Certain robotic medical procedures can involve interaction between one or more medical instruments and one or more medical instrument drive assemblies, which can include sterile adapters, robotic arm assemblies, and/or similar devices. In some cases, physicians may attach and/or mate a medical instrument to a medical instrument drive assembly while the physician navigates the medical instrument through a patient's body.
Various embodiments are depicted in the accompanying drawings for illustrative purposes and should in no way be interpreted as limiting the scope of the inventions. In addition, various features of different disclosed embodiments can be combined to form additional embodiments, which are part of this disclosure. Throughout the drawings, reference numbers may be reused to indicate correspondence between reference elements.
The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed invention. Although certain preferred embodiments and examples are disclosed below, inventive subject matter extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses and to modifications and equivalents thereof. Thus, the scope of the claims that may arise herefrom is not limited by any of the particular embodiments 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 be described as multiple discrete operations in turn, in a manner that may be helpful in understanding certain embodiments; however, the order of description should not be construed 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, certain aspects and advantages of these embodiments are described. Not necessarily all such aspects or advantages are achieved by any particular embodiment. Thus, for example, various 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 aspects or advantages as may also be taught or suggested herein.
Although certain spatially relative terms, such as “outer,” “inner,” “upper,” “lower,” “below,” “above,” “vertical,” “horizontal,” “top,” “bottom,” “lateral,” and similar terms, are used herein to describe a spatial relationship of one device/element or anatomical structure to another device/element or anatomical structure, it is understood that these terms are used herein for ease of description to describe the positional relationship between element(s)/structures(s), such as with respect to the illustrated orientations of the drawings. It should be understood that spatially relative terms are intended to encompass different orientations of the element(s)/structures(s), in use or operation, in addition to the orientations depicted in the drawings. For example, an element/structure described as “above” another element/structure may represent a position that is below or beside such other element/structure with respect to alternate orientations 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 relative to a respective illustrated orientation of a referenced figure.
Certain reference numbers are re-used across different figures of the figure set of the present disclosure as a matter of convenience for devices, components, systems, features, and/or modules having features that may be similar in one or more respects. However, with respect to any of the embodiments disclosed herein, re-use of common reference numbers in the drawings does not necessarily indicate that such features, devices, components, or modules are identical or similar. Rather, one having ordinary skill in the art may be informed by context with respect to the degree to which usage of common reference numbers can imply similarity between referenced subject matter. Use of a particular reference number in the context of the description of a particular figure can be understood to relate to the identified device, component, aspect, feature, module, or system in that particular figure, and not necessarily to any devices, components, aspects, features, modules, or systems identified by the same reference number in another figure. Furthermore, aspects of separate figures identified with common reference numbers can be interpreted to share characteristics or to be entirely independent of one another. In some contexts features associated with separate figures that are identified by common reference numbers are not related and/or similar with respect to at least certain aspects.
The present disclosure provides systems, devices, and methods for facilitate interaction between one or more medical instruments and one or more medical instrument drive assemblies. With respect to medical instruments described in the present disclosure, the term “instrument” is used according to its broad and ordinary meaning and may refer to any type of tool, device, assembly, system, subsystem, apparatus, component, or the like. In some contexts herein, the term “device” may be used substantially interchangeably with the term “instrument.” Furthermore, the term “assembly” is used herein according to its broad and ordinary meaning and may refer to any device and/or set of devices. The term “drive assembly” is used herein according to its broad and ordinary meaning and may refer to any device and/or set of devices associated with driving one or more medical instruments.
Although certain aspects of the present disclosure are described in detail herein in the context of renal, urological, and/or nephrological procedures, such as kidney stone removal/treatment procedures, it should be understood that such context is provided for convenience and clarity, and robotic and/or manual drive concepts disclosed herein are applicable to any suitable medical procedures, such as robotic bronchoscopy. However, as mentioned, description of the renal/urinary anatomy and associated medical issues and procedures is presented below to aid in the description of the inventive concepts disclosed herein.
In certain medical procedures, such as ureteroscopy procedures, elongate medical instruments that access the treatment site through an access sheath may be utilized to remove debris, such as kidney stones and stone fragments or other refuse or contaminant(s), from the treatment site. Kidney stone disease, also known as urolithiasis, is a medical condition that involves the formation in the urinary tract of a solid piece of material, referred to as “kidney stones,” “urinary stones,” “renal calculi,” “renal lithiasis,” or “nephrolithiasis.” Urinary stones may be formed and/or found in the kidneys, the ureters, and the bladder (referred to as “bladder stones”). Such urinary stones can form as a result of mineral concentration in urinary fluid and can cause significant abdominal pain once such stones reach a size sufficient to impede urine flow through the ureter or urethra. Urinary stones may be formed from calcium, magnesium, ammonia, uric acid, cystine, and/or other compounds or combinations thereof.
Several methods can be used for treating patients with kidney stones, including observation, medical treatments (such as expulsion therapy), non-invasive treatments (such as extracorporeal shock wave lithotripsy (ESWL)), minimally invasive or surgical treatments (such as ureteroscopy and percutaneous nephrolithotomy (“PCNL”)), and so on. In some approaches (e.g., ureteroscopy and PCNL), the physician gains access to the stone, the stone is broken into smaller pieces or fragments, and the relatively small stone fragments/particulates are extracted from the kidney using a basketing device and/or aspiration.
In some procedures, surgeons may insert an endoscope (e.g., ureteroscope) into the urinary tract through the urethra to remove urinary stones from the bladder and ureter. Typically, a ureteroscope includes a camera at its distal end configured to enable visualization of the urinary tract. The ureteroscope can also include, or allow for placement in a working channel of the ureteroscope, a lithotripsy device configured to capture or break apart 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(s).
In some procedures, such as procedures for removing relatively large stones/fragments, physicians may use a percutaneous nephrolithotomy (“PCNL”) technique that involves inserting a nephroscope through the skin (i.e., percutaneously) and intervening tissue to provide access to the treatment site for breaking-up and/or removing the stone(s). A percutaneous-access device (e.g., nephroscope, sheath, sheath assembly, and/or catheter) used to provide an access channel to the target anatomical site (and/or a direct-entry endoscope) may include one or more fluid channels for providing irrigation fluid flow to the target site and/or aspirating fluid from the target site (e.g., through passive outflow and/or active suction).
For ureteroscopic procedures, a physician may implement a procedure to break a relatively large kidney stone into a relatively smaller fragments to facilitate extraction thereof. For example, certain instruments may be utilized to break the stone into smaller fragments, such as by lasing, or through other application of cleaving force to the kidney stone. According to some procedures, a basketing device/system may be used to capture the relatively smaller stone fragment(s) and extract them from the treatment site out of the patient. Generally, when a stone is captured, the surgeon may wish to quickly extract the stone through the uretereral access sheath prior to opening the basket to deposit/drop the stone into a specimen collection structure or area, after which the basket may be closed and reinserted (e.g., within a working channel of an endoscope/ureteroscope) through the access sheath for the purpose of extracting remaining stones or stone fragments, should there be any.
Robotic-assisted ureteroscopic procedures can be implemented in connection with various medical procedures, such as kidney stone removal procedures, wherein robotic tools can enable a physician/urologist to perform endoscopic target access as well as percutaneous access/treatment. Advantageously, aspects of the present disclosure relate to systems, devices, and methods for managing and/or facilitating interaction (which can including attaching, mating, contacting, locking, latching, removing, guiding, driving, among other interactions described herein) between one or more medical instruments (which can include endoscopes/ureteroscopes, basketing devices/systems, lithotripsy device(s), and/or various other instruments) and/or medical instrument drive assemblies (which can include adapters, sterile adapters, robotic arm devices, and/or various other devices).
