EP4649371A1

EP4649371A1 - Surgical robotic system and method for communication between surgeon console and bedside assistant

Info

Publication number: EP4649371A1
Application number: EP24700488.0A
Authority: EP
Inventors: Faisal I. Bashir; Meir Rosenberg
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2023-01-09
Filing date: 2024-01-02
Publication date: 2025-11-19
Also published as: WO2024150077A1; CN120476370A

Abstract

A surgical robotic system includes an assistant access port configured to receive an assistant instrument, an endoscopic camera configured to generate a video feed of a surgical site and the assistant instrument, and a control tower having a first screen, and a surgeon console having a second screen and a handle controller configured to receive user input. The system further includes a video processing device configured to render a virtual instrument of the assistant instrument in the video feed to generate an augmented video feed, move the virtual instrument in the augmented video feed in response to received user input, output the augmented video feed with the virtual instrument on the first screen and the second screen, confirm whether the assistant instrument is disposed at a location of the virtual instrument, and indicate on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

Description

SURGICAL ROBOTIC SYSTEM AND METHOD FOR COMMUNICATION BETWEEN SURGEON CONSOLE AND BEDSIDE ASSISTANT

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63/437,786, filed January 9, 2023, the entire content of which is incorporated herein by reference.

BACKGROUND

[0002] Surgical robotic systems are used in a variety of surgical procedures, including minimally invasive medical procedures. Some surgical robotic systems include a surgeon console controlling a surgical robotic arm and a surgical instrument having an end effector (e.g., forceps or grasping instrument) coupled to and actuated by the robotic arm. In operation, the robotic arm is moved to a position over a patient and then guides the surgical instrument into a small incision via a surgical port or a natural orifice of a patient to position the end effector at a work site within the patient’s body.

[0003] Minimally invasive surgery and robotic assisted surgery enable the surgeon to perform surgical procedures at a remote console in tele-operation mode. The surgeon scrubs out and leaves the sterile field during the surgical procedure during tele-operation mode. There are multiple needs for having a bedside assistant during the surgical procedure. Some of the assist activities require streamlined communication between the assistant and the surgeon. There is an unmet need to optimize communication between assistant and surgeon.

SUMMARY

[0004] The current disclosure provides an augmented reality (AR) guided communication platform between a surgeon and an assistant where the surgeon can show the assistant through tool gestures how to perform a complicated maneuver. This avoids the need for the surgeon to disrupt the surgical workflow or have to scrub in and perform the maneuver laparoscopically themselves. Instead, the surgeon can communicate the complicated surgical maneuver to the assistant by manipulating a virtual tool that both surgeon and the assistant can visualize on one or more of their respective screens.

[0005] According to one embodiment of the present disclosure, a surgical robotic system is disclosed. The surgical robotic system includes an assistant access port configured to receive an assistant instrument. The system also includes an endoscopic camera configured to generate a video feed of a surgical site and the assistant instrument. The system further includes a control tower having a first screen, and a surgeon console having a second screen and a handle controller configured to receive user input. The system further includes a video processing device configured to render a virtual instrument of the assistant instrument in the video feed to generate an augmented video feed and to move the virtual instrument in the augmented video feed in response to the user input. The video processing device is further configured to output the augmented video feed with the virtual instrument on the first screen and the second screen and confirm whether the assistant instrument is disposed at a location of the virtual instrument. The video processing device is additionally configured to indicate on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

[0006] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the surgical robotic system may further include a robotic arm having a robotic instrument and a robotic access port configured to receive the robotic instrument. The surgeon console may be configured to switch between controlling the robotic instrument and controlling the virtual instrument. The surgical robotic system may also include a tracking unit configured to track positions of the assistant access port and the robotic access port. The video processing device may be configured to determine the location of the assistant instrument based on the positions of the assistant access port and the robotic access port. The video processing device may be also configured to render the virtual instrument based on 3D model data of the assistant instrument. The endoscopic camera may be a stereoscopic camera and the processing device may be configured to generate a depth map of the surgical site. The processing device may be further configured to generate a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map. The surgeon console may be also configured to limit the user input for controlling movement of the virtual instrument at the surgeon console based on the virtual boundary.

