The systems and methods disclosed herein are directed to devices and methods for indicating locations of surgical tools, and more particularly to surgical robotic systems for indicating locations of surgical tools.
A robotically enabled medical system is capable of performing a variety of medical procedures, including both minimally invasive procedures, such as laparoscopy, and non-invasive procedures, such as endoscopy (e.g., bronchoscopy, ureteroscopy, gastroscopy, etc.).
Such robotic medical systems may include robotic arms configured to control the movement of surgical tool(s) during a given medical procedure. In order to achieve a desired pose of a surgical tool, a robotic arm may be placed into a particular pose during teleoperation. Some robotically enabled medical systems may include an arm support (e.g., a bar) that is connected to respective bases of the robotic arms and supports the robotic arms.
One or more instruments can be coupled to one or more robotic arms of a robotic medical system (e.g., surgical robotic system) for medical procedures. For example, an instrument can be coupled to a robotic arm as either a starting instrument to perform a procedure, or as a replacement instrument mid-procedure.
In a robotic system that includes multiple robotic arms, at least one robotic arm can be coupled to a camera or scope that provides a surgical field of view. When the medical instruments are within the surgical field of view, a user (e.g., a surgeon or physician assistant) can locate the instruments from the image of the surgical field of view. However, if an instrument is not within the surgical field of view, it is possible that movement of the instrument can lead to a contact between the instrument and an unintended tissue or organ. In addition, if the instrument is not within the surgical field of view, it may take additional time for the user to locate the instrument before starting to use the instrument, which can prolong the medical procedure.
Accordingly, there is a need for a robotic medical system that can facilitate the user to locate an instrument even when the instrument is positioned outside the surgical field of view.
As disclosed herein, a robotic medical system (e.g., a surgical robotic system) can include two or more robotic arms, such as a first robotic arm that is coupled to a surgical tool and a second robotic arm that is coupled to a scope (or a camera). The robotic medical system also includes a viewer for displaying a field of view of a surgical site. A user interface displayed on the viewer may be configured to include an off-screen indicator, which indicates a relative position of a surgical tool and/or a distance to the surgical tool so that the user can locate, and/or ascertain the distance to, the surgical tool.
As disclosed herein, the robotic medical system is configured to determine whether a tool is located within a field of view of the camera. In accordance with a determination that the tool is not within the field of view of the camera, the robotic medical system can provide to a physician and/or physician assistant an indication of a position of the tool and/or a distance to the tool from the field of view.
As disclosed herein, the robotic medical system has knowledge of the camera field of view (e.g., information indicating the camera field of view). In some embodiments, the field of view is determined based on an image provided by the camera. In some embodiments, the field of view is determined based on a position and an orientation of the camera (e.g., a predefined volume of space in front of the camera).
As disclosed herein, the robotic medical system is configured to allow movement of the robotic arms. In some embodiments, the robotic medical system may cause robotic movement of the robotic arms. In some embodiments, the robotic medical system may allow manual movement of the robotic arms.
As disclosed the robotic medical system is configured to determine the position and orientation of the robotic arms, and more specifically, their associated tools. In some embodiments, the robotic medical system determines that at least one of the robotic arms has moved (and hence the position of an associated tool has changed) and updates the off-screen indicator to indicate the changed position of the associated tool. In some embodiments, the robotic medical system updates the off-screen indicator in real time (e.g., while the associated tool is moving) to indicate the changed position of the associated tool.
Accordingly, the systems and/or methods disclosed herein advantageously improve the operation of robotic medical systems during surgery. For example, a user can be notified of a tool position and distance even when the tool is located outside the field of view of a camera. This leads to a better overall user experience because the user can determine the position of the tool quickly. The ability to determine the position of the tool when the tool is located outside the field of view may also improve the safety of the surgery.
The systems, methods and devices of this disclosure each have several innovative aspects, no single one of which is solely responsible for the desirable attributes disclosed herein.
In accordance with some embodiments of the present disclosure, a robotic system includes a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; and a third robotic arm coupled to a scope. The robotic system also includes a viewer for displaying a field of view of a surgical site derived from the scope. The robotic system further includes one or more processors, and memory storing instructions for execution by the one or more processors. The stored instructions include instructions for, in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, providing electrical signals for presenting a first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In some embodiments, the stored instructions also include instructions for: providing electrical signals for presenting the first visual indicator at a first location on the viewer to indicate the location of the first surgical tool; and, subsequent to providing the electrical signals for presenting the first visual indicator at the first location on the viewer, in accordance with a determination that the location of the first surgical tool has changed, providing electrical signals for presenting the first visual indicator at a second location, on the viewer, that corresponds to the changed location of the first surgical tool.
In some embodiments, the first visual indicator also indicates a distance to the first surgical tool from the field of view.
In some embodiments, the stored instructions also include instructions for, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the distance from the field of view to the first surgical tool has changed, providing electrical signals for presenting an updated first visual indicator on the viewer that indicates the changed distance from the field of view to the first surgical tool.
In some embodiments, the stored instructions also include instructions for, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the first surgical tool is within the field of view, ceasing to provide the electrical signals for presenting the first visual indicator on the viewer.
In some embodiments, the first visual indicator includes a graphical element having a size that indicates the distance to the first surgical tool from the field of view.
In some embodiments, the first visual indicator includes information identifying a robotic arm associated with the graphical element.
In some embodiments, the first visual indicator identifies a type of the first surgical tool.
In some embodiments, the first visual indicator includes a graphical representation of the first surgical tool.
In some embodiments, the first visual indicator is concurrently displayed with a display of the field of view of the surgical site on the viewer.
In some embodiments, the first visual indicator is displayed around the display of the field of view of the surgical site.
In some embodiments, the first visual indicator is displayed over the display of the field of view of the surgical site.
In some embodiments, the stored instructions also include instructions for providing electrical signals for highlighting a predefined region of the display of the field of view of the surgical site and the first visual indicator is displayed along a periphery of the predefined region.
In some embodiments, the stored instructions also include instructions for providing a rendered image that includes the first visual indicator.
In some embodiments, the rendered image also includes a second visual indicator indicating a location of the second surgical tool.
In some embodiments, the first visual indicator includes information identifying the first robotic arm associated with the first surgical tool and the second visual indicator includes information identifying the second robotic arm associated with the second surgical tool.
In some embodiments, the first visual indicator includes a graphical representation of the first surgical tool and the second visual indicator includes a graphical representation of the second surgical tool.
In some embodiments, the stored instructions include instructions for replacing the display of the field of view with the rendered image.
In some embodiments, the stored instructions include instructions for overlaying the rendered image partially over the display of the field of view.
In some embodiments, the stored instructions include instructions for, in response to receiving a request for displaying the first visual indicator and in accordance with the determination that second surgical tool is within the field of view and the first surgical tool is not within the field of view, providing the electrical signals for presenting the first visual indicator on the viewer.
In some embodiments, the stored instructions include instructions for, in response to determining that the request for displaying the first visual indicator has ceased, ceasing to provide the electrical signals for presenting the first visual indicator on the viewer.
In some embodiments, the first robotic arm and the second robotic arm are positioned bilaterally relative to an operating table.
In some embodiments, the first robotic arm is supported on a first adjustable arm support and the second robotic arm is supported on a second adjustable arm support.
In some embodiments, the first robotic arm and the second robotic arm are positioned on a same side of an operating table.
In some embodiments, the first robotic arm and the second robotic arm are supported on an adjustable arm support.
In some embodiments, the viewer is part of a surgeon console.
In some embodiments, the surgeon console includes an input device. The stored instructions include instructions for: receiving an input on the input device; and in response to receiving the input on the input device, providing electrical signals for presenting a bird's eye view of the first robotic arm, the second robotic arm, and the third robotic arm.
In some embodiments, the input device includes a foot pedal.
