal end of the elongate shaft 508. In some embodiments, scope system 502 may house electrical wires and/or optical fibers to transmit signals to/from the optical assembly and the distal end of scope system 502.

Scope system 502 may also include a working channel 514 for deploying instruments/tools 516 and/or for other functions. Exemplary instruments 516 include a laser device configured to provide a laser, a basket device configured to capture/retrieve a subject (e.g., fragments of kidney stones), forceps configured to grasp/hold a subject, a scalpel configured to cut a subject, a lithotripter, an irrigation/aspiration device configured to provide irrigation/aspiration to a target site, and the like. In the example of fig. 5, the basket apparatus is deployed through working channel 514. Working channel 514 may extend longitudinally through scope system 502 from a proximal end to a distal end. In various examples, the working channel 514 is offset to one side of the elongate shaft 508 (e.g., offset from the longitudinal axis), such as shown in fig. 5. In other examples, working channel 514 is positioned at the center or another location of scope system 502. Although imaging device 512 is shown attached to the distal end of scope system 502 (e.g., integral to scope system 502), in some cases imaging device 512 is a separate device deployed through working channel 514. Further, although a single working channel 514 is shown, any number of working channels may be implemented.

In some cases, scope system 502 may be powered through power interface 518 and/or the basket system may be controlled through control interface 520, each or both of which may interface with the robotic arms/components of robotic system 110.

In some embodiments, scope system 502 includes a sensor 522 (sometimes referred to as a "position sensor") configured to generate sensor data and/or transmit the sensor data to another device. The sensor data may indicate a position and/or orientation of scope system 502 (e.g., a distal end thereof), and/or may be used to determine/infer a position/orientation of scope system 502. For example, sensor 522 may provide sensor data to a control system, which may then be used to determine the position and/or orientation of scope system 502. Sensor 522 may be positioned on the distal end of scope system 502 and/or at another location. In some embodiments, the sensor 522 may comprise another form/embodiment of an Electromagnetic (EM) sensor or antenna having a coil of conductive material. However, scope system 502 may include other types of sensors, such as shape sensing optical fibers, accelerometers, gyroscopes, satellite-based positioning sensors (e.g., global Positioning System (GPS) sensors), radio frequency transceivers, and the like.

Scope system 502 may be, for example, articulatable relative to at least a distal portion of the scope such that scope system 502 may be steered within the anatomy of the human body. In some embodiments, scope system 502 is configured to articulate in, for example, five degrees of freedom (DOF), including XYZ coordinate movements, as well as pitch and yaw. Furthermore, in some embodiments, scope system 502 may be articulated in six DOF, including XYZ coordinate movements, as well as pitch, yaw, and roll. In other embodiments, scope system 502 may be articulated at other DOFs. In embodiments where scope system 502 is equipped with a position sensor, the position sensor may provide position information such as 5-DOF position information (e.g., x, y, and z coordinates and pitch and yaw angles), 6-DOF position information (e.g., x, y, and z coordinates and pitch, yaw, and roll angles), and the like. In some embodiments, scope system 502 may include telescoping components, such as an inner guide portion and an outer sheath portion, that may be manipulated to telescopically extend scope system 502.

Scope system 502 may include one or more elongated moving members (not shown) configured to control movement of an elongated shaft 508, such as a distal end of scope system 502. The elongate moving member may include one or more wires (e.g., pull wires or push wires), cables, optical fibers, and/or flexible shafts. The pull wire may comprise any suitable or desired material, such as metallic and non-metallic materials, such as stainless steel, kevlar, tungsten, carbon fiber, etc. In some embodiments, scope system 502 is configured to exhibit non-linear behavior in response to forces exerted by the elongate moving member. The non-linear behavior may be based on the stiffness and/or compressibility of scope system 502, as well as the sag or stiffness variability between different elongated moving members. For robotic implementations, the robotic arm may be configured to actuate one or more pull wires coupled to scope system 502 to deflect the tip of elongate shaft 508. Alternatively, for user-held implementations, a user may provide manual input via an actuator to actuate one or more pull wires of scope system 502 to deflect the tip of elongate shaft 508.

Fig. 5 also shows an instrument feeder assembly 504 that includes an instrument feeder device 530 (sometimes referred to as an "instrument feeder 530") and an access sheath assembly 560 that may be physically coupled to the instrument feeder device 530.

Instrument feeder device 530 may include an engagement assembly 532 configured to engage and/or control at least a portion of a shaft-type instrument, such as scope 130. The engagement assembly 532 may include a channel 534 sized and/or configured for placement of at least a portion of the shaft instrument therein. For example, instruments may be at least partially nested within channel 534 when a scope or the like is placed to allow instrument feeder device 530 to drive such instruments axially. Engagement assembly 532 may also include retention features 536 to maintain the instrument within channel 534. For example, the retention feature 536 may include a robotically actuated cover that allows for selective opening or closing of the channel 534. Further, engagement assembly 532 may include an actuator device/mechanism 538 to move the shaft/instrument axially, such as when loaded with channel 534. While the various components are shown as being included within the engagement assembly 532, the engagement assembly 532 may include fewer or more components. In some cases, the instrument feeder device 530 is sensorless, such as a sensor for detecting a state of the instrument feeder device 530, while in other cases, the instrument feeder device 530 includes such a sensor.

The actuator 538 may be configured to cause movement of a shaft-type instrument placed in engagement therewith relative to an axis of the instrument. In examples, the actuator 538 includes one or more shaft engaging wheels/rollers, conveyor belts, gears, tracks, finger/needle features, or other actuators. The actuator 538 may be controlled through engagement with one or more drive inputs 540, which may allow physical engagement with mechanical components of the instrument feeder device 530 that actuate the actuator device/mechanism 538 and/or may directly actuate the actuator device/mechanism 538. In one example, the actuator 538 includes one or more feed rollers. As used herein, the term "feed roller" may include any number of rollers/wheels configured to effect axial movement of a shaft engaged therewith. The "feed roller" may also include input or output drivers associated with the instrument feeder device 530 that directly or indirectly cause movement of the roller/wheel. In some embodiments, the roller 538 may include a deformable material that provides grip, friction, traction, and/or pressure between the roller 538 and the elongate shaft 508. The deformable material may comprise silicone rubber or another material.

The instrument feeder device 530 further includes a sheath coupling member/clamp 542 that may be configured to secure or hold at least a portion of the access sheath assembly 560 in place. For example, as shown, the sheath clamp 542 may be configured to clamp over or over at least a portion of the funnel port structure 562 into the sheath assembly 560. The clamp 542 may be supported by one or more clamp support arms 544. The sheath clamp 542 may be positioned at the distal end of the instrument feeder device 530.

In some embodiments, the instrument feeder assembly 504 includes or is associated with a sample collector structure 546 that may be at least partially secured to one or more components of the instrument feeder assembly 504. The sample collector 546 may include a cup-like structure or other structure configured to allow placement or drop of kidney stones or other samples or debris retracted through the access sheath assembly 560, such as by using a basket tool deployed through the instrument shaft. In some embodiments, a sample collector 546 is disposed between the distal opening of the channel 534 and the funnel-shaped port structure 562, wherein an instrument (e.g., a basket device) can be retracted to a position over the sample collector such that stones/samples can fall or be placed in the sample collector 546.

As shown, the access sheath assembly 560 may include an access sheath tube or catheter 564 that may be physically coupled at its proximal end to the funnel port structure 562. The funnel-shaped port structure 562 may provide to an at least partially tapered introducer opening into the access sheath 564, wherein a proximal opening of the port 562 has an area or diameter that is greater than a cross-sectional area or diameter of the access sheath 564. In some embodiments, the access sheath 564 is not docked to the instrument feeder device 530, but is coupled to a robotic arm, bracket, or other structure. The access sheath 564 may include a tube or other structure through which the elongate shaft 508 may be inserted. In some embodiments, the access sheath 564 may comprise an elongated and flexible access sheath configured to be inserted into an anatomical lumen. In some embodiments, an access sheath is not used, and the elongate shaft 508 of the scope assembly 502 may be inserted directly into the patient (e.g., through a natural patient orifice or other surgical access port or incision). While certain examples described herein relate to an access sheath assembly including a port/introducer structure and a sheath component, it should be understood that embodiments of the present disclosure may implement an access sheath with an integrated port and sheath component. Thus, references herein to "access sheath" or simply "sheath" may refer to a sheath portion, a port portion, or both of an access sheath/assembly. Furthermore, the access sheath assembly described herein may be a single device, form or structure, rather than an assembly of separate components.

Fig. 6A-6G illustrate exemplary details of an instrument feeder device 530 according to one or more embodiments. In particular, fig. 6A shows a perspective view of the instrument feeder device 530, fig. 6B shows the instrument feeder device 530 with a portion of the housing removed to illustrate various features of the instrument feeder device 530, fig. 6C shows the instrument feeder device 530 with a portion of the housing and the retention feature 536 removed, and fig. 6D-6G show exemplary features/gears that may be implemented to facilitate movement of the roller 538.

As shown in fig. 6A, the instrument feeder device 530 may include a housing 602 configured to enclose/enclose (partially or completely) various internal components of the instrument feeder device 530. The housing 602 may include an upper portion 604 and a lower portion 606, wherein the lower portion 606 may be configured to attach to a robotic arm, a sterile adapter, and/or other features/components. The upper portion 604 may include a channel 534 formed therein and configured to receive an instrument shaft. Such a configuration may allow for instrument shafts to be loaded into instrument feeder apparatus 530 from the top and/or in a lateral direction. The channel 534 may be sized to receive an instrument shaft such that the channel 534 generally has a width that is greater than an outer diameter of the instrument shaft. The C-clamp support arm 544 may be part of the housing 602 or a separate component.

In some embodiments, instrument feeder device 504 may include one or more clamp/retention features 608 configured to secure an instrument shaft within channel 534. For example, a first clamp 608 (a) may be positioned at a proximal end of the channel 534 and a second clamp 608 (B) may be positioned at a distal end of the channel 534. The clamp may be configured to secure the instrument shaft without substantially restricting axial movement of the shaft through the channel 534. The inner diameter of the retention portion of the clamp 608 may generally be greater than the outer diameter of the instrument shaft. In some cases, the clamp 608 may be configured to provide tactile feedback to the user (such as by snapping through an entry portion of the clamp 608) indicating that the instrument shaft has been properly loaded into the channel 534. In some cases, the instrument shaft may exhibit a certain amount of pivoting/tilting movement about the point where the instrument shaft contacts the actuator, as the contact point may be relatively small. Accordingly, the channel 534, the clamp 608, and/or other features of the instrument feeder device 530 may help maintain the instrument shaft in the proper orientation within the instrument feeder device 504. In some cases, the channel 534 may have a length sufficient to limit/prevent misalignment of the instrument shaft.

In the example shown, the channel 534 includes an expanding or tapered portion 610 that may be positioned at a proximal end of the channel 534. In some cases, an instrument shaft (which may be relatively flexible) may form a repair loop or other excessive slack between the instrument feeder device 530 and an additional robotic arm positioned to couple to an instrument base/handle associated with the instrument shaft. The tapered portion 610 may facilitate advancement of the instrument shaft into the instrument feeder device 530 at an angle and/or with a service ring while avoiding sharp bends in the instrument shaft. For example, the tapered portion 610 may provide space for the elongate shaft to be advanced into the proximal end of the channel 534 at various angles, while the sidewall of the tapered portion 610 may provide an enlarged bend radius or smooth entry point for the instrument shaft at the region where the instrument shaft enters the instrument feeder device 530. The tapered portion 610 may also accommodate a degree of misalignment between the instrument feeder device 530 and the instrument base/handle associated with the instrument shaft. In addition, the tapered portion 610 may facilitate advancement of the shaft through the instrument feeder device 530 when the elongate shaft is axially driven.

As shown in fig. 6B and 6C, the instrument feeder device 530 may include an actuator 538 configured to drive axial movement of the instrument shaft. In this example, the actuator 538 is implemented as a feed roller; however, other types of actuators may be implemented. Rollers 538 may be positioned on opposite sides of the channel 534 such that when an instrument shaft is loaded into the instrument feeder device 530, the rollers 538 are positioned on opposite sides of the instrument shaft. Thus, roller 538 may be referred to as a counter roller. The rollers may be configured to move between a first position generally associated with an engaged state, a second position generally associated with a disengaged state, and/or other positions. For example, in the first position, rollers 538 may press onto or otherwise engage opposite sides of the instrument shaft and/or each other. In various examples, when the roller 538 is positioned in the first position, the roller 538 may be rotated to drive insertion/retraction of the instrument shaft. Further, in various examples, when the roller 538 is positioned in the second position, the roller 538 may be spaced apart from the instrument shaft and/or the channel 534. The second position may be associated with a loading instrument shaft, a roll-over shaft, or the like. Exemplary states/positions of rollers 538 and/or other features of engagement assembly 532 are discussed in further detail below.

As shown in fig. 6B, the instrument feeder device 530 may include a retention feature 536. In this example, the retention feature 536 is implemented as a cover; however, other retention features may also be implemented. Here, the cover 536 is coupled/mechanically connected to one or more other features of the instrument feeder device, such as the roller 538 (a). In various examples, the cover 536 may automatically open or close as the roller 538 (a) moves between various positions/states (e.g., engaged or disengaged states). As shown, the cover 536 may include a plate positioned over the roller 538 (a). The cover 536 may include a slot 616 or other opening to receive/engage a cam/shaft 618 that may extend from the roller 538 (a). In this example, as roller 538 (a) moves, cam 618 engages slot 616 to cause a corresponding movement of cover 536, such as opening/closing cover 536 with movement of roller 538 (a). While various examples are discussed in the context of retaining feature 536 being implemented as a cover, other features may be implemented. For example, clamp 608 may be configured to be selectively opened or closed in some cases to facilitate opening or closing of channel 534. While the illustrated embodiment utilizes a cam mechanism to open/close the sliding cover or translating the cover, other mechanisms may be used to form the operative coupling between the drive input and the cover 536. Additionally or alternatively, the cover 536 may be a pivoting cover or may be actuated to open or close by other movements.