[0007] According to another embodiment of the present disclosure, a non-transitory computer readable medium is disclosed. The medium stores instructions that, when executed by a processor, cause the processor to perform a computer-implemented method for communicating movement instructions using a virtual instrument. The method includes receiving a video feed of a surgical site and an assistant instrument and rendering a virtual instrument of the assistant instrument in the video feed to generate an augmented video feed that is displayed on a first screen of a control tower and a second screen of a surgeon console. The method further includes moving the rendered virtual instrument in the video feed in response to input signals received from the surgeon console and outputting the augmented video feed with the virtual instrument on the first screen and the second screen. The method additionally includes confirming whether the assistant instrument is disposed at a location of the virtual instrument and indicating on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

[0008] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the method may further include switching between controlling a robotic instrument coupled to a robotic arm and inserted through a robotic access port and the virtual instrument. The method may further include tracking positions of an assistant access port through which the assistant instrument is inserted and the robotic access port. The method may also include determining a location of the assistant instrument based on the positions of the assistant access port and the robotic access port. The method may additionally include rendering the virtual instrument based on 3D model data of the assistant instrument. The method may also include generating a depth map of the surgical site. The method may further include generating a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map. The method may also include limiting movement of the virtual instrument at the surgeon console based on the virtual boundary.

[0009] According to a further embodiment of the present disclosure, a surgical robotic system is disclosed. The surgical robotic system includes a robotic arm having a robotic instrument and a robotic access port configured to receive the robotic instrument. The system also includes an assistant access port configured to receive an assistant instrument. The system further includes an endoscopic camera configured to generate a video feed of a surgical site and the assistant instrument. The system also includes a control tower having a first screen and a surgeon console having a second screen and a handle controller configured to receive user input to control the robotic instrument and a virtual instrument. The system further includes a video processing device configured to render the virtual instrument of the assistant instrument in the video feed to generate an augmented video feed and move the virtual instrument in the augmented video feed in response to the user input. The video processing device is also configured to output the augmented video feed with the virtual instrument on the first screen and the second screen, confirm whether the assistant instrument is disposed at a location of the virtual instrument, and indicate on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument. [0010] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the endoscopic camera may be a stereoscopic camera and the processing device may be configured to generate a depth map of the surgical site. The processing device may be configured to generate a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map. The surgeon console may be configured to limit the user input for controlling movement of the virtual instrument at the surgeon console based on the virtual boundary.

BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Various embodiments of the present disclosure are described herein with reference to the drawings wherein:

[0012] FIG. 1 is a schematic illustration of a surgical robotic system including a control tower, a console, and one or more surgical robotic arms each disposed on a mobile cart according to an embodiment of the present disclosure;

[0013] FIG. 2 is a perspective view of a surgical robotic arm of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0014] FIG. 3 is a perspective view of a mobile cart having a setup arm with the surgical robotic arm of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0015] FIG. 4 is a schematic diagram of a computer architecture of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0016] FIG. 5 is a plan schematic view of the surgical robotic system of FIG. 1 positioned about a surgical table according to an embodiment of the present disclosure;

[0017] FIG. 6 is a view of a graphical user interface displayed on a control tower display and a surgeon console display according to an embodiment of the present disclosure; and

[0018] FIG. 7 is a flow chart illustrating a method for providing movement instructions to a bedside assistant according to an embodiment of the present disclosure.

DETAILED DESCRIPTION

[0019] Embodiments of the presently disclosed surgical robotic system are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views.

[0020] As will be described in detail below, the present disclosure is directed to a surgical robotic system, which includes a surgeon console, a control tower, and one or more mobile carts having a surgical robotic arm coupled to a setup arm. The surgeon console receives user input through one or more interface devices, which are processed by the control tower as movement commands for moving the surgical robotic arm and an instrument and/or camera coupled thereto. Thus, the surgeon console enables teleoperation of the surgical arms and attached instruments/camera. The surgical robotic arm includes a controller, which is configured to process the movement commands and to generate torque commands for activating one or more actuators of the robotic arm, which would, in turn, move the robotic arm in response to the movement command.

[0021] The present disclosure provides for a surgical robotic system and method which improve the communication between a surgeon and an assistant. The system enables communication of complicated instrument maneuvers to the assistant without causing disruption to surgical flow by looking away from a screen of a surgeon console or having to scrub in and do the task themselves. In particular, the system is configured to virtualize one or more surgical instruments, which are controlled by the assistant and may be any powered or manual instrument. The guided communication interface is an augmented reality (AR) interface, which generates virtual images of the instrument as overlays over an endoscopic camera feed.

[0022] The workflow for the optimal communication between surgeon and assistant may include the assistant inserting a laparoscopic instrument into a surgical site. The surgeon then moves an endoscopic camera to place the assistant’s instrument in field of view of the camera. The camera may be a stereoscopic camera configured to enable depth mapping of surgical site and the instruments. The camera is calibrated to enable accurate depth perception. The assistant’s instrument is identified through machine vision. The system also includes an external vision system (e.g., one or more cameras or infrared sensors) used to determine port locations of all access ports. This allows the system to determine position of the assistant port relative to the endoscope port in order to generate a virtual instrument in the camera feed which is shown on both the screen of the surgeon console, which is used by the surgeon, and on a screen of the control tower, which is used by the assistant.