Although the system 100 of
The medical system 100 includes a robotic system 10 (e.g., mobile robotic cart) configured to engage with and/or control a medical instrument 19 (e.g., ureteroscope) including a proximal handle 31 and a shaft 40 coupled to the handle 31 at a proximal portion thereof to perform a direct-entry procedure on a patient 7. The term “direct-entry” is used herein according to its broad and ordinary meaning and may refer to any entry of instrumentation through a natural or artificial opening in a patient's body. For example, with reference to
It should be understood that the direct-entry instrument 19 may be any type of shaft-based medical instrument, including an endoscope (such as a ureteroscope), catheter (such as a steerable or non-steerable catheter), nephroscope, laparoscope, or other type of medical instrument. Embodiments of the present disclosure relating to ureteroscopic procedures for removal of kidney stones through a ureteral access sheath (e.g., the ureteral access sheath 90) are also applicable to solutions for removal of objects through percutaneous access, such as through a percutaneous access sheath. For example, instrument(s) may access the kidney percutaneously through, for example, a percutaneous access sheath to capture and remove kidney stones. The term “percutaneous access” is used herein according to its broad and ordinary meaning and may refer to entry, such as by puncture and/or minor incision, of instrumentation through the skin of a patient and any other body layers necessary to reach a target anatomical location associated with a procedure (e.g., the calyx network of the kidney 70).
The medical system 100 includes a control system 50 configured to interface with the robotic system 10, provide information regarding the procedure, and/or perform a variety of other operations. For example, the control system 50 can include various input/output components 258 which can include one or more display(s) 56 configured to present certain information to assist the physician 5 and/or other technician(s) or individual(s). The medical system 100 can include a table 15 configured to hold the patient 7. The system 100 may further include an electromagnetic (EM) field generator 18, which may be held by one or more of the robotic arms 12 of the robotic system 10 or may be a stand-alone device. Although the various robotic arms 12 are shown in various positions and coupled to various tools/devices, it should be understood that such configurations are shown for convenience and illustration purposes, and such robotic arms may have different configurations over time and/or at different points during a medical procedure. Furthermore, the robotic arms 12 may be coupled to different devices/instruments than shown in
In an example use case, if the patient 7 has a kidney stone (or stone fragment) 80 located in a kidney 70, the physician may execute a procedure to remove the stone 80 through the urinary tract (63, 60, 65). In some embodiments, the physician 5 can interact with the control system 50 and/or the robotic system 10 to cause/control the robotic system 10 to advance and navigate the medical instrument shaft 40 (e.g., a scope) from the urethra 65, through the bladder 60, up the ureter 63, and into the renal pelvis 71 and/or calyx network of the kidney 70 where the stone 80 is located. The physician 5 can further interact with the control system 50 and/or the robotic system 10 to cause/control the advancement of a basketing device 30 through a working channel of the instrument shaft 40, wherein the basketing device 30 is configured to facilitate capture and removal of a kidney stone or stone fragment. The control system 50 can provide information via the display(s) 56 that is associated with the medical instrument 40, such as real-time endoscopic images captured therewith, and/or other instruments of the system 100, to assist the physician 5 in navigating/controlling such instrumentation.
The renal anatomy is described herein for reference with respect to certain medical procedures relating to aspects of the present inventive concepts. The kidneys 70, shown roughly in typical anatomical position in
The kidneys 70 are typically located relatively high in the abdominal cavity and lie in a retroperitoneal position at a slightly oblique angle. The asymmetry within the abdominal cavity, generally caused by the position of the liver, results in the right kidney (shown in detail in
The kidneys 70 participate in the control of the volumes of various body fluid compartments, fluid osmolality, acid-base balance, various electrolyte concentrations, and removal of toxins. The kidneys 70 provide filtration functionality by secreting certain substances and reabsorbing others. Examples of substances secreted into the urine are hydrogen, ammonium, potassium and uric acid. In addition, the kidneys also carry out various other functions, such as hormone synthesis, and others.
A recessed area on the concave border of the kidney 70 is the renal hilum 81, where the renal artery 69 (not shown in the detailed view of the kidney 70) enters the kidney 70 and the renal vein 67 (not shown in detailed view) and ureter 63 leave. The kidney 70 is surrounded by tough fibrous tissue, the renal capsule 74, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (rear) surface is the transversalis fascia.
The functional substance, or parenchyma, of the kidney 70 is divided into two major structures: the outer renal cortex 77 and the inner renal medulla 87. These structures take the shape of a plurality of generally cone-shaped renal lobes, each containing renal cortex surrounding a portion of medulla called a renal pyramid 72. Between the renal pyramids 72 are projections of cortex called renal columns 73. Nephrons (not shown in detail in
The tip/apex, or papilla 79, of each renal pyramid empties urine into a respective minor calyx 75; minor calyces 75 empty into major calyces 76, and major calyces 76 empty into the renal pelvis 71, which transitions to the ureter 63. The manifold-type collection of minor and major calyces may be referred to herein as the “calyx network” of the kidney. At the hilum 81, the ureter 63 and renal vein 67 exit the kidney and the renal artery 69 enters. Hilar fat and lymphatic tissue with lymph nodes surround these structures. The hilar fat is contiguous with a fat-filled cavity called the renal sinus. The renal sinus collectively contains the renal pelvis 71 and calyces 75, 76 and separates these structures from the renal medullary tissue. The funnel/tubular-shaped anatomy associated with the calyces can be referred to as the infundibulum/infundibula. That is, an infundibulum generally leads to the termination of a calyx where a papilla is exposed within the calyx.
With further reference to the medical system 100, the medical instrument shaft 40 (e.g., scope, directly-entry instrument, etc.) can be advanced into the kidney 70 through the urinary tract. Specifically, a ureteral access sheath 90 may be disposed within the urinary tract to an area near the kidney 70. The shaft 40 may be passed through the ureteral access sheath 90 to gain access to the internal anatomy of the kidney 70, as shown. Once at the site of the kidney stone 80 (e.g., within a target calyx 75 of the kidney 70 through which the stone 80 is accessible), the medical instrument 19 and/or shaft 40 thereof can be used to channel/direct the basketing device 30 to the target location. Once the stone 80 has been captured in the distal basket portion 35 of the basketing device/assembly 30, the utilized ureteral access path may be used to extract the kidney stone 80 from the patient 7.
The various scope/shaft-type instruments disclosed herein, such as the shaft 40 of the system 100, can be configured to navigate within the human anatomy, such as within a natural orifice or lumen of the human anatomy. The terms “scope” and “endoscope” are used herein according to their broad and ordinary meanings, and may refer to any type of elongate (e.g., shaft-type) medical instrument having image generating, viewing, and/or capturing functionality and being configured to be introduced into any type of organ, cavity, lumen, chamber, or space of a body. A scope can include, for example, a ureteroscope (e.g., for accessing the urinary tract), a laparoscope, a nephroscope (e.g., for accessing the kidneys), a bronchoscope (e.g., for accessing an airway, such as the bronchus), a colonoscope (e.g., for accessing the colon), an arthroscope (e.g., for accessing a joint), a cystoscope (e.g., for accessing the bladder), colonoscope (e.g., for accessing the colon and/or rectum), borescope, and so on. Scopes/endoscopes, in some instances, may comprise an at least partially rigid and/or flexible tube, and may be dimensioned to be passed within an outer sheath, catheter, introducer, or other lumen-type device, or may be used without such devices.
Once the robotic system 10 is properly positioned, the robotic arms 12 may insert the steerable endoscope 52 into the patient robotically, manually, or a combination thereof. The steerable endoscope 52 may comprise at least two telescoping parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument feeder from the set of instrument feeders and/or instrument handles 11, each instrument feeder/handle being coupled to the distal end of a respective robotic arm 12. This linear arrangement of the feeder(s)/handle(s) 11 can create a “virtual rail” 103 that may be repositioned in space by manipulating the one or more robotic arms 12 into different angles and/or positions.