In accordance with some embodiments, an electronic device is in communication with a robotic system with a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer. The electronic device includes one or more processors and memory storing instructions for execution by the one or more processors. The stored instructions include instructions for, in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, providing electrical signals for presenting a first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In accordance with some embodiments, a computer-readable storage medium stores instructions for execution by one or more processors in communication with a robotic system with a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer. The stored instructions include instructions for, in accordance with a determination that the second surgical tool is within a field of view and the first surgical tool is not within the field of view, providing electrical signals for presenting a first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In accordance with some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; a scope; and a viewer for displaying a field of view of a surgical site derived from the scope. The robotic system also includes one or more processors and memory storing instructions for execution by the one or more processors. The stored instructions include instructions for, in response to receiving a request for displaying a first visual indicator, providing electrical signals for presenting the first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In accordance with some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool; a second robotic arm coupled to a second surgical tool; a scope; and a viewer for displaying a field of view of a surgical site derived from the scope. The robotic system also includes one or more processors and memory storing instructions for execution by the one or more processors. The stored instructions include instructions for providing electrical signals for presenting a first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In accordance with some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool; a scope; and a viewer for displaying a field of view of a surgical site derived from the scope. The robotic system also includes one or more processors and memory storing instructions for execution by the one or more processors. The stored instructions including instructions for, in response to receiving a request for displaying a first visual indicator, providing electrical signals for presenting the first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
In accordance with some embodiments, a robotic system includes a first robotic arm coupled to a first surgical tool; a scope; and a viewer for displaying a field of view of a surgical site derived from the scope. The robotic system also includes one or more processors and memory storing instructions for execution by the one or more processors. The stored instructions include instructions for, providing electrical signals for presenting a first visual indicator on the viewer. The first visual indicator indicates a location of the first surgical tool.
Note that the various embodiments described above can be combined with any other embodiments described herein. The features and advantages described in the specification are not all inclusive and, in particular, many additional features and advantages will be apparent to one of ordinary skill in the art in view of the drawings, specification, and claims. Moreover, it should be noted that the language used in the specification has been principally selected for readability and instructional purposes and may not have been selected to delineate or circumscribe the inventive subject matter.
The disclosed aspects will hereinafter be described in conjunction with the appended drawings, provided to illustrate and not to limit the disclosed aspects, wherein like designations denote like elements.
Aspects of the present disclosure may be integrated into a robotically enabled medical system capable of performing a variety of medical procedures, including both minimally invasive, such as laparoscopy, and non-invasive, such as endoscopy, procedures. Among endoscopy procedures, the system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.
In addition to performing the breadth of procedures, the system may provide additional benefits, such as enhanced imaging and guidance to assist the physician. Additionally, the system may provide the physician with the ability to perform the procedure from an ergonomic position without the need for awkward arm motions and positions. Still further, the system may provide the physician with the ability to perform the procedure with improved ease of use such that one or more of the instruments of the system can be controlled by a single user.
Various embodiments will be described below in conjunction with the drawings for purposes of illustration. It should be appreciated that many other embodiments of the disclosed concepts are possible, and various advantages can be achieved with the disclosed embodiments. Headings are included herein for reference and to aid in locating various sections. These headings are not intended to limit the scope of the concepts described with respect thereto. Such concepts may have applicability throughout the entire specification.
The robotically enabled medical system may be configured in a variety of ways depending on the particular procedure.
With continued reference to
The endoscope 13 may be directed down the patient's trachea and lungs after insertion using precise commands from the robotic system until reaching the target destination or operative site. In order to enhance navigation through the patient's lung network and/or reach the desired target, the endoscope 13 may be manipulated to telescopically extend the inner leader portion from the outer sheath portion to obtain enhanced articulation and greater bend radius. The use of separate instrument drivers 28 also allows the leader portion and sheath portion to be driven independent of each other.
For example, the endoscope 13 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. After identifying a nodule to be malignant, the endoscope 13 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 13 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.
The system 10 may also include a movable tower 30, which may be connected via support cables to the cart 11 to provide support for controls, electronics, fluidics, optics, sensors, and/or power to the cart 11. Placing such functionality in the tower 30 allows for a smaller form factor cart 11 that may be more easily adjusted and/or re-positioned by an operating physician and his/her staff. Additionally, the division of functionality between the cart/table and the support tower 30 reduces operating room clutter and facilitates improving clinical workflow. While the cart 11 may be positioned close to the patient, the tower 30 may be stowed in a remote location to stay out of the way during a procedure.
In support of the robotic systems described above, the tower 30 may include component(s) of a computer-based control system that stores computer program instructions, for example, within a non-transitory computer-readable storage medium such as a persistent magnetic storage drive, solid state drive, etc. The execution of those instructions, whether the execution occurs in the tower 30 or the cart 11, may control the entire system or sub-system(s) thereof. For example, when executed by a processor of the computer system, the instructions may cause the components of the robotics system to actuate the relevant carriages and arm mounts, actuate the robotics arms, and control the medical instruments. For example, in response to receiving the control signal, the motors in the joints of the robotics arms may position the arms into a certain posture.
The tower 30 may also include a pump, flow meter, valve control, and/or fluid access in order to provide controlled irrigation and aspiration capabilities to the system that may be deployed through the endoscope 13. These components may also be controlled using the computer system of tower 30. In some embodiments, irrigation and aspiration capabilities may be delivered directly to the endoscope 13 through separate cable(s).
The tower 30 may include a voltage and surge protector designed to provide filtered and protected electrical power to the cart 11, thereby avoiding placement of a power transformer and other auxiliary power components in the cart 11, resulting in a smaller, more moveable cart 11.
The tower 30 may also include support equipment for the sensors deployed throughout the robotic system 10. For example, the tower 30 may include opto-electronics equipment for detecting, receiving, and processing data received from the optical sensors or cameras throughout the robotic system 10. In combination with the control system, such opto-electronics equipment may be used to generate real-time images for display in any number of consoles deployed throughout the system, including in the tower 30. Similarly, the tower 30 may also include an electronic subsystem for receiving and processing signals received from deployed electromagnetic (EM) sensors. The tower 30 may also be used to house and position an EM field generator for detection by EM sensors in or on the medical instrument.
The tower 30 may also include a console 31 in addition to other consoles available in the rest of the system, e.g., console mounted on top of the cart. The console 31 may include a user interface and a display screen, such as a touchscreen, for the physician operator. Consoles in system 10 are generally designed to provide both robotic controls as well as pre-operative and real-time information of the procedure, such as navigational and localization information of the endoscope 13. When the console 31 is not the only console available to the physician, it may be used by a second operator, such as a nurse, to monitor the health or vitals of the patient and the operation of system, as well as provide procedure-specific data, such as navigational and localization information. In other embodiments, the console 30 is housed in a body that is separate from the tower 30.
The tower 30 may be coupled to the cart 11 and endoscope 13 through one or more cables or connections (not shown). In some embodiments, the support functionality from the tower 30 may be provided through a single cable to the cart 11, simplifying and de-cluttering the operating room. In other embodiments, specific functionality may be coupled in separate cabling and connections. For example, while power may be provided through a single power cable to the cart, the support for controls, optics, fluidics, and/or navigation may be provided through a separate cable.
The carriage interface 19 is connected to the column 14 through slots, such as slot 20, that are positioned on opposite sides of the column 14 to guide the vertical translation of the carriage 17. The slot 20 contains a vertical translation interface to position and hold the carriage at various vertical heights relative to the cart base 15. Vertical translation of the carriage 17 allows the cart 11 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 carriage 17 allow the robotic arm base 21 of robotic arms 12 to be angled in a variety of configurations.
In some embodiments, the slot 20 may be supplemented with slot covers that are flush and parallel to the slot surface to prevent dirt and fluid ingress into the internal chambers of the column 14 and the vertical translation interface as the carriage 17 vertically translates. The slot covers may be deployed through pairs of spring spools positioned near the vertical top and bottom of the slot 20. The covers are coiled within the spools until deployed to extend and retract from their coiled state as the carriage 17 vertically translates up and down. The spring-loading of the spools provides force to retract the cover into a spool when carriage 17 translates towards the spool, while also maintaining a tight seal when the carriage 17 translates away from the spool. The covers may be connected to the carriage 17 using, for example, brackets in the carriage interface 19 to ensure proper extension and retraction of the cover as the carriage 17 translates.