[0023] The system is also configured to load 3D and physics models as well as kinematics of the assistant instrument, which are used to render the virtual instrument. The virtual instrument is then rendered as an AR overlay on both screens. Initial placement of the virtual instrument is based on physics modeling a stereo reconstructed depth map from the stereo endoscope.

[0024] The virtual instrument is controlled through the surgeon console in the same manner as any of the actual robotic controller instrument. The surgeon clutches out and gains control of the virtual instrument rendered onscreen and moves the virtual instrument using handle controllers. The virtual tool is tied to the assistant port and the system is configured to realistically move the virtual tool in the video feed of surgical site based on the kinematics of the assistant instrument. The surgeon’s movement trajectory may be recorded so that it is replayable by the assistant at the screen of the control tower. The assistant then moves the assistant instrument until the assistant instrument is at the same position as the virtual instrument, i.e., the assistant instrument is aligned with the virtual instrument, following the trajectory as a guide. The system may verify the assistant instrument is at the virtual instrument location and is oriented in the same location based on the depth mapping and image processing. [0025] With reference to FIG. 1, a surgical robotic system 10 includes a control tower 20, which is connected to all of the components of the surgical robotic system 10 including a surgeon console 30 and one or more mobile carts 60. Each of the mobile carts 60 includes a robotic arm 40 having a surgical instrument 50 removably coupled thereto. The robotic arms 40 also couple to the mobile carts 60. The robotic system 10 may include any number of mobile carts 60 and/or robotic arms 40.

[0026] The surgical instrument 50 is configured for use during minimally invasive surgical procedures. In embodiments, the surgical instrument 50 may be configured for open surgical procedures. In further embodiments, the surgical instrument 50 may be an electrosurgical forceps configured to seal tissue by compressing tissue between jaw members and applying electrosurgical current thereto. In yet further embodiments, the surgical instrument 50 may be a surgical stapler including a pair of jaws configured to grasp and clamp tissue while deploying a plurality of tissue fasteners, e.g., staples, and cutting stapled tissue. In yet further embodiments, the surgical instrument 50 may be a surgical clip applier including a pair of jaws configured apply a surgical clip onto tissue.

[0027] One of the robotic arms 40 may include a laparoscopic camera 51 configured to capture video of the surgical site. The laparoscopic camera 51 may be a stereoscopic endoscopic camera configured to capture two side-by-side (i.e., left and right) images of the surgical site to produce a video stream of the surgical scene. The laparoscopic camera 51 is coupled to an image processing device 56, which may be disposed within the control tower 20. The image processing device 56 may be any computing device configured to receive the video feed from the laparoscopic camera 51 and output the processed video stream.

[0028] The surgeon console 30 includes a first screen 32, which displays a video feed of the surgical site provided by camera 51 of the surgical instrument 50 disposed on the robotic arm 40, and a second screen 34, which displays a user interface for controlling the surgical robotic system 10. The first screen 32 and second screen 34 may be touchscreens allowing for displaying various graphical user inputs.

[0029] The surgeon console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of hand controllers 38a and 38b which are used by a user to remotely control robotic arms 40. The surgeon console further includes an armrest 33 used to support clinician’s arms while operating the hand controllers 38a and 38b.

[0030] The control tower 20 includes a screen 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs). The control tower 20 also acts as an interface between the surgeon console 30 and one or more robotic arms 40. In particular, the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 50, based on a set of programmable instructions and/or input commands from the surgeon console 30, in such a way that robotic arms 40 and the surgical instrument 50 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b. The foot pedals 36 may be used to enable and lock the handle controllers 38a and 38b, repositioning camera movement and electrosurgical activation/deactivation. In particular, the foot pedals 36 may be used to perform a clutching action on the handle controllers 38a and 38b. Clutching is initiated by pressing one of the foot pedals 36, which disconnects (i.e., prevents movement inputs) the handle controllers 38a and/or 38b from the robotic arm 40 and corresponding instrument 50 or camera 51 attached thereto. This allows the user to reposition the handle controllers 38a and 38b without moving the robotic arm(s) 40 and the instrument 50 and/or camera 51. This is useful when reaching control boundaries of the surgical space.

[0031] Each of the control tower 20, the surgeon console 30, and the robotic arm 40 includes a respective computer 21, 31, 41. The computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network, and without limitation as to the full scope of the definition of communication networks as encompassed by the present disclosure. Suitable protocols include, but are not limited to, transmission control protocol/intemet protocol (TCP/IP), datagram protocol/intemet protocol (UDP/IP), and/or datagram congestion control protocol (DC). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-1203 standard for wireless personal area networks (WPANs)).

[0032] The computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, non-volatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and/or set of instructions described herein.