The endoscope 52 may be directed down the patient's trachea and lungs after insertion using precise commands from the robotic system 10 until reaching the target operative site. For example, the endoscope 52 may be directed to deliver a biopsy needle to a target, such as, for example, a lesion or nodule within the lungs of a patient. The needle may be deployed down a working channel that runs the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathology results, additional tools may be deployed down the working channel of the endoscope for additional biopsies. For example, when a nodule is identified as being malignant, the endoscope 52 may endoscopically deliver tools to resect the potentially cancerous tissue. In some instances, diagnostic and therapeutic treatments can be delivered in separate procedures. In those circumstances, the endoscope 52 may also be used to deliver a fiducial to “mark” the location of the target nodule as well. In other instances, diagnostic and therapeutic treatments may be delivered during the same procedure.
In the system 101, a patient introducer 102 is attached to the patient 7 via a port (not shown; e.g., surgical tube). The curvature of the introducer 102 may enable the robotic system 10 to manipulate the instrument 52 from a position that is not in direct axial alignment with the patient-access port, thereby allowing for greater flexibility in the placement of the robotic system 10 within the room. Further, the curvature of the introducer 102 may allow the robotic arms 12 of the robotic system 10 to be substantially horizontally aligned with the patient introducer 102, which may facilitate manual movement of the robotic arm(s) 12 if needed.
As shown, the robotic-enabled table system 104 can include a column 144 coupled to one or more carriages 141 (e.g., ring-shaped movable structures), from which the one or more robotic arms 212 may emanate. The carriage(s) 141 may translate along a vertical column interface that runs at least a portion of the length of the column 144 to provide different vantage points from which the robotic arms 212 may be positioned to reach the patient 7. The carriage(s) 141 may rotate around the column 144 in some embodiments using a mechanical motor positioned within the column 144 to allow the robotic arms 212 to have access to multiples sides of the table 104. Rotation and/or translation of the carriage(s) 141 can allow the system 104 to align the medical instruments, such as endoscopes and catheters, into different access points on the patient. By providing vertical adjustment, the robotic arms 212 can advantageously be configured to be stowed compactly beneath the platform 147 of the table system 104 and subsequently raised during a procedure.
The robotic arms 212 may be mounted on the carriage(s) 141 through one or more arm mounts 145, which may comprise a series of joints that may individually rotate and/or telescopically extend to provide additional configurability to the robotic arms 212. The column 144 structurally provides support for the table platform 147 and a path for vertical translation of the carriage(s) 141. The column 144 may also convey power and control signals to the carriage(s) 141 and/or the robotic arms 212 mounted thereon. The system 104 can include certain control circuitry configured to control driving and/or roll of the instrument shaft using the instrument feeder 11, which may be coupled to an end effector of one of the arms 212, wherein the instrument feeder 11 is controlled to automatically modify axial driving speed with respect to the elongate instrument (e.g., endoscope) 119 based on a determined position of a distal end of the instrument 119. For example, when the distal end of the instrument 119 is positioned at a predetermined automatic pause location, the instrument feeder 11 can be controlled/driven to automatically pause/stop axial retraction to allow for specimen collection, as described in detail herein.
With reference to
The robotic system 10 can be coupled to any component of the medical system 100, such as to the control system 50, the table 15, the EM field generator 18, the scope 40, the basketing system 30, and/or any type of percutaneous-access instrument (e.g., needle, catheter, nephroscope, etc.). In some embodiments, the robotic system 10 is communicatively coupled to the control system 50. For example, the robotic system 10 may be configured to receive control signals from the control system 50 to perform certain operations, such as to position one or more of the robotic arms 12 in a particular manner, manipulate the scope 40, manipulate the basketing system 30, and so on. In response, the robotic system 10 can control, using certain control circuitry 211, actuators 217, and/or other components of the robotic system 10, a component of the robotic system 10 to perform the operations. In some embodiments, the robotic system 10 and/or control system 50 is/are configured to receive images and/or image data from the scope 40 representing internal anatomy of the patient 7 and/or portions of the access sheath or other device components.
The robotic system 10 generally includes an elongated support structure 14 (also referred to as a “column”), a robotic system base 25, and a console 13 at the top of the column 14. The column 14 may include one or more arm supports 17 (also referred to as a “carriage”) for supporting the deployment of the one or more robotic arms 12 (three shown in
The arm support 17 may be configured to vertically translate along the column 14. In some embodiments, the arm support 17 can be connected to the column 14 through slots 20 that are positioned on opposite sides of the column 14 to guide the vertical translation of the arm support 17. The slot 20 contains a vertical translation interface to position and hold the arm support 17 at various vertical heights relative to the robotic system base 25. Vertical translation of the arm support 17 allows the robotic system 10 to adjust the reach of the robotic arms 12 to meet a variety of table heights, patient sizes, and physician preferences. Similarly, the individually configurable arm mounts on the arm support 17 can allow the robotic arm base 21 of robotic arms 12 to be angled in a variety of configurations.
The robotic arms 12 may generally comprise robotic arm bases 21 and end effectors 22, separated by a series of linking arm segments 23 that are connected by a series of joints 24, each joint comprising one or more independent actuators 217. Each actuator may comprise an independently controllable motor. Each independently controllable joint 24 can provide or represent an independent degree of freedom available to the robotic arm. In some embodiments, each of the arms 12 has seven joints, and thus provides seven degrees of freedom, including “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arms 12 to position their respective end effectors 22 at a specific position, orientation, and trajectory in space using different linkage positions and joint angles. This allows for the system to position and direct a medical instrument from a desired point in space while allowing the physician to move the arm joints into a clinically advantageous position away from the patient to create greater access, while avoiding arm collisions.
The robotic system base 25 balances the weight of the column 14, arm support 17, and arms 12 over the floor. Accordingly, the robotic system base 25 and/or control system 50 may house certain relatively heavier components, such as electronics, motors, power supply interface(s) 219, 259, as well as components that selectively enable movement or immobilize the robotic system 10 and/or control system 50. For example, the robotic system base 25 can include wheel-shaped casters 28 that allow for the robotic system to easily move around the operating room prior to a procedure. After reaching the appropriate position, the casters 28 may be immobilized using wheel locks to hold the robotic system 10 in place during the procedure.
Positioned at the upper end of column 14, the console 13 can provide both a user interface for receiving user input and a display screen 16 (or a dual-purpose device such as, for example, a touchscreen) to provide the physician/user with both pre-operative and intra-operative data. Potential pre-operative data on the console/display 16 or display 56 may include pre-operative plans, navigation and mapping data derived from pre-operative computerized tomography (CT) scans, and/or notes from pre-operative patient interviews. Intra-operative data on display may include optical information provided from the tool, sensor and coordinate information from sensors, as well as vital patient statistics, such as respiration, heart rate, and/or pulse. The console 13 may be positioned and tilted to allow a physician to access the console from the side of the column 14 opposite arm support 17. From this position, the physician may view the console 13, robotic arms 12, and patient while operating the console 13 from behind the robotic system 10. As shown, the console 13 can also include a handle 27 to assist with maneuvering and stabilizing the robotic system 10.
The end effector 22 of each of the robotic arms 12 may comprise, or be configured to have coupled thereto, an instrument device manipulator (IDM) 29, which may be attached using a sterile adapter component in some instances. The combination of the end effector 22 and associated IDM, as well as any intervening mechanics or couplings (e.g., sterile adapter), can be referred to as a manipulator assembly. In some embodiments, the IDM 29 can be removed and replaced with a different type of IDM, for example, a first type 111 of IDM/instrument may be configured to manipulate an endoscope/shaft, while a second type 119 of IDM/instrument may be associated with the shaft (e.g., coupled to a proximal portion thereof) and configured to roll and/or articulate the shaft, and/or manipulate a basketing device. Another type of IDM/instrument may be configured to hold an electromagnetic field generator 18. An IDM can provide power 179 and control 178 interfaces. For example, the interfaces can include connectors to transfer pneumatic pressure, electrical power, electrical signals, and/or optical signals from the robotic arm 12 to the IDM. The IDMs 29 may be configured to manipulate medical instruments (e.g., surgical tools/instruments), such as the scope 40, using techniques including, for example, direct drives, harmonic drives, geared drives, belts and pulleys, magnetic drives, and the like. In some embodiments, the device manipulators 29 can be attached to respective ones of the robotic arms 12, wherein the robotic arms 12 are configured to insert or retract the respective coupled medical instruments into or out of the treatment site.