The column 14 may internally comprise mechanisms, such as gears and motors, that are designed to use a vertically aligned lead screw to translate the carriage 17 in a mechanized fashion in response to control signals generated in response to user inputs, e.g., inputs from the console 16.
The robotic arms 12 may generally comprise robotic arm bases 21 and end effectors 22, separated by a series of linkages 23 that are connected by a series of joints 24, each joint comprising an independent actuator, each actuator comprising an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm. Each of the arms 12 have seven joints, and thus provide seven degrees of freedom. A multitude of joints result in a multitude of degrees of freedom, allowing for “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 cart base 15 balances the weight of the column 14, carriage 17, and arms 12 over the floor. Accordingly, the cart base 15 houses heavier components, such as electronics, motors, power supply, as well as components that either enable movement and/or immobilize the cart. For example, the cart base 15 includes rollable wheel-shaped casters 25 that allow for the cart to easily move around the room prior to a procedure. After reaching the appropriate position, the casters 25 may be immobilized using wheel locks to hold the cart 11 in place during the procedure.
Positioned at the vertical end of column 14, the console 16 allows for both a user interface for receiving user input and a display screen (or a dual-purpose device such as, for example, a touchscreen 26) to provide the physician user with both pre-operative and intra-operative data. Potential pre-operative data on the touchscreen 26 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 16 may be positioned and tilted to allow a physician to access the console from the side of the column 14 opposite carriage 17. From this position, the physician may view the console 16, robotic arms 12, and patient while operating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 to assist with maneuvering and stabilizing cart 11.
After insertion into the urethra, using similar control techniques as in bronchoscopy, the ureteroscope 32 may be navigated into the bladder, ureters, and/or kidneys for diagnostic and/or therapeutic applications. For example, the ureteroscope 32 may be directed into the ureter and kidneys to break up kidney stone build up using a laser or ultrasonic lithotripsy device deployed down the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments may be removed using baskets deployed down the ureteroscope 32.
Embodiments of the robotically enabled medical system may also incorporate the patient's table. Incorporation of the table reduces the amount of capital equipment within the operating room by removing the cart, which allows greater access to the patient.
The arms 39 may be mounted on the carriages through a set of arm mounts 45 comprising a series of joints that may individually rotate and/or telescopically extend to provide additional configurability to the robotic arms 39. Additionally, the arm mounts 45 may be positioned on the carriages 43 such that, when the carriages 43 are appropriately rotated, the arm mounts 45 may be positioned on either the same side of table 38 (as shown in
The column 37 structurally provides support for the table 38, and a path for vertical translation of the carriages. Internally, the column 37 may be equipped with lead screws for guiding vertical translation of the carriages, and motors to mechanize the translation of said carriages based the lead screws. The column 37 may also convey power and control signals to the carriage 43 and robotic arms 39 mounted thereon.
The table base 46 serves a similar function as the cart base 15 in cart 11 shown in
Continuing with
In some embodiments, a table base may stow and store the robotic arms when not in use.
In a laparoscopic procedure, through small incision(s) in the patient's abdominal wall, minimally invasive instruments may be inserted into the patient's anatomy. In some embodiments, the minimally invasive instruments comprise an elongated rigid member, such as a shaft, which is used to access anatomy within the patient. After inflation of the patient's abdominal cavity, the instruments may be directed to perform surgical or medical tasks, such as grasping, cutting, ablating, suturing, etc. In some embodiments, the instruments can comprise a scope, such as a laparoscope.
To accommodate laparoscopic procedures, the robotically enabled table system may also tilt the platform to a desired angle.
For example, pitch adjustments are particularly useful when trying to position the table in a Trendelenburg position, i.e., position the patient's lower abdomen at a higher position from the floor than the patient's lower abdomen, for lower abdominal surgery. The Trendelenburg position causes the patient's internal organs to slide towards his/her upper abdomen through the force of gravity, clearing out the abdominal cavity for minimally invasive tools to enter and perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.
The adjustable arm support 105 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment of
The surgical robotics system 100 in
The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the table 101 or base 103. The adjustable arm support 105 can include a carriage 109, a bar or rail connector 111 and a bar or rail 107. In some embodiments, one or more robotic arms mounted to the rail 107 can translate and move relative to one another.
The carriage 109 can be attached to the column 102 by a first joint 113, which allows the carriage 109 to move relative to the column 102 (e.g., such as up and down a first or vertical axis 123). The first joint 113 can provide the first degree of freedom (“Z-lift”) to the adjustable arm support 105. The adjustable arm support 105 can include a second joint 115, which provides the second degree of freedom (tilt) for the adjustable arm support 105. The adjustable arm support 105 can include a third joint 117, which can provide the third degree of freedom (“pivot up”) for the adjustable arm support 105. An additional joint 119 (shown in
In some embodiments, one or more of the robotic arms 142A, 142B comprises an arm with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B can include eight degrees of freedom, including an insertion axis (1-degree of freedom including insertion), a wrist (3-degrees of freedom including wrist pitch, yaw and roll), an elbow (1-degree of freedom including elbow pitch), a shoulder (2-degrees of freedom including shoulder pitch and yaw), and base 144A, 144B (1-degree of freedom including translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arm 142A, 142B, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.
The end effectors of the system's robotic arms comprise (i) an instrument driver (alternatively referred to as “instrument drive mechanism” or “instrument device manipulator”) that incorporate electro-mechanical means for actuating the medical instrument and (ii) a removable or detachable medical instrument, which may be devoid of any electro-mechanical components, such as motors. 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 instruments may be designed to be detached, removed, and interchanged from the instrument driver (and thus the system) for individual sterilization or disposal by the physician or the physician's staff. In contrast, the instrument drivers need not be changed or sterilized, and may be draped for protection.
For procedures that require a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile drape, that sits between the instrument driver and the medical instrument. The chief purpose of the sterile adapter is to transfer angular motion from the drive shafts of the instrument driver to the drive inputs of the instrument while maintaining physical separation, and thus sterility, between the drive shafts and drive inputs. Accordingly, an example sterile adapter may comprise of a series of rotational inputs and outputs intended to be mated with the drive shafts of the instrument driver and drive inputs on the instrument. Connected to the sterile adapter, the sterile drape, comprised of a thin, flexible material such as transparent or translucent plastic, is designed to cover the capital equipment, such as the instrument driver, robotic arm, and cart (in a cart-based system) or table (in a table-based system). Use of the drape would allow the capital equipment to be positioned proximate to the patient while still being located in an area not requiring sterilization (i.e., non-sterile field). On the other side of the sterile drape, the medical instrument may interface with the patient in an area requiring sterilization (i.e., sterile field).
The elongated shaft 71 is designed to be delivered through either an anatomical opening or lumen, e.g., as in endoscopy, or a minimally invasive incision, e.g., as in laparoscopy. The elongated shaft 71 may be either flexible (e.g., having properties similar to an endoscope) or rigid (e.g., having properties similar to a laparoscope) or contain a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of a rigid elongated shaft may be connected to an end effector extending from a jointed wrist formed from a clevis with at least one degree of freedom and a surgical tool or medical instrument, such as, for example, a grasper or scissors, that may be actuated based on force from the tendons as the drive inputs rotate in response to torque received from the drive outputs 74 of the instrument driver 75. When designed for endoscopy, the distal end of a flexible elongated shaft may include a steerable or controllable bending section that may be articulated and bent based on torque received from the drive outputs 74 of the instrument driver 75.