[0033] With reference to FIG. 2, each of the robotic arms 40 may include a plurality of links 42a, 42b, 42c, which are interconnected at joints 44a, 44b, 44c, respectively. Other configurations of links and joints may be utilized as known by those skilled in the art. The joint 44a is configured to secure the robotic arm 40 to the mobile cart 60 and defines a first longitudinal axis. With reference to FIG. 3, the mobile cart 60 includes a lift 67 and a setup arm 61, which provides a base for mounting of the robotic arm 40. The lift 67 allows for vertical movement of the setup arm 61. The mobile cart 60 also includes a screen 69 for displaying information pertaining to the robotic arm 40. In embodiments, the robotic arm 40 may include any type and/or number of joints.

[0034] The setup arm 61 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of the robotic arm 40. The links 62a, 62b, 62c are interconnected at joints 63a and 63b, each of which may include an actuator (not shown) for rotating the links 62b and 62b relative to each other and the link 62c. In particular, the links 62a, 62b, 62c are movable in their corresponding lateral planes that are parallel to each other, thereby allowing for extension of the robotic arm 40 relative to the patient (e.g., surgical table). In embodiments, the robotic arm 40 may be coupled to the surgical table (not shown). The setup arm 61 includes controls 65 for adjusting movement of the links 62a, 62b, 62c as well as the lift 67. In embodiments, the setup arm 61 may include any type and/or number of joints.

[0035] The third link 62c may include a rotatable base 64 having two degrees of freedom. In particular, the rotatable base 64 includes a first actuator 64a and a second actuator 64b. The first actuator 64a is rotatable about a first stationary arm axis which is perpendicular to a plane defined by the third link 62c and the second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis. The first and second actuators 64a and 64b allow for full three-dimensional orientation of the robotic arm 40.

[0036] The actuator 48b of the joint 44b is coupled to the joint 44c via the belt 45a, and the joint 44c is in turn coupled to the joint 46b via the belt 45b. Joint 44c may include a transfer case coupling the belts 45a and 45b, such that the actuator 48b is configured to rotate each of the links 42b, 42c and a holder 46 relative to each other. More specifically, links 42b, 42c, and the holder 46 are passively coupled to the actuator 48b which enforces rotation about a pivot point “P” which lies at an intersection of the first axis defined by the link 42a and the second axis defined by the holder 46. In other words, the pivot point “P” is a remote center of motion (RCM) for the robotic arm 40. Thus, the actuator 48b controls the angle 0 between the first and second axes allowing for orientation of the surgical instrument 50. Due to the interlinking of the links 42a, 42b, 42c, and the holder 46 via the belts 45a and 45b, the angles between the links 42a, 42b, 42c, and the holder 46 are also adjusted in order to achieve the desired angle 0. In embodiments, some or all of the joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.

[0037] The joints 44a and 44b include an actuator 48a and 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a and 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like. In particular, the actuator 48a is configured to rotate the robotic arm 40 about a longitudinal axis defined by the link 42a.

[0038] With reference to FIG. 2, the holder 46 defines a second longitudinal axis and configured to receive an instrument drive unit (IDU) 52 (FIG. 1). The IDU 52 is configured to couple to an actuation mechanism of the surgical instrument 50 and the camera 51 and is configured to move (e.g., rotate) and actuate the instrument 50 and/or the camera 51. IDU 52 transfers actuation forces from its actuators to the surgical instrument 50 to actuate components an end effector 49 of the surgical instrument 50. The holder 46 includes a sliding mechanism 46a, which is configured to move the IDU 52 along the second longitudinal axis defined by the holder 46. The holder 46 also includes a joint 46b, which rotates the holder 46 relative to the link 42c. During endoscopic procedures, the instrument 50 may be inserted through an endoscopic access port 55 (FIG. 3) held by the holder 46. The holder 46 also includes a port latch 46c for securing the access port 55 to the holder 46 (FIG. 2). [0039] The robotic arm 40 also includes a plurality of manual override buttons 53 (FIG. 1) disposed on the IDU 52 and the setup arm 61, which may be used in a manual mode. The user may press one or more of the buttons 53 to move the component associated with the button 53. [0040] With reference to FIG. 4, each of the computers 21, 31, 41 of the surgical robotic system 10 may include a plurality of controllers, which may be embodied in hardware and/or software. The computer 21 of the control tower 20 includes a controller 21a and safety observer 21b. The controller 21a receives data from the computer 31 of the surgeon console 30 about the current position and/or orientation of the handle controllers 38a and 38b and the state of the foot pedals 36 and other buttons. The controller 21a processes these input positions to determine desired drive commands for each joint of the robotic arm 40 and/or the IDU 52 and communicates these to the computer 41 of the robotic arm 40. The controller 21a also receives the actual joint angles measured by encoders of the actuators 48a and 48b and uses this information to determine force feedback commands that are transmitted back to the computer 31 of the surgeon console 30 to provide haptic feedback through the handle controllers 38a and 38b. The safety observer 21b performs validity checks on the data going into and out of the controller 21a and notifies a system fault handler if errors in the data transmission are detected to place the computer 21 and/or the surgical robotic system 10 into a safe state.