As referenced above, the system 100 can include certain control circuitry configured to perform certain of the functionality described herein, including the control circuitry 211 of the robotic system 10 and the control circuitry 251 of the control system 50. That is, the control circuitry of the systems 100, 101, 104 may be part of the robotic system 10, the control system 50, or some combination thereof. Therefore, any reference herein to control circuitry may refer to circuitry embodied in a robotic system, a control system, or any other component of a medical system, such as the medical systems 100, 101, and 104 shown in
The control circuitry 211, 251 may comprise computer-readable media storing, and/or configured to store, hard-coded and/or operational instructions corresponding to at least some of the steps and/or functions illustrated in one or more of the present figures and/or described herein. Such computer-readable media can be included in an article of manufacture in some instances. The control circuitry 211/251 may be entirely locally maintained/disposed or may be remotely located at least in part (e.g., communicatively coupled indirectly via a local area network and/or a wide area network). Any of the control circuitry 211, 251 may be configured to perform any aspect(s) of the various processes disclosed herein.
With respect to the robotic system 10, at least a portion of the control circuitry 211 may be integrated with the base 25, column 14, and/or console 13 of the robotic system 10, and/or another system communicatively coupled to the robotic system 10. With respect to the control system 50, at least a portion of the control circuitry 251 may be integrated with the console base 51 and/or display unit 56 of the control system 50. It should be understood that any description herein of functional control circuitry or associated functionality may be understood to be embodied in the robotic system 10, the control system 50, or any combination thereof, and/or at least in part in one or more other local or remote systems/devices, such as control circuitry associated with a handle/base of a shaft-type instrument (e.g., endoscope) in accordance with any of the disclosed embodiments.
With further reference to
The various components of the system 100 can be communicatively coupled to each other over a network, which can include a wireless and/or wired network. Example networks include one or more personal area networks (PANs), local area networks (LANs), wide area networks (WANs), Internet area networks (IANs), cellular networks, the Internet, personal area networks (PANs), body area network (BANs), etc. For example, the various communication interfaces 254, 214 of the systems of
The control system 50 and/or robotic system 10 can include certain user controls (e.g., controls 55), which may comprise any type of user input (and/or output) devices or device interfaces, such as one or more buttons, keys, joysticks, handheld controllers (e.g., video-game-type controllers), computer mice, trackpads, trackballs, control pads, and/or sensors (e.g., motion sensors or cameras) that capture hand gestures and finger gestures, touchscreens, and/or interfaces/connectors therefore. Such user controls are communicatively and/or physically coupled to respective control circuitry. In some embodiments, the user may engage the user controls 55 to command robotic shaft rotation/roll, as described herein.
The end effectors 22 may be configured to operate one or more adapters 8 (e.g., sterile adapters) which may be removably attached to the end effectors 22. While adapters 8 are shown as part of the robotic system 10, the adapters 8 may be separate devices which may be mated to one or more end effectors 22 to provide a sterile extension of the end effectors 22 for use in operating and/or driving one or more medical instruments. For example, a protective sheet 38 may be configured to separate at least a portion of the arms 12 and/or end effectors 22 from the adapters 8.
The adapters 8 may comprise one or more drive outputs 404 configured to translate force (e.g., torque) from the drive outputs 402 of the end effectors 22 to one or more medical instruments mated to the drive outputs 404 at the adapters 8. One or more adapters 8 may additionally or alternatively comprise one or more drive inputs configured to receive and/or otherwise mate with the drive outputs 402 of the end effectors 22.
The basketing assembly 30 can comprise a basket 35 formed of one or more wire tines 36. For example, the basketing assembly 30 may comprise four wire tines disposed within a basketing sheath 37 over a length thereof, wherein the tines project from a distal end of the sheath 37 to form the basket form 35. The tines 36 further extend from the proximal end of the sheath 37. The tines 36 may be configured to be slidable within the basketing sheath 37, subject to some amount of frictional resistance. The tines 36 and the sheath 37 can be coupled to respective actuators 195 of a basket cartridge component 32. The basket cartridge 32 may be physically and/or communicatively coupled to the handle portion/component 31 of the scope assembly 519. The handle component 31 can be configured to be used to assist in basketing and/or scope control either manually or through robotic control.
The basketing assembly 30 may comprise various interaction elements 411 which may allow the basketing assembly 30 to interact in various ways with the scope assembly 519 and/or components of the robotic system 10 (e.g., end effectors 22 and/or adapters 8). For example, the basketing assembly 30 may comprise one or more drive inputs 413 configured to receive and/or mate with corresponding drive outputs of one or more end effectors 22 and/or adapters 8. Example interactions elements 411 can further include alignment features 415 configured to facilitate alignment of the basketing assembly 30 with the scope assembly 519, an adapter 8, an end effector 22, and/or other device. For example, the basketing assembly 30 may comprise one or more magnetic elements configured to mate with corresponding magnetic elements at the scope assembly 519, adapter 8, and/or other device. The one or more alignment features 415 may be configured to mate with corresponding features only when the basketing assembly 30 is situated in a desired configuration with the scope assembly 519, adapter 8, and/or other device.
In some embodiments, the basketing assembly 30 may comprise one or more securing features 418 configured to secure the basketing assembly 30 to the scope assembly 519, adapter 8, and/or other device. For example, the basketing assembly 30 may comprise one or more hooks and/or similar attachments mechanisms configured to mate with and/or otherwise form an attachment with corresponding attachment mechanisms (e.g., latches) at an adapter 8. The basketing assembly 30 may further comprise a release mechanism to allow the basketing assembly 30 to be removed from the scope assembly 519, adapter 8, and/or other device.
The scope assembly 519 may comprise various interaction elements 401 which may allow the scope assembly 519 to interact in various ways with the basketing assembly 30 and/or components of the robotic system 10 (e.g., end effectors 22 and/or adapters 8). For example, the scope assembly 519 may comprise one or more drive inputs 403 configured to receive and/or mate with corresponding drive outputs of one or more end effectors 22 and/or adapters 8. Example interactions elements 401 can further include alignment features 405 configured to facilitate alignment of the scope assembly 519 with the basketing assembly 30, an adapter 8, an end effector 22, and/or other device. For example, the scope assembly 519 may comprise one or more magnetic elements and/or other adapter alignment features 406 configured to mate with corresponding magnetic elements and/or other features at an adapter 8. In another example, the scope assembly 519 may comprise one or more magnetic elements and/or other basket alignment features 407 configured to mate with corresponding magnetic elements and/or other features at the basketing assembly 30. The one or more alignment features 405 may be configured to mate with corresponding features only when the scope assembly 519 is situated in a desired configuration with the basketing assembly 30, adapter 8, and/or other device.
In some embodiments, the scope assembly 519 may comprise one or more securing features 418 configured to secure the scope assembly 519 to the basketing assembly 30, adapter 8, and/or other device. For example, the scope assembly 519 may comprise one or more indentations and/or similar attachments features configured to mate with and/or otherwise form an attachment with corresponding attachment mechanisms (e.g., latches) at an adapter 8. The scope assembly 519 may further comprise a release mechanism to allow the scope assembly 519 to be removed from the basketing assembly 30, adapter 8, and/or other device.
The scope assembly 519 can be powered through a power interface 45 and/or controlled through a control interface 78, each or both of which may interface with a robotic arm/component of the robotic system 10. The scope assembly 519 may further comprise one or more sensors 172, such as pressure and/or other force-reading sensors, which may be configured to generate signals indicating forces experienced at/by one or more of the actuators 195 and/or other couplings of the scope/basket system 519.