Torque from the instrument driver 75 is transmitted down the elongated shaft 71 using tendons along the shaft 71. These individual tendons, such as pull wires, may be individually anchored to individual drive inputs 73 within the instrument handle 72. From the handle 72, the tendons are directed down one or more pull lumens along the elongated shaft 71 and anchored at the distal portion of the elongated shaft 71, or in the wrist at the distal portion of the elongated shaft. During a surgical procedure, such as a laparoscopic, endoscopic or hybrid procedure, these tendons may be coupled to a distally mounted end effector, such as a wrist, grasper, or scissor. Under such an arrangement, torque exerted on drive inputs 73 would transfer tension to the tendon, thereby causing the end effector to actuate in some way. In some embodiments, during a surgical procedure, the tendon may cause a joint to rotate about an axis, thereby causing the end effector to move in one direction or another. Alternatively, the tendon may be connected to one or more jaws of a grasper at distal end of the elongated shaft 71, where tension from the tendon cause the grasper to close.
In endoscopy, the tendons may be coupled to a bending or articulating section positioned along the elongated shaft 71 (e.g., at the distal end) via adhesive, control ring, or other mechanical fixation. When fixedly attached to the distal end of a bending section, torque exerted on drive inputs 73 would be transmitted down the tendons, causing the softer, bending section (sometimes referred to as the articulable section or region) to bend or articulate. Along the non-bending sections, it may be advantageous to spiral or helix the individual pull lumens that direct the individual tendons along (or inside) the walls of the endoscope shaft to balance the radial forces that result from tension in the pull wires. The angle of the spiraling and/or spacing there between may be altered or engineered for specific purposes, wherein tighter spiraling exhibits lesser shaft compression under load forces, while lower amounts of spiraling results in greater shaft compression under load forces, but also exhibits limits bending. On the other end of the spectrum, the pull lumens may be directed parallel to the longitudinal axis of the elongated shaft 71 to allow for controlled articulation in the desired bending or articulable sections.
In endoscopy, the elongated shaft 71 houses a number of components to assist with the robotic procedure. The shaft may comprise of a working channel for deploying surgical tools (or medical instruments), irrigation, and/or aspiration to the operative region at the distal end of the shaft 71. The shaft 71 may also accommodate wires and/or optical fibers to transfer signals to/from an optical assembly at the distal tip, which may include of an optical camera. The shaft 71 may also accommodate optical fibers to carry light from proximally located light sources, such as light emitting diodes, to the distal end of the shaft.
At the distal end of the instrument 70, the distal tip may also comprise the opening of a working channel for delivering tools for diagnostic and/or therapy, irrigation, and aspiration to an operative site. The distal tip may also include a port for a camera, such as a fiberscope or a digital camera, to capture images of an internal anatomical space. Relatedly, the distal tip may also include ports for light sources for illuminating the anatomical space when using the camera.
In the example of
Like earlier disclosed embodiments, an instrument 86 may comprise an elongated shaft portion 88 and an instrument base 87 (shown with a transparent external skin for discussion purposes) comprising a plurality of drive inputs 89 (such as receptacles, pulleys, and spools) that are configured to receive the drive outputs 81 in the instrument driver 80. Unlike prior disclosed embodiments, instrument shaft 88 extends from the center of instrument base 87 with an axis substantially parallel to the axes of the drive inputs 89, rather than orthogonal as in the design of
When coupled to the rotational assembly 83 of the instrument driver 80, the medical instrument 86, comprising instrument base 87 and instrument shaft 88, rotates in combination with the rotational assembly 83 about the instrument driver axis 85. Since the instrument shaft 88 is positioned at the center of instrument base 87, the instrument shaft 88 is coaxial with instrument driver axis 85 when attached. Thus, rotation of the rotational assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Moreover, as the instrument base 87 rotates with the instrument shaft 88, any tendons connected to the drive inputs 89 in the instrument base 87 are not tangled during rotation. Accordingly, the parallelism of the axes of the drive outputs 81, drive inputs 89, and instrument shaft 88 allows for the shaft rotation without tangling any control tendons.
The instrument handle 170, which may also be referred to as an instrument base, may generally comprise an attachment interface 172 having one or more mechanical inputs 174, e.g., receptacles, pulleys or spools, that are designed to be reciprocally mated with one or more torque couplers on an attachment surface of an instrument driver.
In some embodiments, the instrument 150 comprises a series of pulleys or cables that enable the elongated shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself comprises an instrument-based insertion architecture that accommodates insertion of the instrument, thereby minimizing the reliance on a robot arm to provide insertion of the instrument 150. In other embodiments, a robotic arm can be largely responsible for instrument insertion.
Any of the robotic systems described herein can include an input device or controller for manipulating an instrument attached to a robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electronically, electrically, wirelessly and/or mechanically) with an instrument such that manipulation of the controller causes a corresponding manipulation of the instrument e.g., via master slave control.
In the illustrated embodiment, the controller 182 is configured to allow manipulation of two medical instruments and includes two handles 184. Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.
As shown in
In some embodiments, one or more load cells are positioned in the controller. For example, in some embodiments, a load cell (not shown) is positioned in the body of each of the gimbals 186. By providing a load cell, portions of the controller 182 are capable of operating under admittance control, thereby advantageously reducing the perceived inertia of the controller while in use. In some embodiments, the positioning platform 188 is configured for admittance control, while the gimbal 186 is configured for impedance control. In other embodiments, the gimbal 186 is configured for admittance control, while the positioning platform 188 is configured for impedance control. Accordingly, for some embodiments, the translational or positional degrees of freedom of the positioning platform 188 can rely on admittance control, while the rotational degrees of freedom of the gimbal 186 rely on impedance control.
Traditional endoscopy may involve the use of fluoroscopy (e.g., as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide endoluminal guidance to an operator physician. In contrast, the robotic systems contemplated by this disclosure can provide for non-radiation-based navigational and localization means to reduce physician exposure to radiation and reduce the amount of equipment within the operating room. As used herein, the term “localization” may refer to determining and/or monitoring the position of objects in a reference coordinate system. Technologies such as pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to achieve a radiation-free operating environment. In other cases, where radiation-based imaging modalities are still used, the pre-operative mapping, computer vision, real-time EM tracking, and robot command data may be used individually or in combination to improve upon the information obtained solely through radiation-based imaging modalities.
As shown in
The various input data 91-94 are now described in greater detail. Pre-operative mapping may be accomplished through the use of the collection of low dose CT scans. Pre-operative CT scans are reconstructed into three-dimensional images, which are visualized, e.g., as “slices” of a cutaway view of the patient's internal anatomy. When analyzed in the aggregate, image-based models for anatomical cavities, spaces and structures of the patient's anatomy, such as a patient lung network, may be generated. Techniques such as center-line geometry may be determined and approximated from the CT images to develop a three-dimensional volume of the patient's anatomy, referred to as model data 91 (also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of center-line geometry is discussed in U.S. patent application Ser. No. 14/523,760, the contents of which are herein incorporated in its entirety. Network topological models may also be derived from the CT-images and are particularly appropriate for bronchoscopy.
In some embodiments, the instrument may be equipped with a camera to provide vision data 92. The localization module 95 may process the vision data to enable one or more vision-based location tracking. For example, the preoperative model data may be used in conjunction with the vision data 92 to enable computer vision-based tracking of the medical instrument (e.g., an endoscope or an instrument advance through a working channel of the endoscope). For example, using the preoperative model data 91, the robotic system may generate a library of expected endoscopic images from the model based on the expected path of travel of the endoscope, each image linked to a location within the model. Intra-operatively, this library may be referenced by the robotic system in order to compare real-time images captured at the camera (e.g., a camera at a distal end of the endoscope) to those in the image library to assist localization.
Other computer vision-based tracking techniques use feature tracking to determine motion of the camera, and thus the endoscope. Some features of the localization module 95 may identify circular geometries in the preoperative model data 91 that correspond to anatomical lumens and track the change of those geometries to determine which anatomical lumen was selected, as well as the relative rotational and/or translational motion of the camera. Use of a topological map may further enhance vision-based algorithms or techniques.
Optical flow, another computer vision-based technique, may analyze the displacement and translation of image pixels in a video sequence in the vision data 92 to infer camera movement. Examples of optical flow techniques may include motion detection, object segmentation calculations, luminance, motion compensated encoding, stereo disparity measurement, etc. Through the comparison of multiple frames over multiple iterations, movement and location of the camera (and thus the endoscope) may be determined.
