Patent Application
20230402174
This document relates generally to medical devices, and more particularly, to user control systems and methods for teleoperated surgical systems.
Surgical systems, such as those employed for minimally invasive and orthopedic medical procedures, can include large and complex equipment to precisely control and drive relatively small instruments. Such systems are sometimes referred to as a teleoperated systems or robotic surgical systems. One example of a teleoperated surgical system is the da Vinci® Surgical System commercialized by Intuitive Surgical, Inc.
Teleoperated systems can control and drive multiple instruments through one or more access ports in the body of the patient. Each instrument is typically configured for articulation and to perform various medical tasks (e.g., grasping, cutting, et cetera), and they are controlled by a clinician through a sophisticated computer-assisted user control system.
Among many other functions, the user control system is configured to translate movements of one or more input controls of the user control system by the clinician into movements of the corresponding one or more instruments of the surgical system. During the course of a procedure, however, the clinician may become fatigued or may experience some level of physical discomfort and physical stagnation by being poised in a constant position at the user control system to operate the instruments of the surgical system for a long time. Such fatigue and discomfort become especially serious when a clinician performs several procedures during a single day. One option for reducing fatigue and discomfort is for the clinician to take rest breaks from the procedure and move away from the user control system, for example to stretch, take a walk, etc. But, these rest breaks extend the length of the procedure, and minimizing patient time under anesthesia is an important clinical consideration. Therefore, it would be beneficial to have one or more systems incorporated into the user control system to alleviate physical fatigue, discomfort, and stagnation experienced by clinicians during teleoperated surgical procedures.
An example teleoperated surgery user control system includes a first user control and a controller. The first user control is configured to be used by a user to teleoperate one or more aspects of a surgical system. The first user control includes one or more portions configured to articulate and to support one or more body portions of a user. The controller is communicatively connected to the first user control. The controller is configured to execute instructions to automatically articulate the one or more portions periodically or continually during a surgical procedure teleoperated by the user with the surgical system.
An example method of operation of teleoperated surgery user control system includes positioning a first user control for use by a user. The first user control is configured to be used by the user to teleoperate one or more aspects of a surgical system. The first user control includes one or more portions configured to articulate and to support one or more body portions of a user. The method also includes automatically articulating, by a controller communicatively connected to the first user control, at least one of the one or more portions periodically or continually during a surgical procedure teleoperated by the user with the surgical system.
An example teleoperated surgery user control system includes a first user control and a processor communicatively connected to the first user control. The first user control includes one or more manipulable input controls for teleoperation of one or more aspects of a surgical system, and one or more body rests configured to articulate and to support portions of a body of a user. The processor is configured to execute instructions to automatically articulate the one or more body rests periodically or continually in micro-increments.
An example telesurgical system control unit includes a movable component contacted by a clinical user during an operation of the control unit by the clinical user to perform a medical procedure, an actuator coupled to move the movable component, and a control system coupled to control the actuator. The control system comprises coded instructions to automatically activate the actuator to move the movable component during the operation of the control unit by the clinical user.
Each of these non-limiting examples can stand on its own or can be combined in various permutations or combinations with one or more of the other examples.
This Summary is intended to provide an overview of subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the invention. The detailed description is included to provide further information about various aspects of the inventive subject matter of the present patent application.
In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
An example teleoperated surgery user control system in accordance with this disclosure includes a user control device and a controller. The user control device is configured to be used by a surgeon to teleoperate one or more aspects of a teleoperated surgical system. The user control device can include one or more body rests against which body portions of the surgeon are configured to rest. The body rests are configured to articulate (e.g., in one or more directions and/or through one or more orientations). The controller is communicatively connected to the user control device and configured to automatically articulate the one or more body rests periodically or continually.