In some embodiments, the instrument device manipulator assembly 150 further includes an adapter component 8 that is mountable to the end effector 6 and configured to provide a driver interface between the end effector 6 and the medical instrument 31. The adapter 8 and/or the medical instrument 31 may be removable or detachable from the robotic arm 12 and may be devoid of any electro-mechanical components, such as motors, in some embodiments. This dichotomy may be driven by the need to sterilize medical instruments used in medical procedures and the inability to adequately sterilize expensive capital equipment due to their intricate mechanical assemblies and sensitive electronics. Accordingly, the medical instrument 31 and/or adapter 8 may be designed to be detached, removed, and interchanged from the end effector 6 (and thus the system) for individual sterilization or disposal. In contrast, the end effector 6 need not be changed or sterilized in some cases and may be draped (e.g., using drape 38) for protection.
In some embodiments, the adapter 8 can include connectors to transfer pneumatic pressure, electrical power, electrical signals, and/or optical signals from the robotic arm 12 and/or end effector 6 to the medical instrument 31 and/or to additional instruments. The robotic arm 12 can advance/insert or retract the coupled medical instrument 31 into or out of the treatment site. In some embodiments, the medical instrument 31 can be removed and replaced with a different type of instrument and/or can be supplemented with additional instruments. The end effector 6 of the robotic arm 12 can include various components/elements configured to connect to and/or align with components of the adapter 8, instrument handle, and/or shaft 40. For example, the end effector 6 can include drive outputs 502 (e.g., drive splines, gears, or rotatable disks with engagement features) to control/articulate a medical instrument and/or one or more fasteners 506 to attach the medical instrument 31 and/or adapter 8 to the end effector 6. In some embodiments, a portion (e.g., plate) 515 of the adapter 8 can be configured to rotate/spin independently of one or more other components of the adapter 8 and/or end effector 6 when coupled to the end effector 6.
In some configurations, a sterile drape 38, such as a plastic sheet or the like, may be disposed between the end effector 6 and the adapter 8 to provide a sterile barrier between the robot arm 12 and the instrument handle 31. For example, the drape 38 may be coupled to the adapter 8 in such a way as to allow for translation of mechanical torque from the end effector 6 to the adapter 8. The adapter 8 may generally be configured to maintain a seal around the actuating components thereof, such that the adapter 8 provides a sterile barrier itself. The use of a drape 38 coupled to the adapter 8 and/or more other component(s) of the device manipulator assembly 150 may provide a sterile barrier between the robotic arm 12 and the surgical field, thereby allowing for the use of the robotic cart associated with the arm 12 in the sterile surgical field. The end effector 6 may be configured to be coupled to various types of sterile adapters that may be loaded onto and/or removed from the end effector 6 of the robotic arm 12. With the arm 12 draped in plastic, the physician and/or other technician(s) may interact with the arm 12 and/or other components of the robotic cart (e.g., screen) during a procedure. Draping may further protect against equipment biohazard contamination and/or minimize clean-up after procedure. The adapter 8 may comprise a base portion 508 configured to provide a foundation for various components of the adapter 8.
The medical instrument 31 can include a plurality of drive inputs 503, 529 on a lower surface 536 of the housing of the instrument handle 31. In the illustrated embodiment, the medical instrument 31 includes three drive inputs 503, 529, although other numbers of drive inputs can be included in other embodiments. The drive inputs can be in fixed positions spaced apart along the lower mating surface 536 of the medical instrument 31, which facilitates coupling the drive inputs 503, 529 to the corresponding drive outputs 502 of the end effector 6 and/or drive outputs of the adapter 8, which may be in fixed positions spaced apart along a corresponding mating surface designed for modular use and attachment to a variety of other instruments. The instrument 31 can include latching clips 512 or other latching features/means for physically coupling to corresponding structure of the adapter 8 and/or end effector 6.
Other example instruments that can be manipulated via the device manipulator assembly can include robotically controlled catheters, EM field generators, retrieval basket tools, laser fiber drivers, and/or distal drive devices, among others.
References herein to an “instrument device manipulator assembly,” “instrument manipulator assembly,” “manipulator,” “manipulator assembly,” as well as other variations thereof, can refer to any subset of the components of the assembly 150 shown in
The adapter 8 may comprise one or more drive outputs 509 configured to translate torque from one or more drive outputs 502 of, for example, an end effector of a robotic system, to corresponding drive inputs 503 of one or more medical instruments. The end effector 6 and/or robotic system may comprise one or more drive outputs 502 configured to mate with corresponding drive inputs of the adapter 8. For example, each drive output 509 at the adapter 8 may be associated with a corresponding drive input (e.g., at an underside of the drive output 502) and/or may be configured to translate force (e.g., torque) from the robotic system. The adapter 8 may be configured to be removably attached to the robotic system. In some cases, a drape 38 may be configured to be situated at least partially between at least a portion of the robotic system and the adapter 8.
The one or more drive outputs 509 of the adapter 8 may be configured to translate movement and/or force of one or more drive outputs 502 of a robotic system to one or more medical instruments 31 which may be removably attached to the drive outputs 509 of the adapter 8. The one or more medical instruments 31 may be configured to mate with and/or attach to one or more drive outputs 509 of the adapter 8. For example, the medical instrument 31 (e.g., a scope device) illustrated in
While only a single adapter 8 is shown in
The adapter 8 may be configured for facilitating attachment of one or more medical instruments 31 with the adapter 8 before, during, and/or following a medical procedure. For example, the adapter 8 may be configured to facilitate docking of one or more medical instruments 31 while the one or more medical instruments is in use and/or after the medical instrument 31 has been delivered into a patient's body. To minimize the risk of harm to the patient, the adapter 8 and/or medical instrument 31 may be configured to simplify and/or facilitate docking of the medical instrument 31 at the adapter 8 using various means which will be described herein. In this way, docking of the medical instrument 31 at the adapter 8 may require minimal attention from a physician guiding the medical instrument at the patient's body.
In some embodiments, transfer of force from the end effector 6 to the adapter 8 and/or from the adapter 8 to the medical instrument 31 may involve ultra-low friction input transfer. Translation of force may involve mesh engagement between one or more drive outputs and/or one or more drive inputs. For example, teeth of a gear at a drive output may be configured to mesh with and/or fit into corresponding receptors at a drive input.
The platform 610 may be configured to be movable between an elevated (e.g., raised) configuration (shown in
The drive assembly may comprise one or more docking portions configured to receive one or more medical instruments. As used herein, the term “docking portion” is used in accordance with its plain and ordinary meaning and may refer to any portion of a drive assembly 600 including any number of components of the drive assembly 600 that may be configured to receive one or more medical instruments by, for example, forming a removable and/or secure attachment to the one or more medical instruments and/or accommodating placement and/or attachment of the one or more medical instruments at and/or to the drive assembly 600. In some embodiments, the platform 610 and/or a first set of drive outputs may be associated with and/or comprise at least a portion of a first docking portion and/or may be configured to receive one or more medical instruments by allowing placement of one or more medical instruments at the platform 610, attaching to one or more medical instruments using magnetic elements and/or other features, and/or forming a secure attachment to one or more medical instruments attached via latching mechanisms 611 of the drive assembly 600. A second set of drive outputs (e.g., a fourth drive output 602d and/or a fifth drive output 602e) and/or a release mechanisms 605 may be associated with and/or comprise at least a portion of a second docking portion and/or may be configured to receive one or more medical instruments by mating the second set of drive outputs with the one or more medical instruments and/or allowing the one or more medical instruments to attach and/or latch to the release mechanism 605.