In some embodiments, where the position of the cover 536 is mechanically coupled to the position of the roller 538 (as in the example shown), the cover 536 may be long enough so that the cover may continue to close the channel 534 even if the roller 538 is first disengaged from the instrument shaft. Then, as roller 538 continues to move away from the shaft, cover 536 may continue to move, exposing channel 534. In other embodiments, the position of the cover 536 may be controlled by different methods. For example, cover 536 need not be mechanically coupled to roller 538 (a). In some cases, the cover 536 is independently controlled and/or not mechanically connected to the roller 538 (a), in which case the full opening, closing, or any other intermediate position of the cover 536 may be controlled by another drive input and/or in another manner. That is, in some cases, the cover 536 is coupled to its own drive input.

The instrument feeder device 530 may also include one or more springs 612, which may be configured to apply a force to the roller 538. In some examples, the spring 612 may bias the roller 538 toward a particular position, such as a first position (e.g., a closed/engaged state) in which the roller 538 is engaged. Here, to move roller 538 to the second position in which roller 538 is disengaged, the drive output may provide/apply a force to overcome the force of spring 612. In examples, in addition to biasing roller 538 toward the engaged position, spring 612 may be configured to provide a compressive or frictional force to cause roller 538 to engage with the instrument shaft. Thus, the spring force may be selected such that roller 538 begins to slip on the instrument shaft under a prescribed load. By tuning the drive/spring force, the system can maintain a level of applied force that is considered or defined to be tolerable or safe for the patient. While various examples are discussed in the context of spring 612 biasing roller 538 toward a first position in which the roller is engaged, spring 612 may be configured to bias roller 538 toward a second position in which roller 538 is disengaged and/or to bias roller 538 to another position. In some cases, one or more springs 612 are part of engagement assembly 532.

In various examples, the one or more springs 612 include mechanical springs, such as torsion springs. However, other types of springs, such as coil springs or other types of springs, may also be implemented. In the case of a mechanical spring, the force of the spring 612 may be adjusted (to provide the safety features described above) by adjusting the size of the spring 612 and/or the material from which the spring 612 is made. In addition, various other parameters of the instrument feeder device 530 may be considered. For example, the material of the contact area of the roller 538 may be adjusted upward or a different coefficient of friction may be provided between the instrument shaft and the roller 538. Similarly, the coefficient of friction of the instrument shaft may be adjusted. One or more of these parameters may be configured to cause the roller 538 to slip relative to the instrument shaft to reduce or prevent the shaft from exerting excessive forces on the patient's anatomy. In some embodiments, the spring 612 may be omitted and the instrument feeder device 530 may include a virtual spring that is controlled via operation of the drive shaft or drive output to apply a force to the instrument shaft. For example, instead of or in addition to including spring 612, drive input 540 may operate in a manner that provides a function similar to a mechanical spring, thereby providing a virtual spring that may clamp against an instrument shaft.

In various examples, roller 538 is coupled to drive shaft 614 to facilitate rotation of roller 538. For example, the drive shaft 614 may be coupled to a drive input 540 of the instrument feeder device 530 to receive input from a drive output of the robotic arm to control rotation of the roller 538. The drive shaft 614 may rotate to provide corresponding rotation at the roller 538. In one illustration, drive shaft 614 (a) may be coupled to drive input 540 (a) and/or drive shaft 614 (B) may be coupled to drive input 540 (B) (as shown in fig. 7). In various examples, each of the rollers 538 may be driven independently. Roller 538 may be connected to drive input 540 and/or drive shaft 614 by a direct connection and/or by a gear assembly, belt drive system, and/or other devices/mechanisms. Although two rollers 538 and two drive shafts 614 are shown in this example, any number of rollers and/or drive shafts may be implemented. For example, a single drive shaft may be implemented to drive one or more rollers.

In examples, rollers 538 operate in a cooperative relationship such that rollers 538 move closer to each other or farther from each other in a related manner. For example, each of the rollers 538 may be coupled to a carrier plate/support plate, with two carrier plates geared together or otherwise coupled together such that rotation of one carrier plate causes opposite and corresponding rotation of the other carrier plate, as discussed in the examples of fig. 6D-6G below. In this way, rotation of the two carrier plates may be driven by a single on/off drive input, such as drive input 540 (C) (as shown in fig. 7 and elsewhere). Thus, in some cases, a single drive input may control the engagement assembly 532 of the instrument feeder device 530.

Fig. 6D illustrates a perspective view of an exemplary actuator/roller assembly 620 that may be implemented within instrument feeder device 530 to facilitate movement of rollers 538. This illustrates one example implementation of many. In the example shown, roller assembly 620 includes a right assembly and a left assembly. Each of the right and left components may include a carrier plate 622. The term "plate" may generally refer to a support structure, and the carrier plate 622 need not be considered necessarily flat or planar. Instead, the carrier plate 622 may include various shapes and/or geometries configured to support the various components of the roller assembly 620. The carrier plate 622 may also be referred to as a link or other support structure.

Generally, the carrier plate 622 supports or is connected to various other features or structures of the roller assembly 620. For example, each carrier plate 622 may support or be connected to one of the rollers 538 and one of the roller drive shafts 614. As shown in fig. 6D, each roller 538 is configured to rotate about a roller axis 626. Each roller drive shaft 614 may be configured to rotate about a drive input axis 628. As shown, the roller axis 626 and the drive input axis 628 need not be coaxial. In some examples, the roller axis 626 and the drive input shaft 628 are parallel (e.g., as shown). The carrier plate 622 may also support or be connected to a gear assembly 630 that connects the roller drive shaft 614 to the roller 538 such that rotation of the roller drive inputs 540 (a), 540 (B) may cause rotation of the roller 538, as will be described below with reference to fig. 6E and 6F.

In the example shown, the carrier plate 622 may be configured to rotate about a drive input axis 628. Rotation of carrier plate 622 about drive input axis 628 may move roller 538 between various positions. As shown in fig. 6G, instrument feeder device 530 may include a drive input 540 (C) (also referred to as an "on/off drive input 540 (C)") configured to cause roller 538 to move between various positions. The on/off drive input part 540 (C) may be connected to the on/off drive shaft 632 shown in fig. 6D. Rotation of the on/off drive input 540 (C) may cause rotation of the on/off drive shaft 632. The on/off drive input 540 (C) and the on/off drive shaft 632 are rotatable about an on/off drive axis 634. The on/off drive shaft 632 may also be connected to an off-axis protrusion 636. Thus, as the on/off drive shaft 632 rotates, the off-axis protrusion 636 also rotates about the on/off drive axis 634. However, the off-axis protrusion 636 may not be symmetrical about the opening/Guan Zhouxian 634. Thus, the off-axis protrusion 636 may provide an eccentric member that may move in an arc about the opening/Guan Zhouxian 634.

As shown in fig. 6D, the carrier plates 622 may each include a dimple/cavity 638. In the illustrated embodiment, the off-axis protrusion 636 is positioned at least partially within the recess 638 of one of the carrier plates 622. As the off-axis protrusion 636 rotates about the opening/Guan Zhouxian 634, the off-axis protrusion 636 may contact the wall of the recess 638, which may cause the carrier plate 622 to rotate about the drive input axis 628. The off-axis protrusion 636 may also be rotated to a position where it does not contact the walls of the recess 638. In this position, the force exerted by the roller 538 on the shaft of the medical device without the off-axis protrusion 636 contacting the dimple 638 may be entirely determined by the spring 612, which may be tuned to provide the desired force. In this position, the carrier plate 622 may be biased by the spring 612 to rotate to a position in which the roller 538 is in a particular position (e.g., a closed position). Rotating the off-axis protrusion 636 such that it contacts and presses against the side walls of the recess 638 may cause the carrier plate 622 to rotate, overcoming the spring force of the spring 612. In some examples, the off-axis protrusion 636 comprises a roller configured to rotate about an axis that is not coaxial with the on/off drive axis 634. Such rollers may reduce friction between the off-axis protrusions 636 and the dimples 638.

In the example of fig. 6D, the roller assembly 620 includes an on/off drive shaft 632 and an off-axis protrusion 636. In some cases, such as in this example (and as seen in fig. 6E-6G), two carrier plates 622 may be geared together such that rotation of one carrier plate 622 causes opposite and corresponding rotation of the other carrier plate 622. In this way, the rotation of the two carrier plates 622 may be driven by a single on/off drive input 540 (C). This may also allow roller 538 to be symmetrically positioned about channel 534 of instrument feeder device 530. In the example shown, both carrier plates 622 may include dimples 638, although one off-axis protrusion 636 is included, and one of the dimples 638 may be empty. The inclusion of empty pockets may facilitate manufacturing because the same or similar mold may be used for each carrier plate 622. Additionally or alternatively, a second switch off-axis protrusion or other drive member may be used to independently rotate another carrier plate, in which case the two carrier plates do not need to be geared together. Furthermore, one of the carrier plates 622 may not include dimples.

Fig. 6E and 6F illustrate isometric and top views of roller assembly 620 with roller 538 and a portion of carrier plate 622 removed to illustrate exemplary gear assembly 630 thereof. Gear assembly 630 may transfer rotational motion between drive inputs 540 (a), 540 (B) and roller 538. As shown, the gear assembly 630 may include (for each carrier plate 622) a first gear 640 (e.g., a sun gear) and a second gear 642 (e.g., a track gear). In the example shown, each first gear 640 may be connected to a roller drive shaft 614/roller drive input 540 (a), 540 (B) such that rotation of the roller drive shaft 614/roller drive input 540 (a), 540 (B) causes rotation of the first gear 640. The first gear 640 may be mounted on the carrier plate 622 such that the first gear 640 may rotate relative to the carrier plate 622. Each first gear 640 is rotatable about a respective drive input shaft 628 (shown in fig. 6D).

Each first gear 640 may be engaged with an associated second gear 642 such that rotation of the first gear 640 causes rotation of the second gear 642. The second gear 642 may be mounted on the carrier plate 622 such that the second gear 642 is rotatable relative to the carrier plate 622. The second gear 642 is rotatable about a respective roller axis 626 (shown in fig. 6D). The second gear 642 may also be attached to (or otherwise engaged with) the roller 538 such that rotation of the second gear 642 causes rotation of the roller 538. Accordingly, rotation of the roller drive inputs 540 (a), 540 (B) may cause rotation of the roller 538 by transmission of the first gear 640 and the second gear 642.

As described above, the carrier plate 622 is rotatable about the drive input shaft 628 to move the rollers 538 between various positions (e.g., a closed position and an open position). In the example shown, the second gear 642 is mounted on the carrier plate 622 at a location remote from the drive input shaft 628 and thus rotates (with the carrier plate 622) about the drive input shaft 628. As the second/orbital gear 642 rotates with the carrier plate 622 about the drive input shaft 628, the second/orbital gear also rotates about the first/sun gear 640.

This arrangement of the second/orbital gear 642 rotating about the first/sun gear 640 can be seen in the top view of fig. 6F. As shown, the off-axis protrusion 636 may be rotated such that it contacts the recess 638 of the carrier plate 622 to drive rotation of the carrier plate 622 in the direction indicated by the arrow in fig. 6F. In particular, with respect to the orientation shown in the figures, the bottom of the carrier plate 622 may rotate inward toward the center of the page and the top of the carrier plate 622 may rotate outward toward the outer edge of the page. The transmission 644 between the plates 622 may cause corresponding and opposite rotation of one carrier plate 622 as the other plate 622 moves/rotates. Each of the carrier plates 622 is rotatable about a corresponding drive input shaft 628. As the carrier plate 622 rotates, the second/orbital gear 642 is driven outwardly, thereby rotating about the sun gear 640. This arrangement may allow the roller 538 (not shown in fig. 6F, but connected to the second/track gear 642) to be driven regardless of the rotational position of the carrier plate 622. This may accommodate, for example, shafts of instruments having different diameters.

Fig. 6G illustrates a bottom view of a roller assembly 620 showing the relationship of the roller drive inputs 540 (a), 540 (B) and the on/off drive input 540 (C) of the roller assembly 620, according to an example.

Fig. 6D-6G illustrate one exemplary actuator/roller assembly 620 that may be implemented within an instrument feeder device 530. Although various features are shown in a particular arrangement, these features may be implemented in other ways and/or other features may be implemented to facilitate movement of roller 538.

Exemplary features of the instrument feeder assembly are discussed in application Ser. No. 16/994,504, entitled "Axial Motion Drive Devices, system, and Methods for a Robotic Medical System," filed 8/14/2020, the entire contents of which are incorporated herein by reference.

Fig. 7 illustrates an exploded view of an exemplary instrument device manipulator assembly 702 associated with the robotic arm 112 in accordance with one or more embodiments. The instrument device manipulator assembly 702 includes an end effector 704 associated with a distal end of the robotic arm 112. Instrument manipulator assembly 702 also includes instrument feeder 530/instrument feeder assembly 504. Instrument feeder 530/instrument feeder assembly 504 may include an electromechanical device for actuating instrument 706, such as scope 502 or other shaft-type instrument. In various examples, instrument manipulator assembly 702 may further include an adapter 708 configured to provide a driver interface between end effector 704 and instrument feeder 530/instrument feeder assembly 504. The description herein of upwardly and downwardly facing surfaces, plates, faces, components, and/or other features or structures may be understood with reference to the particular orientation of the instrument device manipulator assembly 702 shown in fig. 7. That is, while the end effector 704 may generally be capable of being configured to face and/or be oriented in a range of directions and orientations, for convenience, the description of such components herein may be made in the context of a generally vertical facing orientation of the end effector 704.

As shown, the end effector 704 of the robotic arm 112 may include components configured to connect to and/or align with the adapter 708, instrument feeder assembly 504, access sheath assembly 560, and/or instrument 706. For example, the end effector 704 may include a drive output 710 (e.g., drive spline, gear, or rotatable disk with engagement features) for controlling/actuating the medical instrument, a reader 712 (e.g., a Radio Frequency Identification (RFID) reader for reading serial numbers from the medical instrument), one or more fasteners 714 for attachment to the instrument feeder 530/instrument feeder assembly 504 and/or adapter 708, a flag 716 for alignment with an instrument manually attached to the patient (e.g., access sheath 564), and/or for defining a front surface of the device manipulator assembly 702. In some embodiments, the end effector 704 and/or the robotic arm 112 include a button 718 to enable an admittance control mode, wherein the robotic arm 112 is manually movable.