Generally, the algorithmic automated motion control of user control devices according to this disclosure may be configured to modulate the position/location/orientation/etcetera of one or more portions of the user control device over time, for example, either periodically or continually. Example control algorithms can, for example, vary the time at which automatic articulations occur, either at a constant or variable frequency, and, additionally, the algorithm(s) can vary the number, sequence, and/or type of articulation that occurs in each movement of the user control device. The control algorithm can execute a set of articulations in series, e.g. one after another in a predefined sequence, and can execute a set of articulations in parallel, e.g. simultaneous movement of multiple portions (e.g., multiple body rests) of the user control device. Additionally, the controller of the user control system can be configured to control motion of multiple user control devices, such automated articulation of multiple devices can be coordinated, e.g. the articulation routine of a first user control device can be algorithmically related to and dependent upon the articulation of a second user control device, or can be executed in separate and unrelated control algorithms.
Automated articulation of user control devices of a teleoperated surgical system can be executed in micro-increments. In some examples, the magnitude of the incremental value of and direction, orientation, etcetera of automated articulation of a user control device may be configured such that the motion is or is nearly imperceptible to the surgeon employing the teleoperated surgery user control system. One way in which such automated motion can be executed to reduce or minimize the perception of such motion by the surgeon is to execute the motion in relatively small increments. For example, each individual articulation may be limited to a maximum value on the order of millimeters versus centimeters (or 1/16 of an inch versus ¼ of an inch). In other examples, a maximum incremental value of each articulation of a user control device may be smaller or greater, depending upon the intended application, including, for example, depending upon user reaction to such automated articulation during a mock or actual surgical procedure.
To better understand the environment, systems, and other factors of teleoperated surgery encountered by a surgeon during a procedure, an example teleoperated surgical system and the user control system for the surgical system is depicted and described with reference to
The manipulating system 100 or system 200 may be part of a larger system 10, which may include other sub-systems, including, for example, fluoroscopy or other imaging equipment. One or both of the manipulating systems 100, 200 may be operatively coupled to a user control system 150 or an auxiliary system 175, or both. The user control system 150 (sometimes referred to as user control console and/or surgeon console) may include one or more user input devices (e.g., controls) that may be configured to receive inputs from a user. The user control system 150 may also include or one or more user feedback devices (e.g., viewing system, or tactile or auditory feedback system) that may be configured to provide information to the user regarding the movement or position of an end effector, or an image of a surgical area. The auxiliary system 175 may, for example, include computer processing equipment (e.g., a processor circuit or graphics hardware), or communication equipment (e.g., wired or wireless communication circuits), or endoscopic camera control and image processing equipment.
In the foregoing examples, one or more of the components in the depicted environment may be considered to form a teleoperated surgical system. For example, and at the least, manipulating systems 100, 200 of
In
Seating device 201 is merely one example of a device of a user control system for a teleoperated surgical system. The manner in which seating device 201 is configured to articulate and the number or character of the directions/orientations through which seating device 201 is configured to move can vary in other examples according to this disclosure. Additionally, the physical configuration of seating device 201 can vary in other examples according to this disclosure. Example seating devices can include stools or other seating configurations that are not a traditional seat with back rest, including example seating device 180 of
The mechanical, electro-mechanical, and other devices and systems by which seating device 201 articulates through the various degrees of freedom of motion indicated in
Regardless of the particular shape, configuration, degrees of freedom of motion, etcetera, seating device 201 and other teleoperated surgery user control devices according to this disclosure are configured to automatically articulate periodically or continually to modulate the position of a seated surgeon in micro-increments, which automated articulation, in turn, is configured to guard against and decrease the prevalence of surgeon stagnation and/or fatigue during teleoperated procedures.
In an example, seating device 201 of
Controller 214 is, as depicted schematically in
Controller 214 may include storage media to store and/or retrieve data or other information, for example, signals from sensors. For example, seating device 201 may include various devices to provide feedback to controller 214. In an example, electric motors and other devices associated with the multiple degrees of freedom of movement of seating device 201 can be configured to send signals indicative of the current position and/or orientation of seating device 201 to controller 214.