In some embodiments, the platform 610 may be biased in the elevated configuration shown in
The platform 610 may be associated with and/or situated adjacent to one or more drive outputs 602 coupled to and/or extending from the base portion 608 of the drive assembly 600. The one or more drive outputs 602 may be configured to drive one or more medical instruments. One or more of the one or more drive outputs 602 may be configured to drive a single type of medical instrument and/or may be configured to drive multiple types of medical instruments. For example, a drive output 602 may be configured to mate with a first type of drive input associated with a first type of medical instrument and/or with a second type of drive input associated with the first type of medical instrument and/or a second type of medical instrument. In some embodiments, the drive assembly 600 may comprise a first set of one or more drive outputs 602 (e.g., including a first drive output 602a, a second drive output 602b, and a third drive output 602c) configured to drive a first medical instrument and/or a first type of medical instrument and/or the drive assembly 600 may comprise a second set of one or more drive outputs 602 (e.g., including a fourth drive output 602d and a fifth drive output 602e) configured to drive a second medical instrument and/or a second type of medical instrument.
In some embodiments, the platform 610 may comprise one or more apertures 609, which may include openings, cavities, gaps, grooves, indentations, and/or similar features, configured to accommodate at least a first set of the one or more drive outputs 602. As shown in the example shown in
In the depressed configuration shown in
In some embodiments, the platform 610 and/or base portion 608 may comprise various features configured to guide (e.g., funnel, direct, move) one or more medical instruments to the platform 610. For example, one or more magnetic elements may be situated at a surface of the platform 610, within the platform 610, and and/or beneath the platform 610 (e.g. between the platform 610 and the base portion 608). In some embodiments, the platform 610 and or base portion 608 may comprise a first magnetic element having a first polarity and/or a second magnetic element having a second polarity such that the first and second magnetic elements may be configured to align the one or more medical instruments with the platform 610. For example, the magnetic elements may have suitable polarities and/or may be situated such that one or more medical instruments may be configured to mate with the magnetic elements in only a single configuration.
When the platform 610 is in the elevated configuration shown in
The drive assembly 600 may comprise any of a variety of suitable features for holding the platform 610 in the depressed configuration and/or for maintaining an attachment between one or more medical instruments and the platform 610 while the platform is in the depressed configuration. As shown in
In some embodiments, the one or more latching mechanisms 611 may be biased in outward 613 direction at least in part by a torsion spring and/or similar device. The torsion spring may comprise a coiled portion 614 and/or one or more elongate ends 615 which may be configured to press the one or more latching mechanisms 611 in the outward 613 direction. The release mechanism 605 may comprise one or more arm portions 616 which may press the elongate ends 615 of the torsion spring inwards (e.g., opposite the biased direction) when the release mechanism 605 is pressed against the torsion spring and/or moved towards the platform 610. Moreover, a medical instrument may be configured to press the one or more latching mechanisms inward during a docking process of the medical instrument.
The platform may further comprise various engagement features 707 (e.g., a first engagement feature 707a, a second engagement feature 707b, and/or a third engagement feature 707c) for engaging with the base portion and/or other elements of the drive assembly. For example, the one or more engagement features 707 may have generally cylindrical shapes and/or may be configured to extend into corresponding openings (e.g., lumens) of a base portion to allow the platform 710 to extend along the openings of the base portion. Moreover, the engagement features 707 may be configured to maintain a connection between the platform 710 and a base portion while the platform 710 moves between the elevated configuration and the depressed configuration.
In some embodiments, the first medical instrument 811 may be configured to operatively receive at least a portion of the second medical instrument 812. For example, the first medical instrument 811 may comprise a receptor 844, which can include a lumen, chamber, and/or other feature, configured to receive at least a portion of the second medical instrument 812. The second medical instrument 812 may comprise one or more tines 835 and/or a sheath 836 extending from the second medical instrument 812. The one or more tines 835 and/or sheath 836 may be configured to be operated via drive inputs at the second medical instrument 812. The tines 835 may a medical tool configured to extend out of a distal end portion of the sheath 836. As shown in
The first medical instrument 811 and/or the second medical instrument 812 may comprise one or more features for facilitating an attachment between the first medical instrument 811 and the second medical instrument 812. For example, the second medical instrument 812 may comprise one or more engagement features, such as magnetic elements, which may be configured to fit into slots 827 of the second medical instrument 812. The one or more engagement features at the second medical instrument 812 may be configured to engage with corresponding features at the first medical instrument 811. For example, the second medical instrument 812 and/or first medical instrument 811 may comprise one or more magnetic elements configured to mate with each other when the first medical instrument 811 and/or the second medical instrument 812 is/are docked at the adapter 808. In this way, the first medical instrument 811 and/or second medical instrument 812 may be prevented from rolling and/or otherwise moving out of a desired position/orientation.
The first medical instrument 811 may be configured to dock at and/or attach to a first docking portion of the adapter 808. For example, the first medical instrument may be configured to attach to a movable platform at the first docking portion of the adapter 808. The first docking portion may comprise one or more drive outputs 802 configured to receive and/or drive one or more drive inputs of the first medical instrument (see, e.g.
The adapter 808 may comprise one or more latches (see, e.g., the latching mechanisms 611 of
In some embodiments, the one or more latches may be biased outwardly toward an outer ring of the adapter 808 by one or more biasing mechanisms which can include torsion spring devices (see, e.g., the torsion spring devices 614, 615 of
The second medical instrument 812 may comprise one or more attachment devices 821 configured to attach to the release device 805 and/or one or more areas of the first docking portion. For example, as shown in
As shown in
While magnetic elements 914 are described herein for illustrative purposes, other alignment features may be substituted for magnetic elements 914. In some embodiments, one or more magnetic elements 914 situated at and/or otherwise associated with the first docking portion may be configured to guide and/or establish alignment between a first medical instrument and the first docking portion and/or one or more drive outputs 902 associated with the first docking portion. For example, the one or more magnetic elements 914 may be configured to attract corresponding magnetic elements at the first medical instrument when the first medical instrument is placed within a magnetic field of the one or more magnetic elements 914. Accordingly, a physician may advantageously be enabled to dock the first medical instrument at the first docking portion by simply situating the first medical instrument within a general area of the first docking portion and/or may not be required to physically align the first medical instrument with the first set of drive outputs 902.
Two dashed circles 913 illustrated in
The adapter 908 may be configured to receive additional medical instruments. For example, while the adapter 908 illustrated in
The process 1000 may be implemented in connection with a medical procedure, such as a kidney stone removal procedure, or other procedure that may be implemented using one or more medical instruments, such as endoscopes, ureteroscopes, EM field generators, basketing tools, laser fiber drivers, or the like. In some embodiments, the process 1000 may be implemented at least in part following placement of a distal end of a shaft of a first medical instrument (e.g., endoscope) within certain target anatomy of a patient, such as a calyx network of a kidney of the patient. One or more operations of the process 1000 may be implemented prior to access of the target anatomy by the distal end of the shaft of the first medical instrument.
At block 1002, the process 1000 involves attaching and/or docking a first medical instrument at an adapter of a drive assembly. In some embodiments, attaching, and/or docking the first medical instrument at the adapter may be facilitated at least in part via one or more alignment features (e.g., magnetic elements) at the adapter, as described herein. The one or more alignment features may be configured to form a breakable attachment between the first medical instrument and the adapter. For example, application of approximately 2 Newtons of pulling force may be sufficient to detach the first medical instrument from the platform. The one or more alignment features may advantageously allow physicians to focus on navigating the first medical instrument through a patient's body to prevent and/or minimize damage to the kidneys and/or other tissue which may be caused imprecise navigation of the first medical instrument.
The first medical instrument may be configured to be docked and/or attached at least partially at a platform of the adapter. In some embodiments, the platform may extend from a base portion of the adapter. The first medical instrument may extend beyond the surface of the platform in at least some places.