The localization module 95 may use real-time EM tracking to generate a real-time location of the endoscope in a global coordinate system that may be registered to the patient's anatomy, represented by the preoperative model. In EM tracking, an EM sensor (or tracker) comprising of one or more sensor coils embedded in one or more locations and orientations in a medical instrument (e.g., an endoscopic tool) measures the variation in the EM field created by one or more static EM field generators positioned at a known location. The location information detected by the EM sensors is stored as EM data 93. The EM field generator (or transmitter) may be placed close to the patient to create a low intensity magnetic field that the embedded sensor may detect. The magnetic field induces small currents in the sensor coils of the EM sensor, which may be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations may be intra-operatively “registered” to the patient anatomy (e.g., the preoperative model) in order to determine the geometric transformation that aligns a single location in the coordinate system with a position in the pre-operative model of the patient's anatomy. Once registered, an embedded EM tracker in one or more positions of the medical instrument (e.g., the distal tip of an endoscope) may provide real-time indications of the progression of the medical instrument through the patient's anatomy.
Robotic command and kinematics data 94 may also be used by the localization module 95 to provide localization data 96 for the robotic system. Device pitch and yaw resulting from articulation commands may be determined during pre-operative calibration. Intra-operatively, these calibration measurements may be used in combination with known insertion depth information to estimate the position of the instrument. Alternatively, these calculations may be analyzed in combination with EM, vision, and/or topological modeling to estimate the position of the medical instrument within the network.
As
The localization module 95 may use the input data 91-94 in combination(s). In some cases, such a combination may use a probabilistic approach where the localization module 95 assigns a confidence weight to the location determined from each of the input data 91-94. Thus, where the EM data may not be reliable (as may be the case where there is EM interference) the confidence of the location determined by the EM data 93 can be decrease and the localization module 95 may rely more heavily on the vision data 92 and/or the robotic command and kinematics data 94.
As discussed above, the robotic systems discussed herein may be designed to incorporate a combination of one or more of the technologies above. The robotic system's computer-based control system, based in the tower, bed and/or cart, may store computer program instructions, for example, within a non-transitory computer-readable storage medium such as a persistent magnetic storage drive, solid state drive, or the like, that, upon execution, cause the system to receive and analyze sensor data and user commands, generate control signals throughout the system, and display the navigational and localization data, such as the position of the instrument within the global coordinate system, anatomical map, etc.
This application discloses robotic medical systems that determine whether a tool is located outside a surgical field of view provided by a camera. Based on this data, the system can provide an indication of the position of the tool.
In some embodiments, the robotic medical system can provide the indication via a user interface or display device of the robotic medical system. For example, in some embodiments, the robotic medical system provides a visual indication of a position (or a relative direction) of the tool.
In some embodiments, the robotic medical system updates the visual indication in response to determining that the tool has changed its position (e.g., the tool has changed its relative direction to the field of view or its distance to the field of view).
In some embodiments, the visual indication is provided only when at least one tool is located outside the field of view. In some embodiments, the visual indication is provided regardless of whether any tool is located outside the field of view. In some embodiments, the robotic medical system provides the visual indication in response to (or while) receiving a request to provide the visual indication. In some embodiments, the robotic medical system ceases to provide the visual indication in response to determining that the request to provide the visual indication has ceased or in response to receiving a request to cease display of the visual indication.
The robotic medical system 200 also comprises a base 206 for supporting the robotic medical system 200. The base 206 includes wheels 208 that allow the robotic medical system 200 to be easily movable or repositionable in a physical environment. In some embodiments, the wheels 208 are omitted from the robotic medical system 200 or are retractable, and the base 206 can rest directly on the ground or floor. In some embodiments, the wheels 208 are replaced with feet.
The robotic medical system 200 includes one or more robotic arms 210. The robotic arms 210 can be configured to perform robotic medical procedures as described above with reference to
The robotic medical system 200 also includes one or more bars 220 (e.g., adjustable arm support or an adjustable bar) that support the robotic arms 210. Each of the robotic arms 210 is supported on, and movably coupled to, a bar 220, by a respective base joint of the robotic arm. In some embodiments, and as described in
In some embodiments, the adjustable arm supports 220 can be configured to provide a base position for one or more of the robotic arms 210 for a robotic medical procedure. A robotic arm 210 can be positioned relative to the patient support platform 202 by translating the robotic arm 210 along a length of its underlying bar 220 and/or by adjusting a position and/or orientation of the robotic arm 210 via one or more joints and/or links (see, e.g.,
In some embodiments, the adjustable arm support 220 can be translated along a length of the patient support platform 202. In some embodiments, translation of the bar 220 along a length of the patient support platform 202 causes one or more of the robotic arms 210 supported by the bar 220 to be simultaneously translated with the bar or relative to the bar. In some embodiments, the bar 220 can be translated while keeping one or more of the robotic arms stationary with respect to the base 206 of the robotic medical system 200.
In the example of
During a robotic medical procedure, one or more of the robotic arms 210 can also be configured to hold instruments 212 (e.g., robotically controlled medical instruments or tools, such as an endoscope and/or any other instruments (e.g., sensors, illumination instrument, cutting instrument, etc.) that may be used during surgery), and/or be coupled to one or more accessories, including one or more cannulas, in accordance with some embodiments.
With continued reference to
In some embodiments, the robotic medical system 200 includes a tower 230 (e.g., tower viewer) or a physician console 240 (or both), as illustrated in
In
A proximal end of the robotic arm 210 may be connected to a base 306 and a distal end of the robotic arm 210 may be connected to an advanced device manipulator (ADM) 308 (e.g., a tool driver, an instrument driver, or a robotic end effector, etc.). The ADM 308 may be configured to control the positioning and manipulation of a medical instrument s (e.g., a tool, a scope, etc.).
The robotic arm 210 can also include a cannula sensor 310 for detecting presence or proximity of a cannula to the robotic arm 210. In some embodiments, the robotic arm 210 is placed in a docked state (e.g., docked position) when the cannula sensor 310 detects presence of a cannula (e.g., via one or more processors of the robotic medical system 200). In some embodiments, when the robotic arm 210 is in a docked position, the robotic arm 210 can execute null space motion to maintain a position and/or orientation of the cannula, as discussed in further detail below. Conversely, when no cannula is detected by the cannula sensor 310, the robotic arm 210 is placed in an undocked state (e.g., undocked position).
In some embodiments, and as illustrated in
In some embodiments, the links 302 may be detachably coupled to the medical tool 212 (e.g., to facilitate ease of mounting and dismounting of the medical tool 212 from the robotic arm 210). The joints 304 provide the robotic arm 210 with a plurality of degrees of freedom (DoFs) that facilitate control of the medical tool 212 via the ADM 308. In an embodiment as shown in
In some embodiments, for admittance control, a force sensor or load cell can measure the force that the operator is applying to the robotic arm 210 and move the robotic arm 210 in a way that feels light. Admittance control may feel lighter than impedance control because, under admittance control, one can hide the perceived inertia of the robotic arm 210 because motors in the controller can help to accelerate the mass. In contrast, with impedance control, the user is responsible for most if not all mass acceleration, in accordance with some embodiments.
In some circumstances, depending on the position of the robotic arm 210 relative to the operator, it may be inconvenient to reach the button 312 and/or the button 314 to activate a manual manipulating mode (e.g., the admittance mode and/or the impedance mode). Accordingly, under these circumstances, it may be convenient for the operator to trigger the manual manipulation mode other than by buttons.
In some embodiments, the robotic arm 210 includes a single button (e.g., the button 312 or 314) that can be used to place the robotic arm 210 in the admittance mode and/or the impedance mode (e.g., by using different presses, such as a long press, a short press, press and hold etc.). In some embodiments, the robotic arm 210 can be placed in impedance mode by a user pushing on arm linkages (e.g., the links 302) and/or joints (e.g., the joints 304) and overcoming a force threshold. In some embodiments, the admittance mode and the impedance mode are common in that they both allow the user to grab the robotic arm 210 and command motion by directly interfacing with it.