In this example, instrument device manipulator assembly 702 includes an adapter component 708 configured to provide a driver interface between end effector 704 and instrument feeder 530/instrument feeder assembly 504. In some embodiments, the adapter 708 and/or instrument feeder 530 may be removable or detachable from the robotic arm 112, and may be devoid of any electromechanical components, such as a motor. The dichotomy may be driven by: a need to sterilize medical devices used in medical procedures; and the inability to adequately sterilize expensive capital equipment due to the complex mechanical components and sensitive electronics of the expensive capital equipment. Accordingly, instrument feeder 530/instrument feeder assembly 504 and/or adapter 708 may be designed to be disassembled, removed, and interchanged from end effector 704 (and thus from the system) for separate sterilization or disposal. For example, the instrument feeder assembly 504 may be removed and replaced with a different type of instrument. Alternatively, the end effector 704 need not be changed or sterilized in some cases and may be covered (e.g., using drape 711) for protection. The adapter 708 may include a connector for transmitting pneumatic pressure, electrical power, electrical signals, and/or optical signals from the robotic arm 112 and/or end effector 704 to the instrument feeder 530/instrument feeder assembly 504. In various examples, the adapter 708 includes a coupler/drive feature 720 configured to couple a drive output 710 of the end effector 704 to a drive input 540 of the instrument feeder assembly 504. Further, in some cases, the adapter 708 may include a fastener 722 configured to couple the adapter 708 to the end effector 704.

In some configurations, a sterile drape 711 (such as a plastic sheet, etc.) may be provided between the end effector 704 and the adapter 708 to provide a sterile barrier between the robotic arm 112 and the instrument feeder assembly 504. For example, the drape 711 may be coupled to the adapter 708 in a manner that allows mechanical torque to translate from the end effector 704 to the adapter 708. The adapter 708 may generally be configured to maintain a seal around its actuation components such that the adapter 708 itself provides a sterile barrier. Using a drape 711 coupled to the adapter 708 and/or to more other components of the device manipulator assembly 702 may provide a sterile barrier between the robotic arm 112 and the surgical field, allowing use of a robotic cart associated with the arm 112 in a sterile surgical field. The end effector 704 may be configured to be coupled to various types of sterile adapters that may be loaded onto and/or removed from the end effector 704 of the robotic arm 112. With the arm 112 covered in plastic, a physician and/or other technician may interact with the arm 112 and/or other components (e.g., screen) of the robotic cart during a procedure. The covering may also prevent biohazard contamination of the device and/or minimize cleanup after the procedure.

In this example, instrument feeder 530 includes a plurality of drive inputs 540. In the illustrated embodiment, the instrument feeder 530 includes three drive inputs 540, although other numbers of drive inputs may be included. Drive inputs 540 may be located at fixed locations spaced apart along lower mating surface 724 of instrument feeder 530, which facilitates coupling drive inputs 540 to corresponding drive outputs (e.g., on sterile adapter 708 and/or end effector 704). The drive inputs 540 may be located at fixed locations spaced apart along corresponding mating surfaces designed for modular use and attachment to various other instruments. Although various examples discuss the drive input 540 being implemented at a fixed location, in some cases the drive input 540 may move within the lower surface 724. For example, drive inputs 540 (a) and 540 (B) may be repositioned within lower surface 724 to cause opposing rollers 538 to engage and/or disengage from each other and/or the instrument shaft.

The mechanical components within instrument feeder 530 may allow drive input 540 to be used to drive rotation of actuator 538 (e.g., to drive rotation of opposing rollers) for axial movement of the instrument shaft and/or to facilitate a change in the engagement of engagement assembly 532 with the instrument shaft. For example, drive inputs 540 (a) and 540 (B) may receive inputs to control actuator 538 to drive a shaft disposed in channel 534 axially. Drive inputs 540 (a) and/or 540 (B) may receive torque/force applied by the drive outputs that causes the feed roller or other actuator to axially drive the shaft-like instrument. Further, the drive input 540 (C) (also referred to as an "on/off drive input") may receive input from the drive output to control the engagement assembly 532 to engage/disengage with the instrument shaft, open/close the channel 534 (e.g., using the retention feature 536), or achieve another state, as discussed in further detail below. The various states of the engagement assembly 532 may facilitate loading or unloading of the instrument shaft, engagement with the instrument shaft, actuation of the instrument shaft, or other functions. In the example shown, three drive inputs 540 are shown; however, any number of drive inputs may be implemented. Each of the drive inputs 540 may be configured to engage with a corresponding drive output on the robotic arm 112 and/or the sterile adapter 708. For example, each drive input 540 may include a receiver configured to mate with a drive output configured as a spline. The drive input and the drive output may be configured to engage to transfer motion therebetween. Thus, the drive output may be rotated to cause corresponding rotation of the drive input 540 to control various functions of the instrument feeder 530.

References herein to "instrument device manipulator assembly," "instrument manipulator assembly," "manipulator assembly," and other variations thereof may refer to any subset of the components of assembly 702 shown in fig. 702, including a robotic arm, an end effector of the robotic arm, an adapter configured to couple to the robotic end effector, an instrument feeder configured to couple to the end effector and/or adapter, an actuator of the instrument feeder (e.g., feed rollers, shaft channels, retention features, and/or other components), and/or a device/mechanism associated with the instrument feeder. Further, it should be understood that reference herein to an "actuator" may refer to any component of the assembly 702 that directly or indirectly affects or results in movement of an instrument engaged with, coupled to, or otherwise actuatable by the instrument feeder. For example, according to embodiments disclosed herein, an "actuator" may include any set or subset of the following devices or components: feed rollers, shaft actuation wheels/rollers, feed roller channels, instrument feeder drive inputs, adapter drive outputs, adapter drive inputs, and/or end effector drive outputs.

Fig. 8-11 illustrate exemplary states/positions of the engagement assembly 532 of the instrument feeder device 530 according to one or more embodiments. Generally, the drive output may be engaged with one or more drive inputs 540 (not shown) of instrument feeder device 530 to actuate one or more components of engagement assembly 532 to cause engagement assembly 532/instrument feeder device 530 to enter a state/position. In this example, engagement assembly 532 is implemented by opposing feed roll 538, channel 534, and/or cover 536. However, feed roller 538 may be implemented as other types of actuators and/or cover 536 may be implemented as another type of retention feature. Further, one or more of the illustrated components of engagement assembly 532 may be eliminated and/or otherwise implemented. For example, in some cases, the cover 536 may not be implemented.

Fig. 8-1 and 8-2 illustrate a state in which roller 538 is engaged and cover 536 is closed. In examples, rollers 538 may apply an amount of force to each other and/or to hard stop features (not shown) when engaged, possibly due to the biasing force of one or more springs 612 (not shown), the force applied by the drive output, and/or another force applied to actuate rollers 538 toward each other. In various examples, rollers 538 may contact each other. However, rollers 538 may not contact each other, but may be within a threshold distance of each other (which may be facilitated by a hard stop feature).

In this example, the cover 536 is closed to prevent objects from entering/exiting the channel 534. As described above, in some cases, the cover 536 may be coupled to one or more of the rollers 538 such that movement of the rollers 538 causes the cover 536 to open or close. However, the cover 536 may be independently actuated. The cover 536 may have a variety of shapes and/or sizes. In this example, the cover 536 includes dimensions that substantially close/cover the channel 534 when positioned over the channel 534.

In some cases, the outer edge portions 538 (a) (1)/538 (B) (1) of the rollers 538 (a)/538 (B) may be formed of a different material than the inner portions 538 (a) (2)/538 (B) (2) of the rollers 538. For example, the outer/circumferential portions 538 (a) (1)/538 (B) (1) may include a deformable material configured to grip/contact the instrument shaft to axially drive the elongate shaft and/or avoid damaging the elongate shaft. However, the outer edge portion 538 (a) (1)/538 (B) (1) and the inner portion 538 (a) (2)/538 (B) (2) may be formed of the same material.

Fig. 9-1 and 9-2 illustrate a state in which roller 538 is engaged with instrument shaft 902 and cover 536 is closed. As shown, the rollers 538 may engage or otherwise contact opposite or opposite sides of the elongate shaft 902 positioned between the rollers 538 within the channel 534. As shown, the elongate shaft 902 is loaded into the channel 534 and inserted into the access sheath assembly 560. The rollers 538 are pressed into or otherwise engaged with the elongate shaft 902. In examples, the rollers 538 may apply an amount of force to engage the elongate shaft 902, possibly due to a biasing force of one or more springs 612 (not shown), a force applied by a drive output, and/or another force applied to actuate the rollers 538 toward each other.

In this position/state, the roller 538 may rotate to drive axial movement of the instrument shaft 902 (e.g., insert/retract the shaft 902). For example, rotating roller 538 in a first direction may result in insertion of shaft 902 (e.g., in a distal direction toward the patient), and rotating roller 538 in a second, opposite direction may result in retraction of shaft 902 (e.g., in a proximal direction away from the patient). Here, the direction of the roller 538 may refer to a movement direction of a portion of the roller 538. For example, rotation in a first direction for insertion shaft 902 may refer to rotation of the engagement portion of roller 538 in a distal direction, and rotation for retraction may refer to rotation of the engagement portion of roller 538 in a proximal direction. With respect to the view of roller 538 in fig. 9-2, left roller 538 (B) may be rotated counterclockwise while right roller 538 (a) may be rotated clockwise to rotate roller 538 in a distal direction (e.g., to insert shaft 902) and vice versa to rotate roller 538 in a proximal direction (e.g., to retract shaft 902).

In this example, the cover 536 is at least partially closed to help retain the instrument shaft 902 in the channel 534, such as to prevent the rollers 538 from ejecting the shaft 902 upward and/or subsequently out of the channel 534. In other words, the cover 536 encloses at least a portion of the channel 534 in which the instrument shaft 902 is located to prevent the shaft 902 from exiting the channel 534. However, as described above, in some cases, the cover 536 may be eliminated.

Fig. 10-1 and 10-2 illustrate a state in which roller 538 is disengaged and cover 536 is closed. Such a state/position may be an intermediate state between the closed/engaged state and the open/loaded state. As shown, the rollers 538 can be disengaged from the elongate shaft 902 or otherwise moved without contacting the elongate shaft 902. Further, the cover 536 may be closed over at least a portion of the channel 534 such that the instrument shaft 902 remains within the channel 534. In this state/position, roller 538 may disengage from instrument shaft 902, allowing shaft 902 to freely slide or roll over in channel 534.

In various examples, this position/state is for various situations where it is desirable to hold an instrument shaft during a procedure, but where it is desirable to have a greater freedom of movement of the shaft relative to the instrument feeder device 530. For example, this state/position may be used to allow the instrument shaft 902 to be flipped about its longitudinal axis, allow the robotic arm coupled to the instrument feeder apparatus 530 to be repositioned (while avoiding insertion/retraction of the shaft 902), allow the robotic arm coupled to the handle/instrument base of the shaft 902 to be repositioned (and allow the shaft 902 to freely slide within the channel 534), and/or allow other functions to be performed without engaging the shaft 902. In some cases, the robotic arm may move while operating in admittance/manual mode. However, the robotic arm movement may be controlled based on control signals or other inputs.

In one illustration, the robotic arm coupled to the instrument feeder device 530 may be moved during a procedure (or at other times) to adjust the position/placement of an access sheath coupled to the robotic arm. The access sheath may be at least partially disposed within the patient and used to insert a medical device into the patient. To remain within the instrument feeder device 530, the instrument feeder device 530 may achieve this intermediate state to allow the elongate shaft 610 to move freely within the instrument feeder device 530 while repositioning the robotic arm coupled to the instrument feeder device. In examples, an admittance control mode is used to move the robotic arm; however, the robotic arm may move in other ways.

Fig. 11-1 and 11-2 show a state in which the roller 538 is disengaged and the cover 536 is opened. Such a state/position may be referred to as a fully open/disengaged or loaded state. As shown, the rollers 538 may be disengaged from the elongate shaft 902 or otherwise moved without contacting the elongate shaft 902 and the cover 536 is fully open to allow access to the channel 534. Although rollers 538 are shown as being positioned farther from each other than the intermediate state of fig. 10-1 and 10-2, rollers 538 may be positioned in the same position as fig. 10-1 and 10-2 and/or another disengaged position. The cover 536 may be opened or otherwise repositioned to provide access to the channel 534 (e.g., from above). In the example shown, the cover 536 is positioned entirely below the upper housing 604. However, the cover 536 may be positioned in other locations that may be at least partially within the channel 534, but may otherwise allow for loading or unloading of the instrument shaft 902 from the channel 534.

In various examples, the open/fully disengaged state may facilitate loading or unloading of the instrument shaft 902 into the instrument feeder device 530, which may simplify use of the device and/or reduce operating time. For example, the open channel may facilitate loading and/or unloading of the instrument shaft 902 before, during, or after a medical procedure. In one illustration, the fully open/disengaged state may allow a user to manually adjust the shaft 902 and/or associated medical device without fully retracting the shaft 902 from the patient.

Fig. 12 and 13 illustrate an exemplary state of the engagement assembly 532 and various details regarding the exemplary drive output 1202 for the state of the engagement assembly 532 in accordance with one or more embodiments. Specifically, fig. 12 illustrates a state 1204 in which the engagement assembly 532 of the instrument shaft is not disposed/stowed (within block 1206), while fig. 13 illustrates a state 1204 in which the engagement assembly 532 of the instrument shaft is disposed/stowed. These figures illustrate some of the many exemplary states of the engagement assembly 532 discussed herein. While various states are shown, any number of states may be implemented, such as to transition between the states shown and/or to implement other states not explicitly shown.

In fig. 12 and 13, the images within box 1208 illustrate exemplary positions (e.g., rotation angles) of the drive output 1202 that are associated with the end effector 1210 of the robotic arm. Here, the end effector 1210 is coupled to an instrument feeder device 530, which is shown separate from the end effector 1210 for purposes of illustration. In these examples, drive output 1202 rotates to achieve various states 1204 of engagement assembly 532. For ease of illustration, the drive output 1202 is shown as a gear (which includes indicia to show the rotational position of the gear); however, the drive output 1202 may be implemented in other ways. The illustrated positions of the drive outputs 1202 indicate relative positions to each other and may not indicate the actual amount of rotation of the drive outputs 1202 in order to facilitate a particular state of the engagement assembly 532. For example, the drive output 1202 may be rotated any number of times to facilitate a particular position.