The platform may be movable between two or more positions with respect to the base portion and/or other portions of the adapter. For example, the platform may be biased a first distance apart from the base portion such that the platform may be situated in a relatively elevated position when not acted upon by outside forces. The platform may be biased in the elevated position at least in part by one or more springs configured to press against a lower surface of the platform (e.g., between the platform and the base portion).
The adapter may comprise one or more drive outputs configured to drive corresponding drive inputs of the first medical instrument. The first medical instrument may be configured to attach and/or dock to the platform in a configuration in which at least some of the drive inputs of the first medical instrument are generally aligned with at least some of the drive outputs of the adapter. In some embodiments, the drive inputs of the first medical instrument may be suspended above the drive outputs when the first medical instrument is attached to the platform in the elevated position.
At step 1004, the process 1000 involves pressing the platform down overcome a bias of the platform. In some cases, the platform may be pressed down by a physician. The platform may be pressed down by pressing down on the first medical instrument while the first medical instrument is in contact with the platform. Pressing the platform down may move the platform from the elevated configuration to a depressed configuration, in which a distance between the platform and the base portion and/or other portion of the adapter may be less than in the elevated configuration.
At step 1006, the process 1000 involves latching the first medical instrument to secure the first medical instrument to the platform and/or to secure the platform in the depressed configuration. For example, latching the first medical instrument may prevent the platform from being raised to the elevated configuration. Latching the first medical instrument may involve use of one or more latches and/or latching mechanisms at the base portion and/or other portion of the adapter. When the first medical instrument and/or platform are pressed downwards (i.e., towards the base portion) attachment features (e.g., grooves, edges, indentations, latches, etc.) at the first medical instrument may be configured to latch to corresponding features at the adapter. For example, an edge portion of the first medical instrument may be configured to press one or more latching mechanisms inwards to overcome an outward bias of the latching mechanisms and/or one or more indentations at the first medical instrument may be configured to allow the latching mechanisms to return to a biased configuration to lock the first medical instrument in place.
At step 1008, the process 1000 involves attaching a second medical instrument at a second docking portion of the adapter to prevent release of the first medical instrument from the adapter. For example, the second medical instrument, when docked at the second docking portion of the adapter, may be configured to at least partially cover and/or otherwise prevent activation of a release mechanism at the adapter which may be configured to de-latch the first medical instrument from the adapter. In this way, the first medical instrument may be prevented from being removed when removing the first medical instrument can cause damage to the patient.
In some embodiments, the second medical instrument may be a working channel tool (e.g., a basketing tool) having at least a portion configured to fit into a receptor of the first medical instrument.
At step 1010, the process 1000 involves removing the second medical instrument from the second docking portion of the adapter. The second medical instrument may be attached and/or docked at the adapter for use in performing a medical procedure (e.g., grasping a kidney stone within a patient). When the medical procedure is completed, the second medical instrument may be removed from the adapter. In some embodiments, removing the second medical instrument may involve activation a release button and/or similar device at the second medical instrument and/or adapter to disengage latching mechanisms at the second medical instrument and/or adapter. Moreover, removing the second medical instrument may involve detaching the second medical instrument from the first medical instrument. For example, a sheath and/or medical extending from the second medical instrument may be removed from a receptor of the first medical instrument. In another example, a breakable attachment between the first medical instrument and the second medical instrument (e.g., using magnetic elements) may be broken to allow removal of the second medical instrument.
At step 1012, the process 1000 may involve activating a release mechanism at the adapter to release and/or allow removal of the first medical instrument from the adapter. The release mechanism may be a device configured to move along at least a portion of the adapter and/or may be configured to press against one or more torsion springs biasing latching mechanisms at the adapter in an outward configuration. The release mechanism may be configured to press the torsion springs inwards, thereby pressing one or more latching mechanisms inwards and/or dislodging the one or more latching mechanisms from indentations and/or other attachment features of the first medical instrument.
At step 1014, the process 1000 may involve removing the first medical instrument from the adapter and/or platform and/or allowing the platform to return to an elevated configuration.
Moreover, some drive outputs (e.g., the first drive outputs 1102a) may be configured to drive multiple types of medical instruments. For example, a first type of drive output may include a first drive interface configured to drive a first type of medical instrument and/or a second drive interface configured to drive a second type of medical instrument (see, e.g.,
One or more drive outputs 1102 may be associated with a first docking portion including a platform 1110, which may extend from the base portion 1109. For example, one or more drive outputs 1102 may be configured to pass at least partially through one or more apertures of the platform 1110. In some embodiments, the platform 1110 may be extendable between a raised and/or lowered configuration. While the second drive outputs 1102b are shown passing at least partially through the platform 1110, first drive outputs 1102a (which may be configured to drive multiple types of medical instruments) may be associated with and/or pass at least partially through the platform 1110 in some embodiments.
In some embodiments, the first drive interface 1222 and the second drive interface 1224 may be configured in a tiered orientation in which one of the first drive interface 1222 and the second drive interface 1224 may extend a greater distance from a base portion 1228 of the drive output 1202. For example, the first drive interface 1222 may extend through and/or from the second drive interface 1224 and/or may extend a greater distance from the base portion 1228 than the second drive interface 1224. The first drive interface 1222 may comprise a distal tip 1230 which may be situated at a maximal distance of the drive output 1202 from the base portion 1228.
The first drive interface 1222 and/or the second drive interface 1224 may be configured to cause a gear ratio change from a drive output of a robotic arm to one or more medical instruments. For example, the first drive interface 1222 and/or second drive interface 1224 may be configured to translate a lower rotational speed at an adapter to a higher rotational speed at one or more medical instruments driven by the drive interfaces. A gear ratio change may enable relatively fast linear travel of opening/closing and/or inserting/retracting of the one or more medical instruments. In some embodiments, the first drive interface 1222 may be configured to drive a first medical instrument and/or a first type of medical instrument with a first drive ratio and/or the second drive interface 1224 may be configured to drive a second medical instrument and/or a second type of medical instrument with a second drive ratio that is different than the first drive ratio.
At step 1302, the process 1300 involves mating and/or attaching a first medical instrument with/to one or more output drivers (e.g., drive outputs) including a first output driver. The first output driver may comprise multiple driving features and/or interfaces (e.g., a first interface and/or a second interface) and/or each of the multiple interfaces may be configured to drive different types of medical instruments. The first medical instrument may be a first type of medical instrument configured to be driven using a first type of interface (e.g., the first interface). In some embodiments, mating the first medical instrument with the first output driver may involve at least partially covering the first output driver and/or the first interface with a corresponding drive input of the first medical instrument.
At step 1304, the process 1300 involves driving the first medical instrument using the first interface of the first output driver. In some embodiments, the first interface may comprise a network of meshing teeth and/or similar features configured to mesh with corresponding features at the first medical instrument.
At step 1306, the process 1300 involves removing the first medical instrument and/or disengaging the first medical instrument from the first interface and/or the first output driver. In some embodiments, removing the first medical instrument may involve activating a release mechanism at the adapter.
At step 1308, the process 1300 involves mating a second medical instrument with the first output driver following removal of the first medical instrument from the first output driver. The second medical instrument may be a second type of medical instrument configured to be driven using a second type of drive interface. The first output driver may comprise a second interface that is the second type of drive interface and/or is configured to drive the second medical instrument.
At step 1310, the process 1300 involves driving the second medical instrument using the second interface and/or driving feature at the first output driver. In some embodiments, the second interface may comprise a network of meshing teeth and/or similar features configured to mesh with corresponding features at the second medical instrument.
Described herein are systems, devices, and methods to facilitate interaction between one or more medical instruments and one or more medical instrument drive assemblies, in connection with certain medical procedures. In particular, systems, devices, and methods in accordance with one or more aspects of the present disclosure can facilitate guiding one or more medical instruments to a desired configuration at and/or with respect a medical instrument drive assembly, driving the one or more medical instruments, and/or managing removal of the one or more medical instruments from the medical instrument drive assembly. Interaction between one or more medical instruments and one or more medical instrument drive assemblies in accordance with the various embodiments disclosed herein can advantageously simplify and/or reduce certain risks associated with use of the one or more medical instruments.