In some embodiments, the robotic arm 210 includes an input control for activating an arm follow mode. For example, in some embodiments, the robotic arm 210 can include a designate touch point that is located on a link 302 or a joint 304 of the robotic arm (e.g., an outer shell of the link 302 or a button 316). User interaction (e.g., user touch, contact, etc.) with the designate touch point activates the arm follow mode. In some embodiments, the robotic arm 210 includes multiple touch points. User interaction with any (e.g., one or more) of the touch points activates the arm follow mode.
During a medical procedure, it can be desirable to have the ADM 308 of the robotic arm 210 and/or a remote center of motion (RCM) of the tool 212 coupled thereto kept in a static pose (e.g., position and/or orientation). An RCM may refer to a point in space where a cannula or other access port through which a medical tool 212 is inserted is constrained in motion. In some embodiments, the medical tool 212 includes an end effector that is inserted through an incision or natural orifice of a patient while maintaining the RCM. In some embodiments, the medical tool 212 includes an end effector that is in a retracted state during a setup process of the robotic medical system.
In some circumstances, the robotic medical system 200 can be configured to move one or more links 302 of the robotic arm 210 within a “null space” to avoid collisions with nearby objects (e.g., other robotic arms), while the ADM 308 of the robotic arm 210 and/or the RCM are maintained in their respective poses (e.g., positions and/or orientations). The null space can be viewed as the set of joint states through which a robotic arm 210 can move that does not result in movement of the ADM 308 and/or RCM, thereby maintaining the position and/or the orientation of the medical tool 212 (e.g., within a patient). In some embodiments, a robotic arm 210 can have multiple positions and/or configurations available for each pose of the ADM 308.
For a robotic arm 210 to move an instrument to a desired pose in space, in certain embodiments, the robotic arm 210 may have at least six DoFs—three DoFs for translation (e.g., X, Y, and Z positions) and three DoFs for rotation (e.g., yaw, pitch, and roll). In some embodiments, each joint 304 may provide the robotic arm 210 with a single DoF, and thus, the robotic arm 210 may have at least six joints to achieve freedom of motion to position the ADM 308 at any pose in space. To further maintain the ADM 308 of the robotic arm 210 and/or the remote center or motion in a desired pose, the robotic arm 210 may further have at least one additional “redundant joint.” Thus, in certain embodiments, the system may include a robotic arm 210 having at least seven joints 304, providing the robotic arm 210 with at least seven DoFs. In some embodiments, the robotic arm 210 may include a subset of joints 304 each having more than one degree of freedom thereby achieving the additional DoFs for null space motion. However, depending on the embodiment, the robotic arm 210 may have a greater or fewer number of DoFs.
Furthermore, as described with respect to
A robotic arm 210 having at least one redundant DoF has at least one more DoF than the minimum number of DoFs for performing a given task. For example, a robotic arm 210 can have at least seven DoFs, where one of the joints 304 of the robotic arm 210 can be considered a redundant joint, in accordance with some embodiments. The one or more redundant joints can allow the robotic arm 210 to move in a null space to both maintain the pose of the ADM 308 and a position of an RCM and avoid collision(s) with other robotic arms or objects.
In some embodiments, the robotic medical system 200 can be configured to perform collision avoidance to avoid collision(s), e.g., between adjacent robotic arms 210, by taking advantage of the movement of one or more redundant joints in a null space. For example, when a robotic arm 210 collides with or approaches (e.g., within a defined distance of) another robotic arm 210, one or more processors of the robotic medical system 200 can be configured to detect the collision or impending collision (e.g., via kinematics). Accordingly, the robotic medical system 200 can control one or both of the robotic arms 210 to adjust their respective joints within the null space to avoid the collision or impending collision. In an embodiment including at least a pair of robotic arms, a base of one of the robotic arms and its end effector can stay in its pose, while links or joints therebetween move in a null space to avoid collisions with an adjacent robotic arm.
In
In some embodiments, the robotic medical system 200 includes a coordinate system (e.g., a robot coordinate system, a coordinate frame, a system frame, etc. that may be a Cartesian or non-Cartesian coordinate system), and respective positions of the patient support platform 202, the robotic arms 210, the adjustable arm supports 220, and/or instruments 212 are represented as coordinates (e.g., x-, y-, and z-coordinates) on the coordinate system. For example, the robotic medical system 200 (e.g., one or more processors 380 of the robotic medical system 200) may be configured to identify positions and orientations of the patient support platform 202, the robotic arms 210, the adjustable arm supports 220, and/or instruments 212 based on coordinates in the coordinate system.
In
In some embodiments, when the medical instrument 550 moves back into the field of view, the user interface 802 is updated to include an image or representation of the medical instrument 550. In some embodiments, the user interface 802, in response to the medical instrument 550 moving back into the field of view, ceases to include the indicator 810-1 (e.g., the indicator 810-1 ceases to be displayed in response to the medical instrument 550 moving back into the field of view). Thus, in some embodiments, the indicator 810-1 (or any other indicator for any medical tool) is displayed only when the corresponding medical tool is located outside the field of view.
In some embodiments, the indicator 810-1 (or any other indicator for any medical tool) is displayed regardless of whether the corresponding medical tool is located within or outside the field of view. For example,
Similarly, the user interface 802 shown in
The user interface 802 in
Although certain aspects of indicators may have been described with respect to a particular example of an indicator (e.g., indicator 810-4), such aspects may be applicable to any other indicators described with respect to
Although
In
In some embodiments, the user interface 802 may include indicators that both identify types of associated medical tools and associated robotic arms (e.g., a combination of a graphical representation of a type of associated medical tool and a robotic arm number).
In some embodiments, instead of the graphical representation 844, any of the graphical representations shown in
In some embodiments, the user interface 802 also includes indicators 842-1, 842-2, and 842-3. In some embodiments, each of the indicators 842-1, 842-2, and 843-3 is shown adjacent to a left-side corner (e.g., a top-left corner or a bottom-left corner) or a right-side corner (e.g., a top-right corner or a bottom-right corner) depending on a position of a corresponding tool relative to a center of the field of view (e.g., the indicator 842-1 is shown in the top-left corner as the corresponding medical tool 550 is positioned on a left side from the center of the field of view and the indicators 842-2 and 842-3 are shown in the top-right corner as the corresponding medical tools 500 and 560 are positioned on a right side from the center of the field of view). In some embodiments, one or more indicators for medical tools located within the field of view are visually distinguishable (e.g., based on the color, size, highlighting, etc.) from one or more indicators for medical tools located outside the field of view (e.g., the indicators 842-1 and 842-2 for medical tools 550 and 500 located within the field of view are highlighted, whereas the indicator 842-3 for medical tool 560 located outside the field of view is not highlighted). In some embodiments, the size, shape, and/or color of an indicator are updated to indicate a distance between the corresponding medical tool and the field of view (e.g., the size of indicator 842-3 is reduced to indicate a distance between the medical tool 560 and the field of view).
In some embodiments, a user (e.g., a surgeon) may switch on or off display of indicators. For example, the user may provide a request for display of indicators or cessation of the display of indicators via one or more input devices (e.g., one or more user interface elements, such as buttons, displayed on a display device, the foot pedal 244, etc.). In some configurations, the user may provide a request for display of indicators or cessation of the display indicators via a voice command. In some embodiments, the user may switch from indicators of a first type to indicators of a second type distinct from the first type (e.g., indicators shown in
As described above,
The surgical robotic system includes a first robotic arm (e.g., a robotic manipulator) (e.g., the robotic arm 210-1 in
The surgical robotic system includes a second robotic arm (e.g., a robotic manipulator) (e.g., the robotic arm 210-2 in
The surgical robotic system includes a third robotic arm (e.g., a robotic manipulator) (e.g., the robotic arm 210-1 in
The robotic system also includes a viewer (e.g., display device 232 located on a tower 230, or display device 242 that is included with a physician console 240) for displaying a field of view of a surgical site derived from the scope.