In some examples, the drive output 1202 is configured to apply different amounts of force to the drive input 540 of the engagement assembly 532 to facilitate different states 1204. Graphs 1212 and 1312 in fig. 12 and 13, respectively, illustrate exemplary forces that the drive output 1202 may apply/experience relative to the position of the drive output 1202. The applied force may be linear (e.g., solid line) or non-linear (e.g., dashed line). The lines in these graphs are provided for illustration purposes and may not reflect the actual force applied by the drive output 1202. Although in this example a different force is applied to control the state of the engagement assembly 532, in other examples the engagement assembly 532 may be controlled in other ways.

In these examples, engagement assembly 532 may generally be configured to be biased toward the engaged/closed state. Such biasing may be facilitated by one or more springs 612 (not shown) and/or other devices/mechanisms, as discussed herein. A representation 1214 of the one or more springs 612 is provided within the block 1206 to indicate an amount of compression and/or force applied by the one or more springs 612 and/or other components of the instrument feeder apparatus 530. It should be appreciated that this representation 1214 is provided for illustrative purposes only and should not be used to limit the features of the instrument feeder apparatus 530 (including the one or more springs 612). In various examples, engagement assembly 532 may be positioned in an engaged state when instrument feeder device 530 is not attached to a robotic arm, less than a threshold amount of force is applied to drive input 540, or the like. Thus, the drive output 1202 may generally be configured to apply a force (e.g., torque) to the drive input 540 to actuate the engagement assembly 532 toward the open/disengaged state.

Although some examples discuss the instrument feeder device 530 as being configured to be biased toward an engaged state, the instrument feeder device 530 may be implemented in other ways. For example, the engagement assembly 532 may be configured to be biased toward the disengaged/open state by using springs in different configurations and/or implementing other features. Further, in some cases, engagement assembly 532 may not be configured to be biased toward any state. Here, the engagement assembly 532 may be configured to remain in any state even when the instrument feeder device 530 is decoupled from the robotic arm.

Fig. 12 illustrates an exemplary state 1204 of engagement assembly 532 when an instrument shaft is not disposed/stowed within engagement assembly 532. As shown at 1218, the states from 1204 (1) to 1204 (3) are generally associated with a disengaged state in which roller 538 is disengaged, while states 1204 (3) -1204 (5) are generally associated with an engaged state in which roller 538 is engaged. The engaged state may refer to rollers 538 contacting each other, being disposed at a hard stop position (which may be facilitated by hard stop features on instrument feeder apparatus 530 that prevent rollers 538 from contacting each other), being disposed within a predetermined distance from each other, being disposed within a predetermined distance from the axis/region, etc. In contrast, the disengaged state may refer to rollers 538 not contacting each other, not contacting an instrument shaft, not disposed at a hard stop position, positioned more than a predetermined distance from each other, positioned more than a predetermined distance from an axis/region, etc. Further, the cover 538 may be implemented to facilitate an open or closed state. For example, the cover 538 may be in an open/partially open state from 1204 (1) to 1204 (2) and a closed state from 1204 (2) -1204 (5). Block 1218 is provided for purposes of illustration and the states of these elements may differ from the depicted states. For example, transitions between different states (e.g., engagement to disengagement and/or lid opening to lid closing) may occur at different points than those depicted.

In fig. 12, states 1204 (1) -1204 (5) are associated with rotational positions 1202 (a) -1202 (E) and applied forces 1216 (a) -1216 (E), respectively. For example, state 1204 (2) may be achieved when drive output 1202 is positioned at rotational position 1202 (B) and/or a certain amount of force 1216 (B) is applied. In some cases, positions 1202 (a) and/or 1202 (E) are associated with hard stop positions facilitated by hard stop features on instrument feeder device 530. The hard stop position may be detected based on a change in the force applied by the drive output 1202 (e.g., a surge in the applied force). In some cases, locations 1202 (a) and/or 1202 (E) are used as reference locations.

The exemplary state 1204 is shown as having a free floating region in which the engagement assembly 532 remains in an engaged state for various rotational positions of the drive output 1202 (e.g., positions 1202 (C) -1202 (E)). This may be implemented to provide an amount of play/backlash between the components of the instrument feeder device 530, which may be facilitated by hard stop features and/or other features in the instrument feeder device 530. However, in other examples, no free floating region is implemented and/or fewer engaged states are implemented.

In the example of fig. 12, to transition the engagement assembly 532 from the engaged state to the disengaged state, the drive output 1202 may rotate and/or apply a certain amount of force. For example, as the drive output 1202 rotates from position 1202 (D) in a clockwise manner and reaches rotational position 1202 (C), the one or more springs 612 of the instrument feeder apparatus 530 may begin to exert a force back onto the drive output 1202 such that more than a threshold amount of force 1220 (as shown in graph 1212) is required to cause the engagement assembly 532 to transition to the disengaged state. Such a change in force at location 1202 (C) may be detected (e.g., as a force surge). In some cases, position 1202 (C) is used as a reference position. In this example, where the instrument shaft is not loaded, state 1204 (3) is generally associated with a transition from the engaged state to the disengaged state.

As shown in fig. 12, drive output 1202 may continue to rotate and/or apply additional force in a clockwise manner to cause engagement assembly 532 to reach state 1204 (2). For example, when the drive output 1202 rotates in a clockwise manner, the distance between the rollers 538 increases and/or the cover 536 begins to move/open. The one or more springs 610 may compress to require the drive output 1202 to increase the amount of force (e.g., torque) applied to reach the state 1204 (2). In state 1204 (2), rollers 538 are disengaged (e.g., separated from one another by a certain distance) and cover 536 remains closed over channel 534 even though cover 536 may have begun to open. State 1204 (2) may be referred to as an intermediate state between the closed/engaged state and the fully open/loaded state. Further, the drive output 1202 may continue to rotate in a clockwise manner to reach state 1204 (1), wherein the rollers 538 are disengaged (e.g., separated from one another more) and the cover 536 is fully open.

Although an increased amount of force (e.g., torque) is required in this example to transition the engagement assembly 532 from state 1204 (3) to state 1204 (1) (as shown in graph 1212), such transition may be accomplished in other ways, such as by applying a reduced amount of force, a constant amount of force, and merely changing the rotational position of the drive output 1202, etc. Further, while this example discusses rotating in a clockwise manner to transition from an engaged state to a disengaged state, the drive output 1202 may rotate counter-clockwise or otherwise.

Fig. 13 illustrates an exemplary state 1204 of engagement assembly 532 when an instrument shaft is disposed/loaded within engagement assembly 532. Here, the engagement assembly 532 may transition between at least some of the states 1204 at different rotational positions of the drive output 1202. Specifically, as the instrument shaft is loaded into the engagement assembly 532, the point at which the one or more springs 612 begin to exert a force on the drive output 1202 is moved (e.g., to the left in the figure). As shown, when the drive output 1202 is rotated to position 1202 (C) (1), the engagement assembly 532 now transitions from the engaged state to the disengaged state. When the drive output 1202 applies a force 1318 exceeding a threshold amount, the engagement assembly 532 may begin transitioning from the engaged state 1204 (3) (a), as shown in graph 1312. Further, in this example, the free floating region has been displaced such that the end of the region is associated with the rotational position 1202 (E) (1) and the engaged state 1204 (5) (a) of the drive output 1202. In some cases, this may occur due to rotational displacement or displacement of components of the engagement assembly 532 that facilitates a hard stop position. For example, rotational position 1202 (E) (1) may be associated with a hard stop feature of instrument feeder device 530. However, in other examples, the free floating region may extend farther to enable the drive output 1202 to reach the previous rotational position 1202 (E). Further, the free floating region may extend to include other rotational positions of the drive output 1202 and/or be otherwise implemented.

While various examples are discussed in the context of determining the status of the instrument feeder device based on the force applied by the drive output and/or the position of the drive output, the status of the instrument feeder device may additionally or alternatively be determined based on other information. For example, the instrument feeder device may include/be on one or more sensors for/on the roller, cover, channel, and/or other component configured to detect proximity, pressure, and/or another characteristic. In one illustration, a sensor may be implemented on the rollers and/or another component surrounding the rollers to determine the proximity of the rollers to each other and/or the instrument shaft. Further, the drive input of the instrument feeder device may include a sensor/feature for detecting the rotational position of the drive input, which sensor/feature may be used to determine the status of the instrument feeder device. Further, a sensor may be implemented on the lid to detect when the lid is open, partially open or closed. Additionally or alternatively, the elongate shaft of the medical device may include a sensor configured to detect pressure/proximity, such as pressure applied by a roller of the engagement assembly. In some cases, the instrument feeder device may not implement a spring to bias the roller to a particular state (e.g., clamp down on the instrument shaft). Here, the state of the instrument feeder device may be based on the position of the drive output and/or the force applied by the drive output (which may include detecting a fully engaged state based on a surge in force due to contact with the instrument shaft). In some cases where a spring is not implemented, the drive output may apply a certain amount of force to fully engage/grip the instrument shaft.

In some examples, the instrument feeder device may be implemented with a first drive input configured to control engagement of the rollers (e.g., distance between the rollers) and a second drive input configured to control actuation of the cover (e.g., opening or closing the cover). Thus, separate drive outputs may be implemented to control different states of the engagement assembly, wherein the state of the rollers may be controlled independently of the state of the cover. Further, in some examples, a condition of a first component (e.g., a roller or a cover) may be manually controlled and detected by a sensor, wherein such detected condition may result in a second component (e.g., a cover or a roller) being controlled to facilitate a particular condition of the engagement assembly.

Fig. 14-18 illustrate exemplary flowcharts of processes 1400, 1500, 1600, 1700, and 1800, respectively, for performing the various techniques discussed herein. The various operations/actions associated with processes 1400, 1500, 1600, 1700, and 1800 may be performed by control circuitry implemented in any one or combination of the devices/systems discussed herein, such as control system 150, robotic system 110, tabletop 170, medical instrument, instrument feeder device, and/or another device. While various blocks are shown as part of processes 1400, 1500, 1600, 1700, and 1800, any of such blocks may be eliminated. Further, additional blocks may be implemented as part of processes 1400, 1500, 1600, 1700, and/or 1800. The order in which the blocks are shown is provided for illustration purposes only and the blocks may be implemented in any order. In some embodiments, one or more of the various blocks of processes 1400, 1500, 1600, 1700, and/or 1800 are implemented as executable instructions that, when executed by control circuitry, cause the control circuitry to perform the functionality/operations discussed. However, one or more of the various blocks of processes 1400, 1500, 1600, 1700, and/or 1800 may be implemented in other manners, such as by other devices/systems, users, etc.

Fig. 14 illustrates an example process 1400 for determining a state of an engagement assembly of an instrument feeder device in accordance with one or more embodiments.

At block 1402, process 1400 may include detecting one or more events. For example, the control circuitry may detect one or more events associated with an instrument feeder device, a medical instrument, a robotic system, and/or another device/component of a medical system configured to perform a medical procedure. To illustrate, the control circuitry may detect a coupling of the instrument feeder device to a robotic arm of the robotic system (e.g., based on sensor data from the robotic arm/instrument feeder device), a coupling/decoupling of an instrument base of the medical instrument to the robotic arm (e.g., based on sensor data from the robotic arm/medical instrument base), a predetermined period of time that the coupling of the instrument base to the robotic arm has elapsed, a request/instruction to flip the elongate shaft (e.g., based on user input, system determination, etc.), a request/instruction to enable/disable manual movement of the robotic arm (e.g., enable admittance control mode), and so forth.

As discussed herein, a medical system may include a robotic system having one or more robotic arms configured to be coupled to a medical instrument, an instrument feeder device, and/or another device/component. For example, the robotic system may include a first robotic arm having an end effector configured to be coupled to an instrument feeder device (which may be engaged with an elongate shaft of a medical instrument) and a second robotic arm configured to be coupled to an instrument base of the medical instrument. The first robotic arm may include one or more drive outputs configured to couple to and/or actuate one or more drive inputs of the instrument feeder device. For example, the first drive output may be configured to actuate a first drive input of the instrument feeder device to control engagement of the instrument feeder with the elongate shaft of the medical instrument, while the second drive output may be configured to actuate a second drive input of the instrument feeder device to axially move the elongate shaft.

Further, the instrument feeder device can include an engagement assembly configured to receive and/or engage an elongate shaft of a medical instrument. The engagement assembly may include an actuator configured to axially move the elongate shaft, a channel configured to receive the elongate shaft, and/or a retaining feature configured to selectively open or close the channel. In some examples, the instrument feeder device is configured to bias the actuator into an engaged state or a disengaged state.

At block 1404, process 1400 may include causing the first drive output to actuate an engagement assembly of the instrument feeder device. For example, the control circuit may cause actuation of a first drive output that causes the robotic arm, thereby causing actuation of a first drive input associated with the engagement assembly of the instrument feeder device. The first drive input may be configured to control an engaged state of the engagement assembly.

In some examples, the control circuit causes actuation of the first drive output based on detection of one or more events at block 1402. This may intelligently/automatically control the engagement assembly, such as without requiring user interaction with the engagement assembly. In some cases, the control circuitry may control the engagement assembly to actuate from the engaged state to the fully open/disengaged state upon detecting that the associated instrument feeder apparatus is loaded onto/coupled to the robotic arm (such as during setup of a procedure). This may allow a user to load a shaft of a medical instrument into the engagement assembly.

Further, in some cases, the control circuitry may control the engagement assembly to actuate from the disengaged state (e.g., the fully open state) toward the engaged state upon detecting that an instrument base of the medical instrument is coupled to the robotic arm and/or after a predetermined period of time has elapsed since detecting that the instrument base is coupled to the robotic arm. For example, a user may first load an instrument shaft into an instrument feeder device coupled to a first robotic arm and then couple an instrument base to a second robotic arm. However, the user may couple/load the components of the medical device in any order. Here, the control circuit may engage with the medical instrument to begin driving the medical instrument by transitioning the instrument feeder device to the engaged state after detecting that the instrument base is coupled to the second robotic arm.

Further, in some cases, the control circuitry may control the engagement assembly to actuate from the engaged state to the disengaged/intermediate state upon determining to invert the elongate shaft of the medical instrument and/or determining to enable an admittance control mode of the robotic arm. For example, a user may provide an input to flip the shaft or enable an admittance control mode of a robotic arm coupled to the instrument feeder apparatus and/or a robotic arm coupled to the instrument base. Admittance control modes may be used to adjust the position of the robotic arm for various purposes. In response to the rollover/admittance control detection, the control circuitry may cause the engagement assembly to transition from the engaged state to an intermediate state in which the cover is substantially closed and the roller is disengaged from the shaft. This may allow the engagement assembly to retain the shaft without restricting movement of the shaft. When the flipping is complete and/or the admittance control mode is disabled, the control circuitry may cause the engagement assembly to return to the engaged state.