Storage devices of controller 214, in some examples, are described as a computer-readable storage medium. In some examples, storage devices include a temporary memory, meaning that a principal purpose of one or more storage devices is not long-term storage. Storage devices are, in some examples, described as a volatile memory, meaning that storage devices do not maintain stored contents when the computer is turned off. Examples of volatile memories include random access memories (RAM), dynamic random access memories (DRAM), static random access memories (SRAM), and other forms of volatile memories known in the art. The data storage devices can be used to store program instructions for execution by processor(s) of controller 214. The storage devices, for example, are used by software, applications, algorithms, as examples, running on and/or executed by controller 214. The storage devices can include short-term and/or long-term memory, and can be volatile and/or non-volatile. Examples of non-volatile storage elements include magnetic hard discs, optical discs, floppy discs, flash memories, or forms of electrically programmable memories (EPROM) or electrically erasable and programmable (EEPROM) memories.
Controller 214 can be configured to communicate with seating device 201 (and other components of teleoperated surgery user control system 212) via various wired or wireless communications technologies and components using various public and/or proprietary standards and/or protocols. In some examples, controller 214 and other components of user control system 212 will communicate over a local wired communication and/or power network of seating device 201. However, controller 214 can also be configured to communicate wirelessly. Additionally, controller 214 can be configured to use various transport mediums and protocols for communicating with components of system 212, including, for example, Ethernet, Transmission Control Protocol/Internet Protocol (TCP/IP), 802.11 or Bluetooth, or other standard or proprietary communication protocols.
In an example, controller 214 is configured to automatically cause seating device 201 to articulate periodically or continually in micro-increments in accordance with an algorithm or other implementation of a predefined routine or schedule of articulation of the user control device. The algorithm by which controller 214 automatically articulates seating device 201 can be designed to vary the position of the seating device, and thereby the surgeon seated therein, as a function of various variables. For example, controller 214 can periodically execute a predefined series of positional and/or orientation changes of seating device 201 at a constant or varying time frequency. In another example, controller 214 can execute a first set of predefined one or more positional and/or orientation changes of seating device 201 at a first time and can execute a second set of predefined one or more positional and/or orientation changes of seating device 201 at a second time.
Additionally, controller 214 can change the position and/or orientation of seating device 201 based on the state of the teleoperated surgical system. For example, controller 214 can be configured to determine a first operating state of the teleoperated surgical system and to move seating device 201 according to a first predefined schedule during the first operating state of the surgical system. Additionally, controller 214 is configured to determine a first operating state of the teleoperated surgical system and to suspend movement of seating device 201 according to the predefined schedule during the first operating state of the surgical system. Controller 214 can also resume movement of seating device 201 according to the first predefined schedule after the first operating state of the surgical system. In an example, controller 214 is configured to determine a first operating state of the teleoperated surgical system, suspend movement of seating device 201 according to the predefined schedule during the first operating state of the surgical system, and move seating device 201 according to a second predefined schedule (the second predefined schedule is different than the first predefined schedule) during the first operating state of the surgical system.
Additionally, controller 214 can execute an algorithm that varies both the time at which automated motion of seating device 201 occurs and the type and/or parameters of the automated motion caused by controller 214. For example, controller 214 can execute an algorithm that causes a random set of one or more articulations of seating device 201, which occur at random time intervals. The algorithm (or other set of instructions executable by a controller and/or processor(s) thereof) defining control of motion of seating device 201 by controller 214 can be configured to vary articulation of the user control device according to other variables. For example, controller 214 can be configured to periodically or continually (time) cause seating device 201 to articulate in one or more directions and/or through one or more orientations as a function of the particular surgical procedure being conducted by the surgeon. For example, controller 214 may be configured to execute relatively more articulations as a function of time during more physically strenuous portions of the procedure and relatively fewer articulations during less physically demanding portions of the procedure.
As previously noted, controller 214 is configured to automatically cause seating device 201 to articulate periodically or continually in micro-increments. In some examples, the magnitude of the incremental value of and direction, orientation, etcetera of automated articulation of seating device 201 by controller 214 may be configured such that the motion is or is nearly imperceptible to the surgeon employing the teleoperated surgery user control system. As used in this disclosure, the relative term “nearly imperceptible” can mean that the incremental value by which a portion of a teleoperated surgery user control articulates can be selected to not substantially interrupt any mental or physical processes of the surgeon during the procedure.