[0041] The controller 21a is coupled to a storage 22a, which may be non-transitory computer- readable medium configured to store any suitable computer data, such as software instructions executable by the controller 21a. The controller 21a also includes transitory memory 22b for loading instructions and other computer readable data during execution of the instructions. In embodiments, other controllers of the system 10 include similar configurations.

[0042] The computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an instrument drive unit (IDU) controller 4 Id. The main cart controller 41a receives and processes joint commands from the controller 21a of the computer 21 and communicates them to the setup arm controller 41b, the robotic arm controller 41c, and the IDU controller 41d. The main cart controller 41a also manages instrument exchanges and the overall state of the mobile cart 60, the robotic arm 40, and the IDU 52. The main cart controller 41a also communicates actual joint angles back to the controller 21a.

[0043] Each of joints 63a and 63b and the rotatable base 64 of the setup arm 61 are passive joints (i.e., no actuators are present therein) allowing for manual adjustment thereof by a user. The joints 63a and 63b and the rotatable base 64 include brakes that are disengaged by the user to configure the setup arm 61. The setup arm controller 41b monitors slippage of each of joints 63a and 63b and the rotatable base 64 of the setup arm 61, when brakes are engaged or can be freely moved by the operator when brakes are disengaged, but do not impact controls of other joints. The robotic arm controller 41c controls each joint 44a and 44b of the robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm 40. The robotic arm controller 41c calculates a movement command based on the calculated torque. The calculated motor commands are then communicated to one or more of the actuators 48a and 48b in the robotic arm 40. The actual joint positions are then transmitted by the actuators 48a and 48b back to the robotic arm controller 41c.

[0044] The IDU controller 41d receives desired joint angles for the surgical instrument 50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU 52. The IDU controller 4 Id calculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller 41a.

[0045] The robotic arm 40 is controlled in response to a pose of the handle controller controlling the robotic arm 40, e.g., the handle controller 38a, which is transformed into a desired pose of the robotic arm 40 through a hand eye transform function executed by the controller 21a. The hand eye function, as well as other functions described herein, is/are embodied in software executable by the controller 2 la or any other suitable controller described herein. The pose of one of the handle controllers 38a may be embodied as a coordinate position and roll-pitch-yaw (RPY) orientation relative to a coordinate reference frame, which is fixed to the surgeon console 30. The desired pose of the instrument 50 is relative to a fixed frame on the robotic arm 40. The pose of the handle controller 38a is then scaled by a scaling function executed by the controller 21a. In embodiments, the coordinate position may be scaled down and the orientation may be scaled up by the scaling function. In addition, the controller 21a may also execute a clutching function, which disengages the handle controller 38a from the robotic arm 40. In particular, the controller 21a stops transmitting movement commands from the handle controller 38a to the robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.

[0046] The desired pose of the robotic arm 40 is based on the pose of the handle controller 38a and is then passed by an inverse kinematics function executed by the controller 21a. The inverse kinematics function calculates angles for the joints 44a, 44b, 44c of the robotic arm 40 that achieve the scaled and adjusted pose input by the handle controller 38a. The calculated angles are then passed to the robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints 44a, 44b, 44c.

[0047] With reference to FIG. 5, the surgical robotic system 10 is setup around a surgical table 90. The system 10 includes mobile carts 60a-d, which may be numbered “1” through “4.” During setup, each of the carts 60a-d are positioned around the surgical table 90. Position and orientation of the carts 60a-d depends on a plurality of factors, such as placement of a plurality of access ports 55a-d, which in turn, depends on the surgery being performed. Once the port placement is determined, the access ports 55a-d are inserted into the patient, and carts 60a-d are positioned to insert instruments 50 and the laparoscopic camera 51 into corresponding ports 55a-d.

[0048] During use, each of the robotic arms 40a-d is attached to one of the access ports 55a-d that is inserted into the patient by attaching the latch 46c (FIG. 2) to the access port 55 (FIG. 3). The IDU 52 is attached to the holder 46, followed by the SIM 43 being attached to a distal portion of the IDU 52. Thereafter, the instrument 50 is attached to the SIM 43. The instrument 50 is then inserted through the access port 55 by moving the IDU 52 along the holder 46. The SIM 43 includes a plurality of drive shafts configured to transmit rotation of individual motors of the IDU 52 to the instrument 50 thereby actuating the instrument 50. In addition, the SIM 43 provides a sterile barrier between the instrument 50 and the other components of robotic arm 40, including the IDU 52. The SIM 43 is also configured to secure a sterile drape (not shown) to the IDU 52.