Further, in some cases, the control circuitry may control the engagement assembly to actuate from the engaged state to the disengaged state upon determining that the instrument base is decoupled from the robotic arm. For example, a user may decouple the instrument base from the robotic arm and/or facilitate manual actuation of the medical instrument upon completion of a procedure. Here, the control circuit may detect removal of the instrument base from the robotic arm and control the engagement assembly to actuate to the fully open state, wherein the shaft may be removed from the engagement assembly.

Although various illustrations are provided, the control circuitry may cause the first drive output to actuate in other scenarios, such as to transition the engagement assembly between any states, to transition the engagement assembly toward a state without changing states, to transition the engagement assembly to a hard stop position (e.g., when coupling the instrument feeder device to the robotic arm), and so forth. Thus, the control circuit may cause the first drive output to actuate for a variety of purposes.

In various examples, the control circuitry may detect that an instrument/device is coupled to/decoupled from the robotic arm based on data from sensors of the end effector, instrument feeder device, medical instrument base, instrument shaft, etc. Such sensors may include proximity sensors, magnetic sensors, and the like. For example, the instrument feeder device/instrument base may include a magnet, a Radio Frequency Identification (RFID) tag, a quick response/bar code, and/or another element, and the end effector of the robotic arm may include a sensor/device configured to detect such element, such as when the instrument feeder device/instrument base is placed in proximity to the end effector.

At block 1406, process 1400 may include determining a magnitude of a force applied by the first drive output and/or a position of the first drive output. For example, the control circuit may determine the magnitude of the force applied by the first drive output and/or the position of the first drive output based on readings/information from one or more sensors (e.g., force/torque sensors for the first drive output), one or more signals generated/sent to control the first drive output, etc. In some cases, the magnitude of the force applied by the first drive output represents a net resultant force that accounts for the amount of force (e.g., torque) applied by the motor/mechanism driving the first drive output and/or the magnitude of the feedback force applied by the drive input of the instrument feeder device (e.g., which may be caused by one or more springs biasing the engagement assembly). Further, in some cases, the position of the first drive output may include a rotational position of the first drive output, which rotational position may include/indicate any number of revolutions/number of turns of the first drive output.

At block 1408, the process 1400 may include determining a state of the engagement assembly based on the magnitude of the force applied by the first drive output and/or the position of the first drive output. For example, the control circuit may determine whether the magnitude of the force applied by the first drive output is above/below one or more thresholds, within a range of predetermined forces, and the like. Thus, in some cases, the control circuit may compare the magnitude of the force applied by the first drive output to one or more thresholds. Further, the control circuit may compare the position of the first drive output to one or more predetermined/reference positions, ranges of positions, etc. in addition, the control circuit may compare the position of the first drive output to one or more predetermined/reference positions. The state of the engagement assembly may indicate whether the engagement assembly is engaged/disengaged, whether the retention feature of the engagement assembly is open/closed (or partially open/closed), whether the elongate shaft of the medical device is received/properly received in the engagement assembly, etc.

In one illustration, the control circuit may determine that the engagement assembly is associated with an engaged state (e.g., a fully engaged state) when the magnitude of the force applied by the first drive output is less than a first threshold. Exemplary engagement states are shown in fig. 8-1 through 8-2 and fig. 9-1 through 9-2. Further, the control circuit may determine that the engagement assembly is associated with a first disengaged state (e.g., an intermediate state) when the magnitude of the force applied by the first drive output is greater than a first threshold and less than a second threshold. The first disengaged state may be a state in which the actuator of the engagement assembly is disengaged from the elongate shaft and the retention feature of the engagement assembly is substantially closed to retain the elongate shaft, such as the engaged state shown in fig. 10-1 and 10-2. Further, the control circuit may determine that the engagement assembly is associated with a second disengaged state (e.g., a fully open state) when the magnitude of the force applied by the first drive output is greater than a second threshold. Examples of such disengaged states are shown in fig. 11-1 and 11-2.

In another illustration, the control circuit may determine a reference position associated with a force change (e.g., a surge in force applied by the first drive output) that exceeds a threshold amount. For example, when the instrument feeder device is first coupled to the robotic arm, the control circuit may actuate the first drive output to and/or in a direction toward the hard stop position. The control circuit may detect a surge in force applied by the first drive output during such actuation and designate a position of the first drive output at the time of the surge in force as a reference position (e.g., a transition position between an engaged state and a disengaged state, a hard stop position of the engagement assembly, or another position/state). Thereafter, the control circuit may determine the state of the engagement assembly based on the proximity of the current position of the first drive output to the reference position (e.g., the proximity of the current rotational position relative to the reference rotational position).

In other illustrations, the control circuit may otherwise determine the state of the engagement assembly based on the force applied by the first drive output and/or the position of the first drive output.

At block 1410, the process 1400 can include causing actuation of the second drive output to axially move the elongate shaft. For example, when the engagement assembly is positioned in an engaged state (e.g., ready for driving), the control circuitry may control a second drive output of the robotic arm to cause actuation of a second drive input of the engagement assembly, wherein the second drive input may be configured to control axial movement of the elongate shaft. Thus, the second drive output may cause the elongate shaft to move axially (e.g., to be inserted or retracted). In various examples, the second drive output may be controlled based on a signal from the I/O device to insert/retract the elongate shaft, a system determination to insert/retract the elongate shaft (e.g., without receiving user input), and so forth.

Fig. 15 illustrates an example process 1500 for determining whether an elongate shaft of a medical instrument is loaded/properly loaded into an instrument feeder device in accordance with one or more embodiments.

At block 1502, the process 1500 may include causing the drive output to actuate the engagement assembly from an engaged state in which the actuator is engaged to a disengaged state in which the actuator is disengaged. For example, the control circuitry may cause actuation (e.g., rotation) of a drive output of the robotic arm to cause actuation (e.g., rotation) of an associated drive input of an engagement assembly of an instrument feeder device coupled to the robotic arm. Actuation of the drive input may cause the engagement assembly to change from an engaged state (which may be a default state of the instrument feeder device) to a disengaged state. In some examples, the engagement assembly may transition to a fully disengaged/open state, such as shown in fig. 11-1 and 11-2. The fully disengaged/open state may allow the instrument shaft to be loaded into the engagement assembly.

At block 1504, the process 1500 may include determining a first position of the drive output that is associated with a first change in a force (e.g., torque) applied by the drive output that occurs when moving the engagement assembly from the engaged state to the disengaged state. For example, the control circuit may monitor the amount of force applied by the drive output when transitioning the engagement assembly from the engaged state to the disengaged state. When the drive output experiences/applies a change in force that exceeds a threshold amount to move the drive output by a particular amount (e.g., a threshold increase/decrease in force for a predetermined amount of rotation), the control circuit may identify the position of the drive output at that point (also referred to as the "initial position of force change" or "reference position"). In one illustration, in the context of fig. 12, the control circuit can transition the engagement assembly 532 from the engaged state 1204 (4) to the disengaged state 1204 (1) and detect a change in the force applied by the drive output 1202 at location 1202 (C), where such change is greater than a threshold value.

At block 1506, the process 1500 may include causing the drive output to actuate the engagement assembly from the disengaged state toward the engaged state. For example, the control circuit may cause the drive output to actuate the engagement assembly from the fully disengaged/open state toward the engaged state. In some examples, this may occur after a predetermined period of time has elapsed since performing operation 1502/1504, upon detecting that an instrument base of a medical instrument is coupled to a robotic arm (e.g., a second robotic arm), after a predetermined period of time has elapsed since coupling the instrument base to the robotic arm (which may be based on starting a timer when coupling occurs), and/or upon detecting another event. In one illustration, operation 1506 may be performed to attempt to engage the engagement assembly with the elongate shaft of the medical device, such as upon determining/inferring that the elongate shaft has been loaded into the engagement assembly.

At block 1508, the process 1500 may include determining a second position of the drive output that is associated with a second change in force. In one example, the engagement assembly may transition from a fully disengaged/open state to an engaged state (e.g., block 1506). Once engagement is complete, the engagement assembly may be moved in a direction back to the disengaged state, and the control circuit may monitor the amount of force applied by the drive output. This may include moving a relatively small amount (e.g., less than a certain amount) in the disengagement direction. When the drive output experiences/applies a change in force that exceeds a threshold amount to move the drive output by a particular amount (e.g., a threshold increase/decrease in force for a predetermined amount of rotation), the control circuit may identify the position of the drive output at that point (also referred to as a "secondary position of force change"). The threshold amount of force change may be greater than the threshold mentioned above for block 1504 and/or another threshold. Thus, the secondary position of the force variation can be identified by detecting the variation of the force (contact force) in the disengagement direction. However, in other examples, the secondary location of the force change may be detected in other ways, such as by detecting a change in force (contact force) in the engagement direction (e.g., losing contact when transitioning to the engaged state). In some cases, the engagement assembly may enter the free-floating region once the secondary location of the force change is identified.

At block 1510, the process 1500 may include identifying a third position of the drive output that is associated with a state in which the hold feature begins to open. For example, the control circuit can identify a position of the drive output that is associated with an intermediate state in which the cover of the engagement assembly is closed (but begins to open) and the roller is disengaged from the elongate shaft. In some cases, such a position may be a predetermined position defined/referenced relative to another position of the drive output, such as a position associated with a fully disengaged/open state, a position associated with an engaged state, a reference position, and/or another position. In one illustration, in the context of fig. 12, the control circuit can identify the position 1202 (B) (where the cover 536 transitions between the closed and open states) based on knowing that the position 1202 (B) is a predetermined degree of rotation from the position 1202 (a)/1202 (C) and/or another position (e.g., any reference position that can be detected based on a change in force).

At block 1512, the process 1500 may determine whether the elongate shaft of the medical device is received and/or properly received in the engagement assembly. For example, the control circuitry can determine whether the elongate shaft is loaded into the channel of the engagement assembly and/or whether the elongate shaft is properly loaded into the channel. Such determination may be based on the position of the second position (i.e., the secondary position of the force variation) relative to the first position and the third position (e.g., the secondary position of the force variation between the first position and the third position).

In one illustration, in the context of fig. 12, it may be assumed that the instrument shaft is not loaded into the engagement assembly 532. For example, the engagement assembly 532 may be transitioned (at block 1502) to a fully open/disengaged state to facilitate loading of the instrument shaft into the engagement assembly 532, but the instrument shaft is not loaded. The control circuit may detect (at block 1504) the position 1202 (C) as the initial position of the force change. Here, the control circuit may transition (at block 1506) the engagement assembly 532 from the fully open/disengaged state 1204 (1) toward the engaged state 1204 (3) and detect (at block 1508) a change in the force applied by the drive output 1202 at the location 1202 (C) (i.e., the secondary location of the force change). At block 1512, the control circuitry may determine that the instrument shaft is not loaded into the engagement assembly 532 based on the secondary position of the force change (1202 (C)) being the same as the initial position of the force change (1202 (C)). The control circuit determines the same position for both cases of force variation. In a similar manner, the control circuit may determine that the instrument shaft is unloaded when the secondary location of the force change is closer to location 1202 (E) (e.g., the secondary location of the force change is between location 1202 (C) and location 1202 (E)).

In another illustration, in the context of fig. 13, it may be assumed that the instrument shaft is properly loaded into the engagement assembly 532. For example, the engagement assembly 532 may be transitioned (at block 1502) to a fully open/disengaged state and the instrument shaft loaded by the user. When transitioning to the fully open/disengaged state, the control circuit may determine (at block 1504) position 1202 (C) as the initial position for the force change. Further, the control circuit may transition (at block 1506) the engagement assembly 532 from the fully open/disengaged state 1204 (1) toward the engaged state 1204 (3) and may detect (at block 1508) a change in the force applied by the drive output 1202 at the location 1202 (C) (1) (i.e., the secondary location of the force change). The control circuitry may identify (at block 1510) the location 1202 (B) as a third location (i.e., an intermediate location). At block 1512, the control circuitry may determine that the instrument shaft is properly loaded into the engagement assembly 532 based on the secondary position (1202 (C) (1)) of the force change being between the initial position (1202 (C)) and the intermediate position (1202 (B)) of the force change (relative to rotation).

In further illustration, it may be assumed that the instrument shaft is improperly loaded into engagement assembly 532, such as by positioning the instrument shaft partially within channel 534 in a manner that prevents cover 536 from being fully closed. For example, the engagement assembly 532 may be transitioned (at block 1502) to a fully open/disengaged state, and the instrument shaft positioned at a top portion of the channel 534. The control circuit may determine (at block 1504) the position 1202 (C) as the initial position of the force change. Further, the control circuit may transition (at block 1506) the engagement assembly 532 from the fully open/disengaged state 1204 (1) toward the engaged state 1204 (3) and detect (at block 1508) a change in force applied by the drive output 1202 at a position (i.e., a secondary position of force change) prior to the position 1202 (B), which may occur due to improper loading of the instrument shaft. The control circuitry may identify (at block 1510) the location 1202 (B) as a third location (i.e., an intermediate location). At block 1512, the control circuitry may determine that the instrument shaft is improperly loaded into the engagement assembly 532 based on the secondary position of the force change being located before the intermediate position (1202 (B)).

In yet another example, it may be determined that the instrument shaft is improperly loaded when the second position of force change is after/past the initial position of force change.

In any event, if it is determined at 1512 that the elongate shaft is received/properly received in the engagement assembly, the process 1500 may proceed to block 1514 (i.e., the "yes" branch). Alternatively, if it is determined that the elongate shaft is not received/properly received in the engagement assembly, the process 1500 may proceed to block 1516 (i.e., the "no" branch).

At block 1514, the process 1500 may include causing the drive output to actuate/actuate the engagement assembly toward the engaged state to actuate and/or drive the elongate shaft. For example, the control circuit may cause the drive output to actuate the engagement assembly to the engaged state, wherein the control circuit may drive the elongate shaft/medical instrument, wherein the elongate shaft is properly loaded in the engagement assembly. In one illustration, in the context of fig. 13, the control circuitry can cause the engagement assembly 532 to transition to state 1204 (4) and then drive/control the medical device (e.g., receive input from a user to insert/retract the elongate shaft and control the elongate shaft to insert/retract).