One way in which controller 214 can execute automated motion of seating device 201 that minimizes the perception of such motion by the surgeon is to execute the motion in relatively small increments. For example, each individual articulation may be limited to a maximum value on the order of millimeters versus centimeters (or 1/16 of an inch versus ¼ of an inch). In other examples, a maximum incremental value of each articulation of seating device 201 or another user control device may be smaller or greater, depending upon the intended application, including, for example, depending upon user reaction to such automated articulation during a mock or actual surgical procedure.
Additionally, although some of the foregoing examples include periodic or episodic execution of automated articulation of seating device 201, in some examples, controller 214 may be configured to continually and constantly vary the position and/or orientation of the seating device in difficult to perceive micro-increments to yield the effect that the seating device or other user control device is breathing or continually slightly refreshing the position/orientation/etcetera of the surgeon employing the device.
Controller 214 can execute each individual articulation of seating device 201 (or other user control device) in series or in parallel with one another. For example, controller 214 can be configured to cause seat 206 of seating device 201 to change vertical position, and, thereafter, cause one or both of arm rests 210 to change forward/backward position. In another example, controller 214 can be configured to simultaneously 1) cause seat 206 of seating device 201 to change vertical position, and 2) cause one or both of arm rests 210 to change forward/backward position.
For example, viewing system 165 can include a forehead rest/pad, against which the surgeon is configured to rest their head during a teleoperated surgical system. This point/location of engagement with the surgeon's body is quite distinct from those of seating device 201, and, yet, the principle of automated periodic or continuous articulation of portions of viewing system 165 are the same or substantially similar. In the example of
When operating hand controls 155 and 156, the surgeon may rest their arms on bar 308, which is coupled to the upper portion of console 300 near a bottom portion of hood 306. In examples, therefore, bar 308 may be configured to automatically periodically or continually articulate up and down, for example, in direction E, as indicated in
In some examples, seating device 201 and console 300 are included in one system and are controlled by the same or separate communicatively connected controllers to automatically modulate the positions/locations/orientations/etcetera of one or more portions of each of seating device 201 and console 300 via a coordinate movement algorithm (or other executable list of instructions) or in separate, automated movement algorithms for each device. Additionally, a teleoperated surgery user control system in accordance with this disclosure may include additional user control devices other than a seating device and surgeon console.
Persons of skill in the art will understand that any of the features described above may be combined with any of the other example features, as long as the features are not mutually exclusive. All possible combinations of features are contemplated, depending on clinical or other design requirements. In addition, if manipulating system units are combined into a single system (e.g., telesurgery system), each individual unit may have the same configuration of features, or, one patient-side unit may have one configuration of features and another patient-side unit may have a second, different configuration of features.
The examples (e.g., methods, systems, or devices) described herein may be applicable to surgical procedures, non-surgical medical procedures, diagnostic procedures, cosmetic procedures, and non-medical procedures or applications. The examples may also be applicable for training, or for obtaining information, such as imaging procedures. The examples may be applicable to handling of tissue that has been removed from human or animal anatomies and will not be returned to a human or animal, or for use with human or animal cadavers. The examples may be used for industrial applications, general robotic uses, manipulation of non-tissue work pieces, as part of an artificial intelligence system, or in a transportation system.
The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as “examples.” Such examples may include elements in addition to those shown or described. But, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.
In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.
In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.
Geometric terms, such as “parallel”, “perpendicular”, “round”, or “square”, are not intended to require absolute mathematical precision, unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as “round” or “generally round”, a component that is not precisely circular (e.g., one that is slightly oblong or is a many-sided polygon) is still encompassed by this description. Coordinate systems or reference frames are provided for aiding explanation, and implantations may use other reference frames or coordinate systems other than those described herein.
The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments may be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments may be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
This application claims the benefit of priority to U.S. Provisional Patent Application No. 63/108,746, filed on Nov. 2, 2020, which is incorporated by reference herein in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2021/057688 | 11/2/2021 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63108746 | Nov 2020 | US |