The robotic system further includes one or more processors (e.g., processor 380) and memory (e.g., memory 382) storing instructions for execution by the one or more processors.
The surgical robotic system, in accordance with a determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, (902) provides electrical signals (e.g., video signals, such as analog video signals or digital video signals) for presenting a first visual indicator on the viewer (e.g., the user interface 802 shown in
In some embodiments, the surgical robotic system (904) provides electrical signals for presenting the first visual indicator at a first location on the viewer to indicate the location (or direction) of the first surgical tool; and, subsequent to providing the electrical signals for presenting the first visual indicator at the first location on the viewer, in accordance with a determination that the location (or direction) of the first surgical tool has changed, (906) provides electrical signals for presenting the first visual indicator at a second location, on the viewer, that corresponds to the changed location (or direction) of the first surgical tool. For example, as shown in
In some embodiments, the first visual indicator also (908) indicates a distance to the first surgical tool from the field of view (e.g., the size, color, and/or shape of the first visual indicator and/or associated text may indicate the distance to the first surgical tool from the field of view). In some embodiments, the distance to the first surgical tool from the field of view corresponds to a distance between the first surgical tool and a point on a boundary of the field of view (e.g., a position on the boundary of the field of view that is the closest to the first surgical tool). For example, the distance to the first surgical tool from the field of view corresponds to a shorted distance between the first surgical tool and any point on a boundary of the field of view. In some embodiments, the distance to the first surgical tool from the field of view corresponds to a distance between the first surgical tool and a center of the field of view.
In some embodiments, the surgical robotic system updates the first visual indicator in real time to indicate the location (or direction) of the first surgical tool and/or the distance between the first surgical tool and the field of view while the first surgical tool is moving relative to the field of view.
In some embodiments, the first visual indicator (910) includes a graphical element having a size that indicates the distance to the first surgical tool from the field of view (e.g.,
In some embodiments, the surgical robotic system, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the distance from the field of view to the first surgical tool has changed, (912) provides electrical signals for presenting an updated first visual indicator on the viewer that indicates the changed distance from the field of view to the first surgical tool (e.g., the size, color, and/or shape of the first visual indicator and/or associated text may be updated to indicate the changed distance between the first surgical tool and the field of view). For example, as shown in
In some embodiments, the first visual indicator (914) includes information identifying a robotic arm associated with the graphical element (e.g., as shown in
In some embodiments, the first visual indicator (916) identifies a type of the first surgical tool. For example, in some embodiments, the first visual indicator (918) includes a graphical representation of the first surgical tool (e.g., representation 812-1 in
In some embodiments, the first visual indicator is (920) concurrently displayed with a display of the field of view of the surgical site on the viewer (e.g.,
In some embodiments, the first visual indicator is (922) displayed around the display of the field of view of the surgical site (e.g., in
In some embodiments, the first visual indicator is (924) displayed over the display of the field of view of the surgical site (e.g.,
In some embodiments, the surgical robotic system (926) provides electrical signals for highlighting a predefined region of the display of the field of view of the surgical site (e.g., as shown in
In some embodiments, the surgical robotic system, in response to receiving a request for displaying the first visual indicator and in accordance with the determination that second surgical tool is within the field of view and the first surgical tool is not within the field of view, (928) provides the electrical signals for presenting the first visual indicator on the viewer. For example, the surgical robotic system may display the first visual indicator only in response to receiving a request for displaying the first visual indicator (e.g., a user input on one or more input devices). In some embodiments, the surgical robotic system, in response to receiving the request for displaying the first visual indicator (and, in some embodiments, regardless of the determination that second surgical tool is within the field of view and the first surgical tool is not within the field of view), provides the electrical signals for presenting the first visual indicator on the viewer.
In some embodiments, the surgical robotic system, in response to determining that the request for displaying the first visual indicator has ceased, (930) ceases to provide the electrical signals for presenting the first visual indicator on the viewer. For example, the surgical robotic system may cease to display the first visual indicator in response to determining that the request for displaying the first visual indicator has ceased. For example, the request for displaying the first visual indicator may include pressing a button or a pedal, and the surgical robotic system may display the first visual indicator while the button or the pedal is being pressed, and ceases to display the first visual indicator in accordance with a determination that the button or the pedal has been released.
In some embodiments, the surgical robotic system, while the robotic system is in an indicator display mode, and in accordance with the determination that second surgical tool is within the field of view and the first surgical tool is not within the field of view, provides the electrical signals for presenting the first visual indicator on the viewer; and while the robotic system is not in the indicator display mode, ceases to provide the electrical signals for presenting the first visual indicator on the viewer. For example, the display of the indicators may be turned on or off. Once the display of the indicators is turned on (e.g., the surgical robotic system is in the indicator display mode), the surgical robotic system displays the indicators (e.g., as shown in
In some embodiments, the surgical robotic system switches into or out of the indicator display mode in response to a user input. For example, in response to a request for display of indicators via one or more input devices (e.g., one or more user interface elements, such as buttons, displayed on a display device, the foot pedal 244, a voice command, etc.), the surgical robotic system switches to (or activates) the indicator display mode. Similarly, in response to a request for cessation of the display of indicators via one or more input devices (e.g., one or more user interface elements, such as buttons, displayed on a display device, the foot pedal 244, a voice command, etc.), the surgical robotic system switches out of (or deactivates) the indicator display mode.
In some embodiments, the surgical robotic system, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the first surgical tool is within the field of view, (932) ceases to provide the electrical signals for presenting the first visual indicator on the viewer (e.g., the surgical robotic system provides electrical signals for presenting a user interface that does not include the first visual indicator). For example, as described with respect to
In some embodiments, the surgical robotic system (934) provides a rendered image that includes the first visual indicator (e.g.,
In some embodiments, the rendered image also (936) includes a second visual indicator indicating a location (or direction) of the second surgical tool (e.g., in
In some embodiments, the first visual indicator (938) includes information identifying the first robotic arm associated with the first surgical tool and the second visual indicator includes information identifying the second robotic arm associated with the second surgical tool (e.g., in
In some embodiments, the first visual indicator (940) includes a graphical representation of the first surgical tool and the second visual indicator includes a graphical representation of the second surgical tool (e.g., in
In some embodiments, the surgical robotic system (942) replaces the display of the field of view with the rendered image. For example, the surgical robotic system may display the field of view (e.g., as part of the user interface 802 shown in any of
In some embodiments, the surgical robotic system (944) overlays the rendered image partially over the display of the field of view (e.g., as shown in
In some embodiments, the viewer is (946) part of a surgeon console (e.g., the display device 242 of the physician console 240).
In some embodiments, the surgeon console includes an input device (e.g., buttons, switches, touch-sensitive surfaces, gimbals, pedals, etc.). The surgical robotic system (948) receives an input on the input device (e.g., pressing on a button or a pedal); and in response to receiving the input on the input device, provides electrical signals for presenting a bird's eye view (e.g., the user interface shown in
In some embodiments, the input device includes a foot pedal (e.g., the foot pedal 244 shown in
In some embodiments, the first robotic arm and the second robotic arm are positioned bilaterally relative to an operating table (e.g., the robotic arms 210-1 and 210-4 in
In some embodiments, the first robotic arm is supported on (e.g., movably coupled to) a first adjustable arm support and the second robotic arm is supported on (e.g., movably coupled to) a second adjustable arm support (e.g., in
In some embodiments, the first robotic arm and the second robotic arm are positioned on a same side of an operating table (e.g., the robotic arms 210-1 and 210-2 in
In some embodiments, the first robotic arm and the second robotic arm are supported on an adjustable arm support (e.g., in
In some embodiments, the surgical robotic system, regardless of the determination that the second surgical tool is within the field of view and the first surgical tool is not within the field of view, provides electrical signals for presenting the first visual indicator on the viewer.
In some embodiments, the surgical robotic system, in accordance with a determination that the first surgical tool is not within the field of view (and in some embodiments, regardless of the determination that the second surgical tool is within the field of view), provides electrical signals for presenting the first visual indicator on the viewer.