At block 1516, the process 1500 may include causing the drive output to actuate the engagement assembly to the disengaged state. For example, the control circuitry may cause the drive output to actuate the engagement assembly to a fully open/disengaged state to facilitate loading/reloading of the elongate shaft of the medical instrument. In one illustration, in the context of fig. 12, the control circuitry may cause the engagement component 532 to transition to state 1204 (1).

At block 1518, the process 1500 may include generating a signal indicating that the elongate shaft is not received/properly received in the channel. For example, the control circuitry may generate a signal (e.g., a fault/error signal) indicating that the elongate shaft is not loaded/properly loaded in the engagement assembly and/or send the signal to another component/device for additional processing. In some cases, the signal may cause a notification to be provided via a user interface, wherein such notification may inform a user to load/reload the elongate shaft of the medical device.

At block 1520, the process 1500 may include determining whether the signal has been addressed. For example, the control circuitry may determine (i) whether user input has been received indicating that the elongate shaft has now been loaded/properly loaded, (ii) whether a certain period of time has elapsed since the failure/error notification was provided, (iii) whether data from sensors (e.g., light blocking sensors, force sensors, etc.) on the instrument feeder device/engagement assembly indicate that the elongate shaft is loaded/properly loaded, (iv) whether the elongate shaft is properly positioned relative to the instrument feeder device/engagement assembly (e.g., based on data from shape sensors in the elongate shaft), and/or another determination.

If it is determined that the signal has been addressed, process 1500 may return to block 1506 (i.e., the "yes" branch). Alternatively, if it is determined that the signal has not been addressed, the process 1500 may return to block 1520 (i.e., the "no" branch) and perform operation 1520 again (e.g., after a certain period of time has elapsed).

FIGS. 16-1 and 16-2 illustrate an example process 1600 for determining and/or removing slack in an elongate shaft of a medical device in accordance with one or more embodiments.

In fig. 16-1, at block 1602, a process 1600 may include determining a slack in an elongate shaft of an inspection medical device. For example, a medical instrument may include an elongate shaft and an instrument handle, wherein the elongate shaft may be coupled to/engage an instrument feeder device that is coupled to a first robotic arm/component and the instrument handle may be coupled to a second robotic arm/component. In some cases, the control circuitry can determine an amount of slack in the elongate shaft between the evaluation instrument handle and the instrument feeder device. Such evaluation may be initiated upon determining insertion (or retraction, in some cases) of the elongate shaft, flipping the instrument shaft, enabling an admittance control mode of the robotic arm, the procedure being completed, a certain period of time has elapsed since a last examination of slack in the elongate shaft, the medical instrument has been recently coupled to the robotic arm (e.g., instrument handle/elongate shaft is loaded to begin driving the medical instrument), the procedure is about to begin, etc. In some cases, the determination is based on receiving user input, system processing (e.g., the system determining that an event has occurred), and so forth.

In one illustration, the inspection of the slack in the elongate shaft can be initiated upon receiving a user input to insert the elongate shaft or otherwise determining insertion of the elongate shaft. For inserting an elongate shaft of a medical instrument, the robotic arms may be operated in a coordinated manner. For example, a first robotic arm may be coupled to the instrument feeder device, while a second robotic arm may be coupled to the instrument handle. The instrument feeder device may cause axial movement of the elongate shaft in the insertion direction, while the second robotic arm moves closer to the first robotic arm in a manner related to the speed of the axial movement of the shaft. If there is slack in the elongate shaft (e.g., a repair loop) as it is inserted, the slack curvature may increase, which may potentially damage the elongate shaft (e.g., by causing the shaft to bend beyond a threshold amount) and/or cause delays in the procedure for reloading/replacing the medical instrument. Thus, an inspection of the slack in the elongate shaft can be initiated to prevent such undesirable problems.

In another illustration, the inspection of slack in the elongate shaft can be initiated upon indication of flipping the instrument shaft, enabling/requesting admittance control mode of the robotic arm, and/or occurrence of another event associated with achieving an intermediate/disengaged state of the instrument feeder apparatus. For example, during procedure/procedure settings, a physician may provide user input for enabling an admittance control mode to manually move a robotic arm coupled to an instrument feeder device and/or provide user input for flipping an instrument shaft. In response to such user input, the control circuitry may generate/receive a signal for inserting the shaft/enabling the admittance control mode. As described above, the admittance control mode may allow a physician to manually adjust the robotic arm and/or an access sheath coupled to the robotic arm. To facilitate movement of the robotic arm/access sheath and/or flipping of the elongate shaft, the instrument feeder device may transition to an intermediate state in which the instrument feeder device is disengaged from the elongate shaft and the elongate shaft is held within the instrument feeder device in a manner that allows movement of the instrument shaft, such as the states shown in fig. 10-1 and 10-2. If there is slack in the elongate shaft (e.g., a service ring) when the instrument feeder device is disengaged from the elongate shaft (e.g., the roller is separated from the shaft), the elongate shaft may move in the insertion direction as the energy/service ring is released, which may result in undesired insertion of the elongate shaft. This may cause injury to the patient (e.g., because the tip of the elongate shaft contacts the patient's tissue with a relatively high force). Thus, an inspection of the slack in the elongate shaft can be initiated to prevent such undesirable problems.

In yet another illustration, a check for slack may be initiated upon determining that the procedure has completed. For example, upon completion of a procedure, a physician may desire to decouple a medical instrument from one or more robotic arms (e.g., remove an elongate shaft from an instrument feeder device). This may involve transitioning the instrument feeder device to a fully open/disengaged state. As similarly discussed above, the elongate shaft may be movable in the insertion direction if there is slack in the elongate shaft when the instrument feeder device is disengaged from the elongate shaft. Thus, a check for slack may be initiated to prevent such problems from occurring.

In further illustration, the check for slack may be initiated periodically when the robotic arm is idle (e.g., not yet moved within a certain period of time), when a medical instrument is coupled to the robotic arm, and/or when various other types of events/determinations occur.

In the example shown in block 1603 of fig. 16-1, the medical instrument may include an elongate shaft 508 coupled to/engaging an instrument feeder apparatus 530 (which is coupled to the first robotic arm 112 (B)) and an instrument handle 506 coupled to the second robotic arm 112 (C). For purposes of illustration, the elongate shaft 508 is shown as having a certain amount of slack.

At block 1604, the process 1600 can include applying a force to an elongate shaft of a medical device to prevent axial movement of the elongate shaft. For example, the control circuitry may control one or more drive outputs of a first robotic arm coupled to the instrument feeder device to actuate to cause the instrument feeder device to apply a force to the elongate shaft to prevent axial movement of a portion of the elongate shaft positioned within the instrument feeder device (e.g., to clamp the elongate shaft). This force may be applied to prevent the elongate shaft 508 from retracting from the patient (or, in some cases, from being inserted into the patient) while other aspects of the procedure 1600 or other procedures are being performed, as discussed below.

In the example shown in blocks 1605 (a) -1605 (C) of fig. 16-1, the rollers 538 can be controlled to apply a force to the elongate shaft 508, such as to clamp the elongate shaft 508 between the rollers 538 with a particular amount of force (e.g., greater than a spring force biasing the rollers 538 toward each other). For example, as described above, the instrument feeder device 530 may include a carrier plate 622 that rotates based on the position of the off-axis protrusions 636 within the recesses 638. Rotation/movement of the carrier plate 622 may cause the rollers 538 to move closer to or farther from each other, thereby positioning the rollers 538 and/or adjusting the amount of force applied to the elongate shaft 508.

To illustrate, the on/off drive shaft 632 may be rotated clockwise (via a drive input, not shown) relative to the image of fig. 16-1 to cause the off-axis protrusion 636 (which is coupled to the on/off drive shaft 632) to contact a first surface/edge within the recess 638, as shown by the darker line in block 1605 (B). A force may be applied to the first surface by the off-axis protrusions 636 to cause the carrier plate 622 to rotate about the axis 628, thereby causing the rollers 538 to move in a direction away from each other (e.g., a disengaged/open state). In contrast, the on/off axis 632 may be rotated counterclockwise to cause the off-axis protrusion 636 to move toward and contact the second surface, as shown by the darker line in block 1605 (C). The off-axis protrusions 636 may apply a force to the second surface to cause the carrier plate 622 to rotate in an opposite direction and to cause the roller 538 to apply an additional force to the elongate shaft 508. In some cases, such as the case shown, the off-axis protrusions 636 are free to move between the first surface and the second surface of the dimple 638 (e.g., without any force applied to either surface). Here, the spring force can cause the roller 538 to apply a force to the elongate shaft 508.

In the example of fig. 16-1, the elongate shaft 508 can be positioned between rollers 538 to facilitate driving of the elongate shaft 508. At block 1604, the roller 538 may be controlled to apply a force to the elongate shaft 508, as shown in block 1605 (C). This may prevent the elongate shaft 508 from sliding between the rollers 538 when performing other actions, such as the robotic arm 112 (C) moving away from the robotic arm 112 (B), as discussed in further detail below. For example, this may prevent the elongate shaft 508 from retracting from the patient without being commanded/indicated. This process of applying a force to the elongate shaft 508 may be referred to as "active clamping".

At block 1606 in fig. 16-2, process 1600 may include causing actuation of a drive output of the first robotic arm and/or causing actuation of the second robotic arm. For example, the instrument feeder device may include one or more drive inputs configured to control axial movement of the elongate shaft, such as to insert or retract the shaft, wherein the one or more drive inputs may be configured to be coupled to one or more drive outputs of the first robotic arm. In various examples, the control circuitry may cause one or more drive outputs of the first robotic arm to actuate (e.g., rotate) to cause axial movement of the elongate shaft. Alternatively or additionally, the control circuit may cause a second robotic arm coupled to the instrument handle to move in a direction away from the first robotic arm. In some cases, the control circuitry may cause the one or more drive outputs and/or the second robotic arm to actuate a particular amount. In various examples, movement of the second robotic arm away from the first robotic arm (or vice versa) and/or the instrument feeder apparatus moves the elongate shaft in the insertion direction to the point where slack (if any) is removed/reduced and/or tension is applied to the elongate shaft. Such tension may be detected by a control circuit, as discussed below.

In the example shown in block 1607 (a) of fig. 16-2, the robotic arm 112 (C) is moved in a direction away from the robotic arm 112 (B) (e.g., in a retraction direction). This may occur while the robotic arm 112 (B) remains relatively stationary and/or without actuating the drive outputs of the robotic arm 112 (B) that are coupled to the instrument feeder device 530 to facilitate rotation of the rollers 538. In some cases, the robotic arm 112 (C) moves in a direction away from the robotic arm 112 (B) while the rollers 538 actively grip/apply force to the elongate shaft 508. In other words, block 1604 may be performed with the robotic arm 112 (C) moving away from the robotic arm 112 (C). This may prevent unwanted retraction (e.g., un-commanded/un-indicated retraction) of the elongate shaft 508 from the patient.

Further, in the example shown in block 1607 (B) of fig. 16-2, the roller 538 is actuated to move the elongate shaft 508 in the insertion direction. This may occur while the robotic arm 112 (C) remains relatively stationary (e.g., without causing movement of the robotic arm 112 (C)).

At block 1608, the process 1600 may include determining a first force applied by (or detected by) the drive output to the drive output, a second force applied by the second robotic arm, a shape of the elongate shaft, and/or a position of at least a portion of the elongate shaft. For example, the control circuitry may detect a first force (e.g., torque) applied to the instrument feeder device by the drive output of the first robotic arm to control the axial movement of the elongate shaft. In the example of block 1607 (B), the control circuitry may determine/detect a force applied to the drive output of the robotic arm 112 (B) when the roller 538 is idle or moving (e.g., a force to maintain or change the rotational position of the roller 538). Additionally or alternatively, the control circuit may detect a second force applied by/to the second robotic arm when the second robotic arm is idle or moving (e.g., to control the position of the second robotic arm). This force may account for an initial reference force applied by the second robotic arm when there is no tension on the elongate shaft, as discussed in further detail below. In the example of block 1607 (a), the control circuitry may determine the force applied by the robotic arm 112 (C) to maintain (or move) the position of the robotic arm 112 (C). Further, the control circuitry may receive/generate shape sensing data indicative of the shape of the elongate shaft (which may include data indicative of tensile stress such as from stress sensing optical fibers), position sensor data indicative of the position of at least a portion of the elongate shaft (e.g., the position of the tip of the elongate shaft or another portion of the elongate shaft associated with the sensor), position data indicative of the position of the first/second robotic arms, and/or other data.

In fig. 16-3, at block 1610, the process 1600 may include determining an amount of slack in an elongate shaft between a first robotic arm and a second robotic arm. For example, the control circuit may determine the amount of slack in the elongate shaft based on the magnitude of the first force applied by (or detected by) the drive output to control the axial movement of the elongate shaft, the magnitude of the second force applied by the second robotic arm, the shape indicated by the shape sensing data, and/or the position indicated by the position data of the elongate shaft/robotic arm. In some cases, the control circuitry may determine that the elongate shaft is relatively straight when the first force (drive output force) is greater than a first threshold amount, the second force (robotic arm force) is greater than a second threshold amount (which may be the same or different than the first threshold), the shape sensing data indicates that the elongate shaft is relatively straight, and/or the position data of the elongate shaft/robotic arm indicates that the elongate shaft is relatively straight.

In one example, the control circuit can use position data of the elongate shaft to determine a position of a tip of the elongate shaft. The control circuitry may also determine the position of the robotic arms (such as the distance between the robotic arms) and/or identify the size of the elongate shaft (e.g., a known/predetermined length of the shaft). Based on this information, the control circuitry may calculate the length of the elongate shaft between the robotic arms. The control circuit may determine that slack is present in the elongate shaft if the length of the elongate shaft between the robotic arms is greater than the distance between the robotic arms. In examples, the control circuitry may use the information discussed above to calculate the amount of slack between the robotic arms.

At block 1612, the process 1600 may include determining if an amount of slack in the elongate shaft is less than a predetermined amount. For example, the control circuitry may determine whether an amount of slack in the elongate shaft between the first robotic arm and the second robotic arm is relatively small (e.g., zero/no slack is present in the shaft, the amount of slack is less than a threshold amount, etc.).