[0049] During setup, an assistant access port 50e is also inserted into the patient and is used to insert any suitable surgical instrument 70. The instrument 70 may be a manual, robotic, or motor-powered surgical instrument, an additional endoscopic camera, an ultrasonic probe, or any other surgical instrument that is not directly controlled by the robotic system 10. In embodiments, more than one assistant access port 55e may be used to accommodate additional instruments.

[0050] The system 10 includes an external vision tracking unit 80 (e.g., one or more cameras or infrared sensors) configured to track location of the access ports 50a-e, the robotic arms 40, etc. The tracking unit 80 may include one or more position sensors, which may be any suitable white light or infrared cameras, electromagnetic sensors, magnetoresistance sensors, radio frequency sensors, or any other sensor adapted to sufficiently sense the position of a navigation marker. The tracking unit 80 may be configured to detect markers disposed on the access ports 50a-e. The markers may be passive tracking elements (e.g., reflectors) for transmitting light signals (e.g., reflecting light emitted from the tracking unit 80). Alternatively, the markers may include a radio opaque material that is identified and trackable by the tracking unit 80. In other configurations, active tracking markers can be employed. The active tracking markers can be, for example, light emitting diodes transmitting light, such as infrared light. Active and passive arrangements are possible. The markers may be arranged in a defined or known position and orientation relative to the other markers in order to allow the tracking unit 80 to determine the position of the access ports 50a-e relative to each other. Access ports 50a-d may be registered to specific robotic arms 40 and corresponding instruments 50 and the access port 50e is registered to the assistant instrument 70 to allow the surgical robotic system 10 to determine the position and/or orientation of the instruments 50, the camera 51, and the instrument 70 within a defined space, such as the surgical field.

[0051] With reference to FIG. 6, the first screen 32 of the surgeon console 30 includes a GUI 100 providing a video feed 102 of the camera 51. The video feed 102 is the field of view of the camera 51 and may show the surgical site, the instruments 50, the instrument 70, etc. The video processing device 56 is configured to output the GUI 100, which may be displayed on any of the screens of the system 10, namely, the first screen 32 of the surgeon console 30 and the screen 23 of the control tower 20.

[0052] FIG. 7 shows a method for providing instructions to a bedside assistant via the GUI 100 displayed on the screen 23 of the control tower 20. The method may be implemented as software instructions executable by a processor (e.g., controller 21a) and in particular as a software application having the GUI 100 for providing virtual instrument location. The virtual instrument is movable by the surgeon through the surgeon console 30 and is used as a guide by the bedside assistant for moving the assistant instrument 70.

[0053] At step 200, external locations of the access ports 50a-e are determined using the tracking unit 80 and are provided to the system 10. The location data is provided to the video processing device 56 in order to output a virtual instrument 170 in the GUI 100 as an overlay in the video feed 102 (FIG. 6). In particular, the access ports 50a-e are registered in a world coordinate system allowing for registration of the instrument(s) 50 and the camera 51 relative to each other.

[0054] At step 202, the controller 21a determines whether the instrument 70 is within the field of view of the camera 51. The video processing device 56 may use machine learning image processing algorithms. In embodiments, machine learning may include a convolutional neural network (CNN) and/or a support vector machine (SVM). The CNN may be trained on previous data, for example, images of various instruments and devices. The video processing device 56 is configured to communicate with the controller 21a to notify the controller 21a whether the instrument 70 is present.

[0055] If the instrument 70 is outside the field of view of the camera 51, at step 204, the controller 21a may output a message at the GUI 100 at the screen 23 of the control tower 20 and/or the screen 32 of the surgeon console 30. The message may include directional arrows to move the camera 51 and/or the instrument 70 such that the instrument 70 is within the field of view of the camera 51.

[0056] Once the instrument 70 is visible to the camera 51, at step 206, the video processing device 56 renders the virtual instrument 170 in video feed 102 to generate an augmented reality video feed. The video processing device 56 is configured to load 3D and physics models as well as kinematics of the assistant instrument 70, which are used to render the virtual instrument 170 and simulate movement of the virtual instrument 170. Rendering the virtual instrument 170 in virtual 3D space of the field of view of the camera 51 may be based on depth mapping of the surgical site. Depth mapping may be performed using image processing techniques on the stereoscopic video feed. As noted above, the virtual instrument 170 is displayed simultaneously on the first screen 32 of the surgeon console 30 and the screen 23 of the control tower 20, each of which is receiving the feed of the camera 51.

[0057] At step 208, the surgeon may control the virtual instrument 170. This may be done in the same manner as controlling the robotic arms 40 and the instrument 50 and/or camera 51 coupled thereto. The surgeon selects the virtual instrument 170 through one of the handle controllers 38a or 38b, which allows for movement of the virtual instrument 170 as if the virtual instrument 170 was an actual instrument, e.g., instrument 50. Movements of the handle controller 38a or 38b moves the virtual instrument 170 in the augmented video feed 102 based on the depth mapping of the scene and the 3D rendering of the model.