The robotic medical system (e.g., surgical robotic system) includes one or more processors 380, which are in communication with a computer-readable storage medium 382 (e.g., computer memory devices, such as random-access memory, read-only memory, static random-access memory, and non-volatile memory, and other storage devices, such as a hard drive, an optical disk, a magnetic tape recording, or any combination thereof) storing instructions for performing any methods described herein (e.g., operations described with respect to
It should be noted that the terms “couple,” “coupling,” “coupled” or other variations of the word couple as used herein may indicate either an indirect connection or a direct connection. For example, if a first component is “coupled” to a second component, the first component may be either indirectly connected to the second component via another component or directly connected to the second component.
The functions for determining whether a tool is within or outside a surgical field of view provided by a camera or scope and rendering one or more indicators representing positions or directions of one or more medical tools described herein may be stored as one or more instructions on a processor-readable or computer-readable medium. The term “computer-readable medium” refers to any available medium that can be accessed by a computer or processor. By way of example, and not limitation, such a medium may comprise random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, compact disc read-only memory (CD-ROM) or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that a computer-readable medium may be tangible and non-transitory. As used herein, the term “code” may refer to software, instructions, code or data that is/are executable by a computing device or processor.
The methods disclosed herein comprise one or more steps or actions for achieving the described method. The method steps and/or actions may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is required for proper operation of the method that is being described, the order and/or use of specific steps and/or actions may be modified without departing from the scope of the claims.
As used herein, the term “plurality” denotes two or more. For example, a plurality of components indicates two or more components. The term “determining” encompasses a wide variety of actions and, therefore, “determining” can include calculating, computing, processing, deriving, investigating, looking up (e.g., looking up in a table, a database or another data structure), ascertaining and the like. Also, “determining” can include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory) and the like. Also, “determining” can include resolving, selecting, choosing, establishing and the like.
The phrase “based on” does not mean “based only on,” unless expressly specified otherwise. In other words, the phrase “based on” describes both “based only on” and “based at least on.”
As used herein, the term “exemplary” means “serving as an example, instance, or illustration,” and does not necessarily indicate any preference or superiority of the example over any other configurations or implementations.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the scope of the invention. For example, it will be appreciated that one of ordinary skill in the art will be able to employ a number corresponding alternative and equivalent structural details, such as equivalent ways of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for producing particular actuation motions, and equivalent mechanisms for delivering electrical energy. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Some embodiments or implementations are described with respect to the following clauses:
Clause 1. A robotic system, comprising:
Clause 2. The robotic system of clause 1, wherein the stored instructions also include instructions for:
Clause 3. The robotic system of clause 1 or clause 2, wherein the first visual indicator also indicates a distance to the first surgical tool from the field of view.
Clause 4. The robotic system of clause 3, wherein the stored instructions also include instructions for, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the distance from the field of view to the first surgical tool has changed, providing electrical signals for presenting an updated first visual indicator on the viewer that indicates the changed distance from the field of view to the first surgical tool.
Clause 5. The robotic system of clause 3 or clause 4, wherein the stored instructions also include instructions for, subsequent to providing the electrical signals for presenting the first visual indicator on the viewer, in accordance with a determination that the first surgical tool is within the field of view, ceasing to provide the electrical signals for presenting the first visual indicator on the viewer.
Clause 6. The robotic system of any of clauses 3-5, wherein the first visual indicator includes a graphical element having a size that indicates the distance to the first surgical tool from the field of view.
Clause 7. The robotic system of clause 6, wherein the first visual indicator includes information identifying a robotic arm associated with the graphical element.
Clause 8. The robotic system of any of clauses 1-7, wherein the first visual indicator identifies a type of the first surgical tool.
Clause 9. The robotic system of clause 8, wherein the first visual indicator includes a graphical representation of the first surgical tool.
Clause 10. The robotic system of any of clauses 1-9, wherein the first visual indicator is concurrently displayed with a display of the field of view of the surgical site on the viewer.
Clause 11. The robotic system of clause 10, wherein the first visual indicator is displayed around the display of the field of view of the surgical site.
Clause 12. The robotic system of clause 10 or clause 11, wherein the first visual indicator is displayed over the display of the field of view of the surgical site.
Clause 13. The robotic system of clause 12, wherein the stored instructions also include instructions for providing electrical signals for highlighting a predefined region of the display of the field of view of the surgical site and the first visual indicator is displayed along a periphery of the predefined region.
Clause 14. The robotic system of any of clauses 1-13, wherein the stored instructions also include instructions for providing a rendered image that includes the first visual indicator.
Clause 15. The robotic system of clause 14, wherein the rendered image also includes a second visual indicator indicating a location of the second surgical tool.
Clause 16. The robotic system of clause 15, wherein the first visual indicator includes information identifying the first robotic arm associated with the first surgical tool and the second visual indicator includes information identifying the second robotic arm associated with the second surgical tool.
Clause 17. The robotic system of clause 15 or clause 16, wherein the first visual indicator includes a graphical representation of the first surgical tool and the second visual indicator includes a graphical representation of the second surgical tool.
Clause 18. The robotic system of any of clauses 14-17, wherein the stored instructions include instructions for replacing the display of the field of view with the rendered image.
Clause 19. The robotic system of any of clauses 14-18, wherein the stored instructions include instructions for overlaying the rendered image partially over the display of the field of view.
Clause 20. The robotic system of any of clauses 1-19, wherein the stored instructions include instructions for, in response to receiving a request for displaying the first visual indicator and in accordance with the determination that second surgical tool is within the field of view and the first surgical tool is not within the field of view, providing the electrical signals for presenting the first visual indicator on the viewer.
Clause 21. The robotic system of clause 20, wherein the stored instructions include instructions for, in response to determining that the request for displaying the first visual indicator has ceased, ceasing to provide the electrical signals for presenting the first visual indicator on the viewer.
Clause 22. The robotic system of any of clauses 1-21, wherein the stored instructions include instructions for:
Clause 23. The robotic system of clause 22, wherein the stored instructions include instructions for switching into or out of the indicator display mode in response to a user input.
Clause 24. The robotic system of any of clauses 1-23, wherein the first robotic arm and the second robotic arm are positioned bilaterally relative to an operating table.
Clause 25. The robotic system of any of clauses 1-24, wherein the first robotic arm is supported on a first adjustable arm support and the second robotic arm is supported on a second adjustable arm support.
Clause 26. The robotic system of any of clauses 1-25, wherein the first robotic arm and the second robotic arm are positioned on a same side of an operating table.
Clause 27. The robotic system of any of clauses 1-26, wherein the first robotic arm and the second robotic arm are supported on an adjustable arm support.
Clause 28. The robotic system of any of clauses 1-27, wherein the viewer is part of a surgeon console.
Clause 29. The robotic system of clause 28, wherein:
Clause 30. The robotic system of clause 29, wherein the input device includes a foot pedal.
Clause 31. An electronic device in communication with a robotic system with a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, the electronic device comprising:
Clause 32. A computer-readable storage medium storing instructions for execution by one or more processors in communication with a robotic system with a first robotic arm coupled to a first surgical tool, a second robotic arm coupled to a second surgical tool, a scope, and a viewer, the stored instructions including instructions for:
Clause 33. A robotic system, comprising:
Clause 34. A robotic system, comprising:
Clause 35. A robotic system, comprising:
Clause 36. A robotic system, comprising:
This application is a continuation of International Patent Application No. PCT/IB2022/062546, filed Dec. 20, 2022, entitled “OFFSCREEN INDICATOR VIEWER USER INTERFACE,” which claims priority to U.S. Provisional Patent Application No. 63/294,383, entitled “OFFSCREEN INDICATOR VIEWER USER INTERFACE,” filed Dec. 28, 2021, the disclosures of each of which are incorporated by reference herein, in their entirety.
Number | Date | Country | |
---|---|---|---|
63294383 | Dec 2021 | US |
Number | Date | Country | |
---|---|---|---|
Parent | PCT/IB2022/062546 | Dec 2022 | WO |
Child | 18750749 | US |