If it is determined that the amount of slack in the elongate shaft is not less than the predetermined amount, the process 1600 may return to block 1606 in fig. 16-2 (i.e., the "no" branch) to cause the drive outputs of the first and/or second robotic arms to be actuated again, such as by a particular amount. This may be repeated any number of times to remove any slack in the elongate shaft and/or to apply tension to the elongate shaft. In the example illustrated by block 1611 of fig. 16-3, the elongate shaft 508 includes a certain amount of slack. Thus, block 1611 is associated with returning to block 1606.

If it is determined that the amount of slack in the elongate shaft is less than the predetermined amount (e.g., the elongate shaft is substantially free of slack), the process 1600 may proceed to block 1614 (i.e., the "yes" branch). In the example shown in block 1613 of fig. 16-3, the elongate shaft 508 is free of slack. Accordingly, block 1613 is associated with proceeding to block 1614.

At block 1614, the process 1600 may include controlling the instrument feeder device and/or the second robotic arm. For example, the control circuitry may control the instrument feeder device to axially move the elongate shaft and/or control the second robotic arm to cooperatively move to insert the elongate shaft, such as for any remaining insertion amount indicated and not yet completed. In particular, the instrument feeder device may cause axial movement of the elongate shaft in the insertion direction (e.g., using a roller) while the second robotic arm moves closer to the first robotic arm in a manner related to the speed of the axial movement of the elongate shaft (e.g., the rotational speed of the roller). This movement may continue until the elongate shaft is inserted a determined/indicated amount. Alternatively or additionally, the control circuitry may cause the instrument feeder device to disengage from the elongate shaft, which may facilitate flipping of the elongate shaft (by enabling an intermediate state of the instrument feeder device), movement of the robotic arm in admittance control mode (by enabling an intermediate state of the instrument feeder device), and/or removal of the elongate shaft (by enabling a fully open/disengaged state), etc.

In some cases, the control circuitry may cause tension (e.g., over-tension) in the elongate shaft to relax, such as prior to performing the operations of block 1614. For example, the control circuitry may cause the drive output of the first robotic arm to axially move the elongate shaft a relatively small amount in the retraction direction and/or cause the second robotic arm to actuate a relatively small amount in a direction toward the first robotic arm. This movement may relax the tension on the elongate shaft, which may be applied when performing the procedure 1600.

Fig. 17 illustrates an example process 1700 of determining and/or removing slack in an elongate shaft of a medical device in the context of insertion of the elongate shaft, in accordance with one or more embodiments. In some cases, the process 1700 can be initiated upon determining to insert the elongate shaft, such as upon receiving user input for inserting the shaft, system determination, or the like.

At block 1702, the process 1700 may include determining an initial force of a first robotic arm coupled to an instrument base of a medical instrument. For example, the control circuit may determine an initial/reference force applied by a first robotic arm coupled to the instrument base when there is no tension on the elongate shaft. Such force may be determined prior to insertion of the elongate shaft.

At block 1704, the process 1700 can include determining whether to insert an elongate shaft of a medical device. For example, the control circuitry can determine whether a user input/input signal is received requesting insertion of the elongate shaft, whether insertion of the elongate shaft is determined, and the like.

If it is determined to insert an elongate shaft, the process 1700 may proceed to block 1706 (i.e., the "yes" branch). Alternatively, if it is determined that the elongate shaft is not to be inserted, the process 1700 may return to block 1704 (i.e., the "no" branch). Thus, the control circuit may wait to receive/determine an insert instruction.

At block 1706, the process 1700 may include determining a drive output force associated with the drive output and/or a robotic arm force associated with the robotic arm. For example, the control circuit may determine a driving force (e.g., torque) applied by a drive output coupled to the instrument feeder device to facilitate insertion/retraction of the shaft. Further, the control circuitry may determine a robotic arm force applied by a robotic arm coupled to the instrument base. In some cases, the robotic arm force may be interpreted as a current force (also referred to as "external force, net instrument force, or resultant force") applied/achieved to control the position of the robotic arm and/or an initial/reference force applied by the robotic arm (determined at block 1702). For example, the robot arm force may be calculated by subtracting the initial/reference force from the external force (i.e., robot arm force = external force-reference force). The robotic arm force may refer to an external force that does not include gravity (e.g., an external force sensed by the robotic arm). However, the robot arm force may be calculated in other ways.

At block 1708, the process 1700 may include determining whether the drive output force is greater than a first threshold and/or whether the robotic arm force is greater than a second threshold. The second threshold may be the same as or different from the first threshold. For example, the control circuitry may determine whether the drive output force determined at block 1706 and/or the robotic arm force determined at block 1706 is greater than their respective thresholds, which may indicate that tension is present on the elongate shaft between the first robotic arm and the second robotic arm. Although two thresholds are used in this example, the technique may be implemented with a single threshold, where the drive output force and the robotic arm force may be combined and compared to the single threshold.

If it is determined that the drive output force is greater than the first threshold and/or the robotic arm force is greater than the second threshold, the process 1700 may proceed to block 1712 (i.e., the "yes" branch). Alternatively, if it is determined that the drive output force is not greater than the first threshold and/or the robotic arm force is not greater than the second threshold, the process 1700 may proceed to block 1710 (i.e., the "no" branch).

At block 1710, the process 1700 may include controlling the instrument feeder device to insert the elongate shaft without actuating a first robotic arm coupled to the instrument base. For example, the control circuitry may control the drive output to cause the instrument feeder device to be inserted into the elongate shaft while preventing actuation of the first robotic arm coupled to the instrument base beyond a threshold amount (e.g., such that the first robotic arm is capable of moving less than the threshold amount). That is, the control circuitry may not actively cause the first robotic arm to move, but allow the first robotic arm to move a relatively small amount (e.g., less than a threshold amount) if a certain amount of force is applied to the first robotic arm, for example, due to tension applied to the elongate shaft. In any event, the control circuitry can cause the elongate shaft to be inserted a particular amount, which can be an increment within an insertion limit defined by user input/processing. Operation 1710 may be repeated any number of times until the tension on the elongate shaft reaches a value greater than a threshold (as determined at block 1708) and/or until an insertion limit is reached. Thus, the amount of insertion of the elongate shaft will generally not exceed the amount requested by the user input and/or the system.

At block 1712, the process 1700 may include controlling an instrument feeder device and a first robotic arm coupled to an instrument base. For example, the control circuitry may control the instrument feeder device to axially move the elongate shaft in the insertion direction and control the first robotic arm (which is coupled to the instrument base) to move in the insertion direction to insert/continue insertion of the elongate shaft, such as for any remaining amount of insertion indicated and not yet completed. The instrument feeder device and the first robotic arm may be cooperatively actuated to insert the elongate shaft.

In some cases, the control circuitry may cause tension (e.g., over-tension) in the elongate shaft to relax, such as prior to performing the operations of block 1712. For example, the control circuitry may cause the drive output of the second robotic arm to control the instrument feeder device to cause the elongate shaft to move axially a relatively small amount in the retraction direction and/or to cause the first robotic arm coupled to the instrument handle to actuate a relatively small amount in a direction toward the second robotic arm. This movement may relax the tension on the elongate shaft, which may be applied when performing the process 1700. In various examples, the tension may be relaxed during insertion, such as by causing the instrument feeder device to be inserted into the elongate shaft at a first rate and causing a first robotic arm coupled to the instrument handle to move toward a second robotic arm at a second rate that is faster than the first rate.

In various examples, the process 1700 may be performed to remove any slack in the elongate shaft of the medical device. Thereafter, upon receiving an insertion/retraction command, the control circuitry may control the instrument feeder device and a robotic arm coupled to the instrument base to cooperatively move to insert/retract the elongate shaft.

18-1 and 18-2 illustrate an example process 1800 for determining and/or removing slack in an elongate shaft of a medical device in the context of enabling an admittance control mode and/or flipping the elongate shaft, in accordance with one or more embodiments. In some cases, the process 1800 may be initiated upon determining to disengage the instrument feeder device from the elongate shaft (e.g., transition to an intermediate state, fully open/disengaged state, etc.), such as upon receiving an input to enable an admittance control mode of the robotic arm, receiving an input to flip the elongate shaft, etc. However, the process 1800 may also be initiated at other times and/or in other circumstances where the elongate shaft may include slack.

In fig. 18-1, at block 1802, a process 1800 may include controlling a medical instrument. For example, the medical instrument may include an elongate shaft coupled to the first robotic arm (via the instrument feeder device) and/or a handle/base coupled to the second robotic arm. The control circuitry may control the first robotic arm, the second robotic arm, and/or another component during normal driving of the medical instrument, such as to manipulate the elongate shaft and/or the handle of the medical instrument.

At block 1804, the process 1800 may include determining whether an admittance control signal and/or a roll-over signal is received. For example, the control circuitry may receive a signal for enabling an admittance control mode of a robotic arm (e.g., coupled to an instrument feeder device) and/or a signal for flipping an elongate shaft of a medical instrument. Based on such signals, the control circuitry may determine to transition the instrument feeder device to a disengaged state (e.g., an intermediate state, a fully open/disengaged state, etc.).

If an admittance control signal and/or a roll-over signal is received, the process may proceed to block 1806 (i.e., the "yes" branch). Alternatively, if an admittance control signal and/or a roll-over signal is not received, process 1800 may return to block 1802 (i.e., the "no" branch) and continue with normal control/actuation of the medical device.

At block 1806, process 1800 may include determining an initial/reference robotic arm force. For example, the control circuit may determine an initial/reference force applied by a second robotic arm coupled to the instrument base when there is no tension on the elongate shaft. Such a force may be determined before admittance control mode is enabled and/or rollover occurs.

At block 1808, the process 1800 may include causing actuation of the second robotic arm in a direction away from the first robotic arm. For example, the control circuit may cause the second robotic arm coupled to the instrument handle to move in a retraction direction away from the first robotic arm coupled to the instrument feeder apparatus. In some cases, the control circuit may cause the second robotic arm to actuate a particular amount. In examples, the second robotic arm may move without actuating a drive output of the first robotic arm configured to control axial movement of the elongate shaft (e.g., without actively actuating the drive output, as some actuation may naturally occur with movement of the second robotic arm). Thus, in some cases, the control circuitry may allow the drive output to actuate/rotate less than a threshold amount while the second robotic arm moves away from the first robotic arm.

At block 1810, the process 1800 may include determining a drive output force associated with a drive output and/or a robotic arm force associated with a robotic arm. For example, the control circuit may determine a driving force (e.g., torque) applied by a drive output coupled to the instrument feeder device to facilitate insertion/retraction of the shaft. Further, the control circuitry may determine a robotic arm force applied by a robotic arm (e.g., a second robotic arm) coupled to the instrument base. In some cases, the robotic arm force may be interpreted as a current force (also referred to as "external force, net instrument force, or resultant force") applied/implemented to control the position of the robotic arm and/or an initial/reference force applied by the robotic arm (determined at block 1806). For example, the robot arm force may be calculated by subtracting the initial/reference force from the external force (i.e., robot arm force = external force-reference force). However, the robot arm force may be calculated in other ways.

At block 1812, the process 1800 may include determining whether a second robotic arm (coupled to the instrument handle) has been actuated beyond a threshold amount and/or has reached a workspace boundary. For example, the control circuitry may monitor/detect a distance that the second robotic arm (which is coupled to the instrument handle) has moved from the first robotic arm (which is coupled to the instrument feeder device) and/or detect a position of the second robotic arm, which may be used to determine whether the second robotic arm has reached a distance limit and/or reached a workspace boundary. Distance limits and/or workspace boundaries may be set/defined to avoid collisions with objects/patients in the environment. For example, the workspace boundary may be a virtual boundary.

If it is determined that the second robotic arm has been actuated beyond the threshold amount and/or has reached the workspace boundary, process 1800 may proceed to block 1814 (i.e., the "yes" branch). Alternatively, if it is determined that the second robotic arm has not actuated beyond the threshold and/or has not reached the workspace boundary, process 1800 may proceed to block 1816 (i.e., the "no" branch).

At block 1814, the process 1800 may include generating a signal indicating that the second robotic arm actuation exceeds a threshold amount and/or reaches a workspace boundary. For example, the control circuitry may generate/send a signal based on determining that the second robotic arm actuation exceeds a threshold amount and/or reaches a workspace boundary at block 1812. The signal may cause a notification to be provided to instruct the user to reload the medical instrument and/or adjust the second robotic arm, such as by removing the instrument handle and reattaching the instrument handle to the second robotic arm, moving the second robotic arm to manually remove slack, or the like. In some cases, a signal may be generated/transmitted in the event that there is too much slack in the elongate shaft (such as exceeding a threshold amount that the system is removable).

Although blocks 1812 and 1814 are shown in the example of fig. 18-1, in some cases, such blocks (and/or other blocks of process 1800) may be eliminated.

At block 1816, process 1800 may include determining whether the drive output force is greater than a first threshold and/or whether the robotic arm force is greater than a second threshold. The second threshold may be the same as or different from the first threshold. For example, the control circuitry may determine whether the drive output force determined at block 1810 and/or the robotic arm force determined at block 1810 is greater than their respective thresholds, which may indicate that tension is present on the elongate shaft between the first robotic arm and the second robotic arm. Thus, at block 1816, the control circuit may determine whether there is less than a predetermined amount of slack (e.g., no slack/zero slack) in the elongate shaft.

Although two thresholds are used in this example, the technique may be implemented with a single threshold, where the drive output force and the robotic arm force may be combined and compared to the single threshold.

If it is determined that the drive output force is greater than the first threshold and/or the robotic arm force is greater than the second threshold, process 1800 may proceed to block 1818 in FIG. 18-2 (i.e., the "Yes" branch). Alternatively, if it is determined that the drive output force is not greater than the first threshold and/or the robotic arm force is not greater than the second threshold, the process 1800 may return to block 1808 (e.g., the "no" branch). If desired, the control circuitry can be cycled through blocks 1808, 1810, and 1812 any number of times to remove slack in the elongate shaft.

In fig. 18-2, at block 1818, the process 1800 may include relaxing tension on the elongate shaft. For example, the control circuitry may cause a second robotic arm coupled to the instrument handle to move closer to the first robotic arm in the insertion direction and/or cause the instrument feeder device to move the elongate shaft in the retraction direction. In some cases, moving the second robotic arm in a direction away from the first robotic arm at block 1808 may cause the elongate shaft to be over-tensioned. Accordingly, the operations of block 1818 may be performed to relax such tension (e.g., slightly).