Some implementations of the present disclosure relate to a medical instrument drive assembly comprising at least a base portion, a first set of one or more drive outputs coupled to and/or extending from the base portion and configured to drive a first medical instrument, and a platform secured to the base portion and movable between an elevated configuration and a depressed configuration. The platform is biased in the elevated configuration. The medical instrument drive assembly further comprises a latching mechanism configured to cause the platform to be held in the depressed configuration.
The medical instrument drive assembly may further comprise a second set of one or more drive outputs configured to drive a second medical instrument. The platform can be configured to guide the first medical instrument onto the first set of one or more drive outputs.
The platform can be configured to attach to the first medical instrument. In some embodiments, the medical instrument drive assembly further comprises a docking portion configured to receive a second medical instrument.
In some embodiments, the medical instrument drive assembly further comprises a release mechanism at the docking portion configured to disengage the latching mechanism to allow the platform to be moved to the elevated configuration. The second medical instrument, when docked at the docking portion, can prevent activation of the release mechanism and/or at least partially cover the release mechanism.
The platform may comprise one or more apertures configured to receive at least a first drive output of the first set of one or more drive outputs. The first drive output can be situated within a first aperture of the one or more apertures when the platform is in the depressed configuration. A first aperture of the one or more apertures can be suspended and/or situated over the first drive output when the platform is in the elevated configuration.
In some embodiments, the first medical instrument is a scope and/or endoscope device. The platform may comprise one or more magnetic elements configured to mate with one or more corresponding magnetic elements at the first medical instrument. The one or more magnetic elements of the platform may comprise a first magnetic element having a first polarity and a second magnetic element having a second polarity.
The medical instrument drive assembly may further comprise one or more springs situated below at least part of the base portion and/or between at least a portion of the base portion and at least a portion of the platform and configured to bias the platform in the elevated configuration. Pressing the platform to the depressed configuration can cause the latching mechanism to secure the platform in the depressed configuration and/or the first medical instrument to the platform.
In some embodiments, the latching mechanism can be configured to cause the platform to be held in the depressed configuration by securing the first medical instrument to the platform. The base portion may comprise one or more drive inputs for interacting with driving features of one or more robotic arms.
In some implementations, the present disclosure relates to a medical instrument drive assembly comprising a first docking portion configured to receive a first medical instrument, a first set of one or more drive outputs associated with the first docking portion and configured to drive the first medical instrument, a latch configured to secure the first medical instrument to the first docking portion, a release configured to disengage the latch to allow the first medical instrument to be displaced from the first docking portion, and a second docking portion configured to receive a second medical instrument in a manner in which the second medical instrument prevents activation of the release.
The second medical instrument may comprise one or more attachment mechanisms configured to attach to the release. The second medical instrument can be a working channel tool configured to fit into a working channel of the first medical instrument. The second medical instrument may comprise one or more alignment features configured to mate with corresponding alignment features of the first medical instrument.
Some implementations of the present disclosure relate to a medical instrument drive assembly comprising a first docking portion configured to receive a first medical instrument, a first set of one or more drive outputs coupled to and/or extending from the first docking portion and configured to drive the first medical instrument, and one or more magnetic elements associated with the first docking portion and configured to guide alignment of the first set of one or more drive outputs with one or more drive inputs of the first medical instrument.
A first magnetic element of the one or more magnetic elements can have a first magnetic polarity and a second magnetic element of the one or more magnetic elements can have a second magnetic polarity. The one or more magnetic elements can be configured to mate with corresponding magnetic elements at the first medical instrument.
In some embodiments, the medical instrument drive assembly further comprises a platform extending from the first docking portion that is movable between an elevated configuration and a depressed configuration. The one or more magnetic elements can be attached to the platform.
In some implementations, the present disclosure relates to a medical instrument drive assembly comprising a base portion and one or more drive outputs coupled to and/or extending from the base portion and configured to drive a first medical instrument. At least a first drive output of the one or more drive outputs includes a first drive interface configured to drive a first type of medical instruments and a second drive interface configured to drive a second type of medical instruments.
The first drive output of the one or more drive outputs comprises mesh engagement features configured to mesh with a corresponding drive input of the first medical instrument. In some embodiments, the first drive interface and the second drive interface are coaxial.
In some embodiments, a diameter of the second drive interface is greater than a diameter of the first drive interface. The first drive interface can be configured to drive the first type of medical instrument with a first drive ratio. The second drive interface can be configured to drive the second type of medical instrument with a second drive ratio that is different than the first drive ratio.
For purposes of summarizing the disclosure, certain aspects, advantages and novel features have been described. It is to be understood 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.
Depending on the embodiment, certain acts, events, or functions of any of the processes or algorithms described herein can be performed in a different sequence, may be added, merged, or left out altogether. Thus, in certain embodiments, not all described acts or events are necessary for the practice of the processes.
Conditional language used herein, such as, among others, “can,” “could,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is intended in its ordinary sense and is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or steps. 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 or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous, are used in their ordinary sense, and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Conjunctive language such as the phrase “at least one of X, Y and Z,” unless specifically stated otherwise, is understood with the context as used in general to convey that an item, term, element, etc. may be either X, Y or Z. Thus, such conjunctive language is not generally 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 above 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 inventive aspects. This method of disclosure, however, is not to be interpreted as reflecting an intention that any claim require more features than are expressly recited in that claim. Moreover, any components, features, or steps illustrated and/or described in a particular embodiment herein can be applied to or used with any other embodiment(s). Further, no component, feature, step, or group of components, features, or steps are necessary or indispensable for each embodiment. Thus, it is intended that the scope of the inventions herein disclosed and claimed below should not be limited by the particular embodiments described above, but should be determined only by a fair reading of the claims that follow.
It should be understood that certain ordinal terms (e.g., “first” or “second”) may be provided for ease of reference and do not necessarily imply physical characteristics or ordering. Therefore, as used herein, an ordinal term (e.g., “first,” “second,” “third,” etc.) used to modify an element, such as a structure, a component, an operation, etc., does not necessarily indicate priority or order of the element with respect to any other element, but rather 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, indefinite articles (“a” and “an”) may indicate “one or more” rather than “one.” Further, an operation performed “based on” a 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 example embodiments belong. It 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 not be interpreted in an idealized or overly formal sense unless expressly so defined herein.
The spatially relative terms “outer,” “inner,” “upper,” “lower,” “below,” “above,” “vertical,” “horizontal,” and similar terms, may be used herein for ease of description to describe the relations between one element or component and another element or component as illustrated in the drawings. It 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 drawings. For example, in the case where a device shown in the drawing is turned over, the device positioned “below” or “beneath” another device may be placed “above” another device. Accordingly, the illustrative term “below” may include both the lower and upper positions. The device may also be oriented in the other direction, and thus the spatially relative terms may be interpreted differently depending on the orientations.
Unless otherwise expressly stated, comparative and/or quantitative terms, such as “less,” “more,” “greater,” and the like, are intended to encompass the concepts of equality. For example, “less” can mean not only “less” in the strictest mathematical sense, but also, “less than or equal to.”
This application is a continuation of International Patent Application No. PCT/IB2022/051380, filed Feb. 16, 2022, entitled MEDICAL INSTRUMENT DRIVE ASSEMBLY AND DOCKING SYSTEM, which claims priority to U.S. Provisional Application No. 63/150,418, filed Feb. 17, 2021, entitled MEDICAL INSTRUMENT DRIVE ASSEMBLY AND DOCKING SYSTEM, the disclosure of which is hereby incorporated by reference in its entirety.
Number | Date | Country | |
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63150418 | Feb 2021 | US |
Number | Date | Country | |
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Parent | PCT/IB2022/051380 | Feb 2022 | US |
Child | 18073254 | US |