[0058] The video processing device 56 is configured to render a physics-based virtual 3D space based on stereo reconstruction (i.e., depth map) from the video feed 102. This would enable creating virtual boundaries in the virtual 3D space that the virtual instrument 170 may not be moved through. Virtual boundaries may be indicated to the user via haptic feedback through the handle controllers 38a and 38b as well as adjusting resistances of the motors of the controllers 38a and 38b. Thus, the surgeon console 30 may limit the movement of the virtual instrument 170 based on the virtual boundaries. In embodiments, the virtual instrument 170 may be used a virtual tool to measure distances in the video feed 102. This may be accomplished by any number of 3D user interface methods, such as moving the virtual instrument 170 between two points to measure the distance like a virtual ruler. [0059] Movement of virtual instrument 170 may also include multiple movements or maneuvers in one or more directions until the virtual instrument 170 is at the desired location. The final location of the virtual instrument 170 is displayed on the GUI 100 and in particular, on the video feed 102 at step 210. In addition, the sequence of movements taken to arrive at the final location may also be replayed on the GUI 100. These aids provide guidance to the assistant who is moving the actual, i.e., physical, assistant instrument 70 to the final location indicated by the virtual instrument 170. The GUI 100 may display direction arrows indicating which way the instrument 70 is to be moved to arrive at the final location.

[0060] At step 212, the video processing device 56 checks whether the assistant instrument 70 is at the same or substantially the same position as the virtual instrument 170. A plurality of keypoints of the assistant instrument 70 are compared to counterpart keypoints of the virtual instrument 170 by the video processing device 56 to determine whether there is 3D alignment between the instrument 70 and the virtual instrument 170. If there is a mismatch between the location of the instrument 70 and the virtual instrument 170, the GUI 100 may indicate that with an alert or by using a specific color (e.g., red) of the virtual instrument 170 on the video feed 102 at step 214. If there is alignment, then at step 216, the GUI 100 may indicate so in a similar manner by changing the color (e.g., green), by a message, etc. In embodiments, the color of the virtual instrument 170 may change like a heatmap from red to green to indicate the closeness of the alignment.

[0061] In embodiments, in addition to or as an alternative to the video processing device 56 checking whether the assistant instrument 70 is at the same or substantially the same position as the virtual instrument 170, the system 10 may display on the surgeon console 30 a prompt to the user to confirm whether the assistant instrument 70 is at indicated position of the virtual instrument 170. The prompt may be generated periodically and/or as a response to the assistant instrument 70 approximating the position of the virtual instrument 170. Once the user affirmatively confirms the assistant instrument 70 is at the indicated position then the GUI 100 may indicate by changing the color (e.g., green) or another message. In embodiments, the color of the virtual instrument 170 may change like a heatmap from red to green to indicate the closeness of the alignment.

[0062] The disclosed system and method may be used with a variety of different surgical instruments and a few exemplary embodiments are provided below. Endoscopic stapling involves a complicated workflow, which includes position the stapling end effector at a precise angle and position. Using a virtual stapler would allow the assistant follow along with the assistant instrument 70, e.g., physical stapler, to the exact location of the tissue where stapling is required.

[0063] In further embodiments, the virtual instrument 170 may be a virtual laparoscopic ultrasound probe and the instrument 70 may be an endoscopic ultrasound probe. Robotic systems may use a robotic drop-in probe that is manipulated by a grasper instrument to obtain ultrasound images of the tissue. However, such probes are expensive and cumbersome to use, they also require one of the robotic arm. Thus, the assistant instrument 70 may be an endoscopic ultrasound probe that the assistant can position as indicated by the virtual instrument 170 representing the location in need of ultrasound imaging. This would allow the surgeon to move the virtual instrument 170, e.g., ultrasound probe along an organ to trace or confirm a tumor boundary or other critical structures.

[0064] In additional embodiments, the virtual instrument 170 may be a virtual endoscope and the assistant instrument 70 may be an additional endoscope, which may be controllable by the assistant or directly by the surgeon through the surgeon console 30. The surgeon can clutch out and manipulate the virtual endoscope without involvement by the assistant. The virtual endoscope may be used to render a view of the surgical site from a different angle without need to move the camera 51. In embodiments, the feed from the virtual endoscope may be combined with feed from the camera 51 to generate stadium view of the surgical site or to simulate port hopping, i.e., switching the video feed being displays on the first screen 32 of the surgeon console 30.

[0065] The virtual endoscope may also be used to render a realistic view of anatomy from multiple angles using a continuously updated depth map. Machine learning may be implemented in the virtual endoscope, e.g., generative adversarial network (GAN) based approaches, to render views not directly visible by the camera 51. The GAN may be trained on other patients’ anatomy from previous videos of similar procedures to generate such views. [0066] It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.

Claims

WHAT IS CLAIMED IS:

1. A surgical robotic system comprising: an assistant access port configured to receive an assistant instrument; an endoscopic camera configured to generate a video feed of a surgical site and the assistant instrument; a control tower including a first screen; a surgeon console including a second screen and a handle controller configured to receive user input; and a video processing device configured to: render a virtual instrument of the assistant instrument in the video feed to generate an augmented video feed; move the virtual instrument in the augmented video feed in response to the user input; output the augmented video feed with the virtual instrument on the first screen and the second screen; confirm whether the assistant instrument is disposed at a location of the virtual instrument; and indicate on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

2. The surgical robotic system according to claim 1, further comprising: a robotic arm including a robotic instrument; and a robotic access port configured to receive the robotic instrument.

3. The surgical robotic system according to claim 2, wherein the surgeon console is configured to switch between controlling the robotic instrument and the virtual instrument.

4. The surgical robotic system according to claim 2, further comprising a tracking unit configured to track positions of the assistant access port and the robotic access port.

5. The surgical robotic system according to claim 4, wherein the video processing device is configured to determine location of the assistant instrument based on the positions of the assistant access port and the robotic access port.

6. The surgical robotic system according to claim 1, wherein the video processing device is configured to render the virtual instrument based on 3D model data of the assistant instrument.

7. The surgical robotic system according to claim 1, wherein the endoscopic camera is a stereoscopic camera, and the processing device is configured to generate a depth map of the surgical site.

8. The surgical robotic system according to claim 7, wherein the processing device is configured to generate a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map.

9. The surgical robotic system according to claim 8, wherein the surgeon console is configured to limit the user input for controlling movement of the virtual instrument at the surgeon console based on the virtual boundary.

10. A non-transitory computer readable medium storing instructions that, when executed by a processor, cause the processor to perform a computer-implemented method for communicating movement instructions using a virtual instrument, the method comprising: receiving a video feed of a surgical site and an assistant instrument; rendering a virtual instrument of the assistant instrument in the video feed to generate an augmented video feed that is displayed on a first screen of a control tower and a second screen of a surgeon console; moving the rendered virtual instrument in the video feed in response to input signals received from the surgeon console; outputting the augmented video feed with the virtual instrument on the first screen and the second screen; prompting a user to confirm whether the assistant instrument is disposed at a location of the virtual instrument; and indicating on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

11. The non-transitory computer readable medium according to claim 10, wherein the computer-implemented method further comprises: switching between controlling a robotic instrument coupled to a robotic arm and inserted through a robotic access port and the virtual instrument.

12. The non-transitory computer readable medium according to claim 11, wherein the computer-implemented method further comprises: tracking positions of an assistant access port through which the assistant instrument is inserted and the robotic access port.

13. The non-transitory computer readable medium according to claim 12, wherein the computer-implemented method further comprises: determining a location of the assistant instrument based on the positions of the assistant access port and the robotic access port.

14. The non-transitory computer readable medium according to claim 10, wherein the computer-implemented method further comprises: rendering the virtual instrument based on 3D model data of the assistant instrument.

15. The non-transitory computer readable medium according to claim 10, wherein the computer-implemented method further comprises: generating a depth map of the surgical site.

16. The non-transitory computer readable medium according to claim 15, wherein the computer-implemented method further comprises: generating a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map.

17. The non-transitory computer readable medium according to claim 16, wherein the computer-implemented method further comprises: limiting movement of the virtual instrument at the surgeon console based on the virtual boundary.

18. A surgical robotic system comprising: a robotic arm including a robotic instrument; and a robotic access port configured to receive the robotic instrument; an assistant access port configured to receive an assistant instrument; an endoscopic camera configured to generate a video feed of a surgical site and the assistant instrument; a control tower including a first screen; a surgeon console including a second screen and a handle controller configured to receive user input to control the robotic instrument and a virtual instrument; and a video processing device configured to: render the virtual instrument of the assistant instrument in the video feed to generate an augmented video feed; move the virtual instrument in the augmented video feed in response to the user input; output the augmented video feed with the virtual instrument on the first screen and the second screen; confirm whether the assistant instrument is disposed at a location of the virtual instrument; and indicate on the first screen and the second screen whether the assistant instrument is disposed at the location of the virtual instrument.

19. The surgical robotic system according to claim 18, wherein the endoscopic camera is a stereoscopic camera and the processing device is configured to generate a depth map of the surgical site.

20. The surgical robotic system according to claim 19, wherein the processing device is configured to generate a virtual boundary corresponding to a physical boundary of the surgical site based on the depth map, and the surgeon console is configured to limit the user input for controlling movement of the virtual instrument at the surgeon console based on the virtual boundary.