At block 1820, the process 1800 may include determining whether the second robotic arm has moved a first predetermined distance and/or whether the elongate shaft has retracted a second predetermined distance. For example, the control circuitry may determine whether the second robotic arm has moved (at block 1818) in the insertion direction by at least a first predetermined amount (e.g., moved closer to the first robotic arm by a particular amount) and/or whether the elongate shaft has been moved (at block 1818) by the instrument feeder device by at least a second predetermined distance. The second predetermined distance may be the same as or different from the first predetermined distance. Additionally or alternatively, at block 1820, the control circuitry may determine whether the magnitude of the force applied by/to the drive output and/or the magnitude of the force achieved/applied by the first robotic arm/second robotic arm for controlling the instrument feeder apparatus/engagement assembly/roller has changed by a threshold amount or less (e.g., indicating that the tension has relaxed).

If it is determined that the second robotic arm has moved the first predetermined distance and/or the elongate shaft has retracted the second predetermined distance, the process 1800 may proceed to block 1822 (i.e., the "yes" branch). Alternatively, if it is determined that the second robotic arm has not moved the first predetermined distance and/or the elongate shaft has not retracted the second predetermined distance, the process 1800 may return to block 1818 (i.e., the "no" branch). The operation at block 1818 may be performed any number of times to gradually relax the tension on the elongate shaft (e.g., each time the second robotic arm is actuated and/or the elongate shaft is moved axially a particular amount at block 1818) until one or more criteria are met.

Although blocks 1818 and 1820 are shown in the example process 1800, in some cases, such blocks may be eliminated. In one illustration, block 1818 (e.g., cancel block 1820) is performed in a single instance.

At block 1822, the process 1800 may include controlling the instrument feeder device to disengage from the elongate shaft and/or to enable the elongate shaft to be flipped. For example, the control circuitry can cause the instrument feeder device to transition to a disengaged state (e.g., an intermediate state in which the elongate shaft is held, a fully open/disengaged state, or another disengaged state). In one illustration, the instrument feeder device can transition to an intermediate state in which the roller/actuator is disengaged from the elongate shaft and the cover/retention feature is closed. This may allow for enabling an admittance control mode (e.g., for manually adjusting a first robotic arm coupled to the instrument feeder apparatus) and/or flipping the elongate shaft (e.g., freely moving within the channel while remaining in the instrument feeder apparatus).

Additional embodiments

Depending on the implementation, the particular actions, events, or functions of any of the processes or algorithms described herein may be performed in a different order, may be added, combined, or ignored entirely. Thus, not all described acts or events are necessary for the practice of the process in certain embodiments.

Unless specifically stated otherwise or otherwise understood within the context of use, conditional language such as "may," "capable," "might," "may," "for example," etc., as used herein refer to their ordinary meaning and are generally intended to convey that a particular embodiment comprises and other embodiments do not include a particular feature, element, and/or step. Thus, such conditional language is not generally intended to imply that features, elements and/or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or steps are included in or are to be performed in any particular embodiment. The terms "comprising," "including," "having," and the like are synonymous and used in their ordinary sense, and are used inclusively in an open-ended fashion, and do not exclude additional elements, features, acts, operations, etc. Moreover, the term "or" is used in its inclusive sense (rather than in its exclusive sense) such that when used, for example, to connect a series of elements, the term "or" refers to one, some, or all of the series of elements. A connective term such as the phrase "at least one of X, Y and Z" is understood in the general context of use to convey that an item, term, element, etc. may be X, Y or Z, unless specifically stated otherwise. Thus, such conjunctive words are generally not intended to imply that certain embodiments require at least one of X, at least one of Y, and at least one of Z to each be present.

It should be appreciated that in the foregoing description of embodiments, various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure and aiding in the understanding of one or more of the various aspects. However, this method of the present disclosure should not be construed as reflecting the following intent: any claim has more features than are expressly recited in that claim. Furthermore, any of the components, features, or steps illustrated and/or described in particular embodiments herein may be applied to or used with any other embodiment. Furthermore, no element, feature, step, or group of elements, features, or steps is essential or necessary for each embodiment. Thus, the scope of the present disclosure should not be limited by the specific embodiments described above, but should be determined only by a fair reading of the claims that follow.

It should be appreciated that a particular ordinal term (e.g., "first" or "second") may be provided for ease of reference and does not necessarily imply physical properties or ordering. Thus, as used herein, ordinal terms (e.g., "first," "second," "third," etc.) for modifying an element such as a structure, a component, an operation, etc., do not necessarily indicate a priority or order of the element relative to any other element, but may generally distinguish the element from another element having a similar or identical name (but for use of the ordinal term). In addition, as used herein, the indefinite articles "a" and "an" may indicate "one or more" rather than "one". Furthermore, operations performed "based on" a certain condition or event may also be performed based on one or more other conditions or events not explicitly recited.

Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which exemplary embodiments belong. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

For ease of description, spatially relative terms "outer," "inner," "upper," "lower," "below," "over," "vertical," "horizontal," and the like may be used herein to describe one element or component's relationship to another element or component's depicted in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, where the apparatus shown in the figures is turned over, elements located "below" or "beneath" another apparatus could be oriented "above" the other apparatus. Thus, the illustrative term "below" may include both a lower position and an upper position. The device may also be oriented in another direction, and thus spatially relative terms may be construed differently depending on the orientation.

Unless explicitly stated otherwise, comparative and/or quantitative terms such as "less", "more", "larger", and the like, are intended to cover the concept of an equation. For example, "less" may refer not only to "less" in the most strict mathematical sense, but also to "less than or equal to".

Claims

1. A system, comprising:

a first robotic arm configured to be coupled to an elongate shaft of a medical instrument, the first robotic arm comprising a drive output configured to control axial movement of the elongate shaft;

a second robotic arm configured to be coupled to an instrument base of the medical instrument; and

a control circuit configured to:

causing actuation of at least one of the drive output or the second robotic arm; and

based at least in part on the actuation, an amount of slack in the elongate shaft between the first and second robotic arms is determined.

2. The system of claim 1, wherein the control circuit is further configured to:

determining at least one of a first force associated with the drive output or a second force associated with the second robotic arm; and

Determining that at least one of the first force or the second force is greater than a threshold;

wherein the amount of slack in the elongate shaft is determined based at least in part on determining that at least one of the first force or the second force is greater than the threshold, the amount of slack in the elongate shaft being less than a predetermined amount.

3. The system of claim 1, wherein the control circuit is configured to cause actuation of the second robotic arm, the actuation of the second robotic arm causing actuation of the second robotic arm in a direction away from the first robotic arm.

4. The system of claim 1, wherein the control circuit is configured to cause actuation of the drive output while enabling actuation of the second robotic arm by less than a threshold amount.

5. The system of claim 4, wherein the control circuit is further configured to:

receiving an input signal indicative of insertion of the elongate shaft;

wherein the control circuitry is configured to cause actuation of the drive output in response to receipt of the input signal, the actuation of the drive output causing insertion of the elongate shaft.

6. The system of claim 1, wherein the first robotic arm is configured to be coupled to an instrument feeder device configured to achieve an engaged state in which the instrument feeder device is engaged with the elongate shaft and a disengaged state in which the instrument feeder device is disengaged from the elongate shaft.

7. The system of claim 6, wherein the control circuit is further configured to:

determining to transition the instrument feeder device from the engaged state to the disengaged state;

wherein the control circuitry is configured to cause actuation of the second robotic arm in response to determining to transition the instrument feeder device from the engaged state to the disengaged state, the actuation of the second robotic arm causing actuation of the second robotic arm in a direction away from the first robotic arm.

8. The system of claim 1, wherein the control circuit is further configured to:

determining that the amount of slack in the elongate shaft is less than a predetermined amount; and

based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount, the drive output and the second robotic arm are caused to cooperatively actuate to axially move the elongate shaft.

9. The system of claim 1, wherein the first robotic arm is configured to be coupled to an instrument feeder device, and the control circuit is further configured to:

causing the instrument feeder device to apply a force to the elongate shaft to axially prevent movement of a portion of the elongate shaft positioned within the instrument feeder device;

Wherein the control circuit is configured to cause actuation of the second robotic arm, the actuation of the second robotic arm causing actuation of the second robotic arm in a direction away from the first robotic arm.

10. A method, comprising:

causing actuation of at least one of a drive output of a first robotic arm or a second robotic arm by a control circuit, the first robotic arm coupled to an elongate shaft of a medical instrument and the second robotic arm coupled to an instrument base of the medical instrument, the drive output configured to control axial movement of the elongate shaft; and

an amount of slack in the elongate shaft between the first and second robotic arms is determined by the control circuit based at least in part on the actuation.

11. The method of claim 10, further comprising:

determining at least one of a first force applied by the drive output or a second force applied by the second robotic arm;

wherein determining the amount of slack in the elongate shaft is based on at least one of the first force or the second force.

12. The method of claim 10, wherein the causing comprises causing the second robotic arm to actuate in a direction away from the first robotic arm.

13. The method of claim 10, wherein the causing comprises causing the drive output to actuate while preventing the second robotic arm from actuating beyond a threshold amount.

14. The method of claim 13, further comprising:

receiving an input signal indicative of insertion of the elongate shaft;

wherein the causing comprises causing actuation of the drive output in response to receiving the input signal, the actuation of the drive output causing insertion of the elongate shaft.

15. The method of claim 10, further comprising:

determining a transition of an instrument feeder device configured to engage the elongate shaft from an engaged state to a disengaged state;

wherein the causing includes causing actuation of the second robotic arm in a direction away from the first robotic arm in response to determining to transition the instrument feeder device from the engaged state to the disengaged state.

16. The method of claim 10, further comprising:

17. The method of claim 10, further comprising:

applying a force to the elongate shaft to prevent retraction of the elongate shaft from a patient;

wherein the causing comprises causing actuation of the second robotic arm in a direction away from the first robotic arm.

18. A system, comprising:

an instrument feeder device configured to axially move an elongate shaft of a medical instrument, the medical instrument including an instrument handle; and

a control circuit configured to:

determining an amount of slack in the elongate shaft between the instrument handle and the instrument feeder device; and

the instrument feeder device is controlled based at least in part on the amount of slack in the elongate shaft.

19. The system of claim 18, wherein the control circuit is further configured to:

determining at least one of a first force applied by a drive output to control the instrument feeder device or a second force applied by a second robotic arm;

wherein the amount of slack in the elongate shaft is determined based on at least one of the first force or the second force.

20. The system of claim 18, wherein the control circuitry is configured to control the instrument feeder device by causing the instrument feeder device to at least one of: axially moving the elongate shaft, disengaging from the elongate shaft, or maintaining engagement with the elongate shaft.

21. The system of claim 18, wherein the control circuit is configured to determine the amount of slack in the elongate shaft based on at least one of: a first force applied to the instrument feeder device, a second force applied by a robotic arm coupled to the instrument handle, shape sensing data indicative of a shape of the elongate shaft, or position sensor data indicative of a position of at least a portion of the elongate shaft.

22. The system of claim 18, wherein the control circuit is further configured to cause actuation of a second robotic arm in a direction away from the first robotic arm, the second robotic arm coupled to the instrument handle;

wherein the amount of slack is determined based at least in part on the actuation of the second robotic arm.

23. The system of claim 22, wherein the control circuitry is configured to cause actuation of the second robotic arm without controlling the instrument feeder device.

24. The system of claim 22, wherein the control circuit is further configured to:

determining that the second robotic arm has at least one of actuated beyond a threshold amount or actuated to a workspace boundary; and

A signal is generated indicating that the second robotic arm has at least one of actuated beyond the threshold amount or actuated to the workspace boundary.

25. The system of claim 18, wherein the control circuit is further configured to:

based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount, the instrument feeder device is caused to disengage from the elongate shaft.

26. The system of claim 18, wherein the control circuit is further configured to:

causing at least one of the following to be performed: axially moving the instrument feeder device along an insertion direction to the elongate shaft or moving the instrument handle in a direction away from the instrument feeder device;

based at least in part on determining that the amount of slack in the elongate shaft is less than the predetermined amount, causing at least one of: the instrument feeder device is moved axially in a retraction direction to the elongate shaft or the instrument handle is moved in a direction toward the instrument feeder device.

27. The system of claim 18, wherein the control circuit is further configured to:

causing the instrument feeder device to apply a force to the elongate shaft to axially prevent movement of a portion of the elongate shaft positioned within the instrument feeder device; and

causing the instrument handle to move in a direction away from the instrument feeder device;

wherein the amount of slack is determined as the instrument handle is moved.

28. A system, comprising:

an instrument feeder device configured to be coupled to the first robotic arm and configured to axially move an elongate shaft of a medical instrument, the medical instrument including an instrument handle; and

a control circuit configured to:

determining that the elongate shaft is substantially free of slack between the instrument handle and the instrument feeder device; and

the instrument feeder device is controlled based at least in part on the elongate shaft being substantially free of slack between the instrument handle and the instrument feeder device.

29. The system of claim 28, wherein the control circuit is further configured to:

Causing actuation of a second robotic arm in a direction away from the first robotic arm, the second robotic arm coupled to the instrument handle;

wherein determining that the elongate shaft is substantially free of slack is based at least in part on the actuation of the second robotic arm.

30. The system of claim 28, wherein the control circuit is further configured to:

causing actuation of a drive output of the first robotic arm to control the instrument feeder device while preventing movement of the instrument handle;

wherein determining that the elongate shaft is substantially free of slack is based at least in part on the actuation of the drive output.

31. The system of claim 28, wherein the control circuit is further configured to:

determining at least one of a first force applied by a drive output to control the instrument feeder device or a second force applied by a second robotic arm coupled to the instrument handle;

wherein determining that the elongate shaft is substantially free of slack is based on at least one of the first force or the second force.

32. The system of claim 28, wherein the control circuitry is configured to control the instrument feeder device by causing the instrument feeder device to at least one of: the elongate shaft is moved axially in the insertion direction or disengaged from the elongate shaft.

33. The system of claim 28, wherein the control circuit is configured to determine that the elongate shaft is substantially free of slack based on at least one of: a first force applied to the instrument feeder device, a second force applied by a second robotic arm coupled to the instrument handle, shape sensing data indicative of a shape of the elongate shaft, or position sensor data indicative of a position of at least a portion of the elongate shaft.

34. The system of claim 28, wherein the control circuit is further configured to: