SYSTEMS AND METHODS FOR INTRA-OPERATIVE ADJUSTMENT OF PROCEDURAL SETUP

Abstract

Robotic medical systems can be capable of intra-operative setup adjustment. A robotic system can include comprises a kinematic chain for performing a procedure. The robotic system can be configured to detect one or more conditions encountered by the kinematic chain. The one or more conditions can correspond to a respective adjustment to a pose of the kinematic chain. In response to detecting the one or more conditions or upon user request, the robotic system can generate a recommended adjustment of the kinematic chain in accordance with the one or more conditions. The robotic system can present a notification of the recommended adjustment of the kinematic chain to a user. In accordance with a determination that a first user command to execute the recommended adjustment has been received, the robotic system can adjust the pose of the kinematic chain in accordance with the recommended adjustment.

Description

TECHNICAL FIELD

The systems and methods disclosed herein are directed to robotic medical systems, and more particularly to adjusting robotically controlled arms of robotic medical systems during medical procedures.

BACKGROUND

A robotically-enabled medical system is capable of performing a variety of medical procedures, including both minimally invasive, such as laparoscopy, and non-invasive, such as endoscopy, procedures. Among endoscopic procedures, the system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.

Such robotic medical systems may include robotic arms configured to control the movement of medical tool(s) during a given medical procedure. In order to achieve a desired pose of a medical tool, a robotic arm may be placed into a pose during a set-up process or 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.

SUMMARY

Due to the kinematic complexities of a robotic medical system, it is not uncommon to encounter situations that require adjustments to the system setup while the robotic medical system is executing a procedure (e.g., while the robotic arms are controlled via teleoperation to perform the procedure, after the initial procedure setup is completed and while the procedure is still in progress, etc.). Intra-operative setup adjustment refers to an adjustment that is made to the robotic system or a portion thereof, during execution of a medical procedure by the robotic system. Oftentimes, the kinematic complexities of the hardware pose challenges to users who do not have deep knowledge on robotics, both in terms of identifying when the surgical platform (e.g., robotic medical system) should be adjusted when a procedure is ongoing, and how to properly adjust the surgical platform intra-operatively and let procedure proceed without unnecessary interruptions. The kinematic complexities lie in both aspects, namely, the detection of a need for adjustment as well as the generation of an appropriate adjustment (e.g., as a recommendation to a user or as an automated action, etc.).

Accordingly, there is a need for systems and methods that take the cognitive load off a user by detecting conditions corresponding to an opportunity or need for a respective intra-operative setup adjustment, and for generating and/or executing recommended adjustments for a given set of conditions, during a medical procedure on a robotic medical system.

In accordance with some embodiments of the present disclosure, an intra-operative adjustment comprises two portions of a task (e.g., performed by a robotic medical system and a user). First, the robotic medical system detects conditions that correspond to an inter-operative adjustment and the user decides to adjust the robotic system or a portion thereof in accordance with the detected conditions. Second, the robotic system generates a recommended adjustment and executes the adjustment. In some embodiments, the user confirms that the recommended adjustment prior to the execution of the adjustment by the robotic system.

In accordance with some embodiments of the present disclosure, the robotic system generates and displays a recommended adjustment as a planned motion (e.g., a planned motion of a kinematic chain from an actual pose to a recommended pose) along a system-generated trajectory. The robotic system executes the adjustment and notifies the user upon completion of the adjustment.

As disclosed herein, in some embodiments, such adjustments can occur while teleoperation is on-going. In other words, a surgeon's assistant or staff can handle the entire intra-operative set-up adjustment without interrupting the surgeon's teleoperative control. In other embodiments, the surgeon may choose to cut off or temporarily interrupt teleoperation.

Accordingly, the systems, methods and devices disclosed herein takes the cognitive loads (e.g., relating to when and how to properly adjust the surgical platform) off a user (e.g., a surgeon, medical personnel assisting the surgery, etc.) while performing surgery. This advantageously allows the user to focus on decision-making and supervision of the system, including deciding whether to make adjustments and confirming continuous activation and/or execution.

The systems, methods and devices disclosed herein also distinguish over existing systems that do not perform intraoperative adjustments. For existing systems that do allow for intra-operative adjustments, the detection and execution of the adjustment is based on a user's proactive and subjective observation, judgement, and decision. In contrast, the present application provides methods and workflows that advantageously rely on the system that, based on preset criteria and conditions, and based on sensor inputs, to detect opportunities and needs for adjustment and execute on adjustments (e.g., by providing system generated trajectories), whereby the user supervises the motion of the system.

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 comprises a kinematic chain for performing a procedure. The robotic system also comprises one or more processors and memory. The memory stores instructions that, when executed by the one or more processors, cause the one or more processors to detect one or more conditions encountered by the kinematic chain. The one or more conditions correspond to a respective adjustment to a pose of the kinematic chain. The memory also stores instructions that, when executed by the one or more processors, cause the one or more processors to: in response to detecting the one or more conditions or upon user request, generate a recommended adjustment of the kinematic chain in accordance with the one or more conditions. The memory also stores instructions that, when executed by the one or more processors, cause the one or more processors to present a notification of the recommended adjustment of the kinematic chain to a user. The memory also stores instructions that, when executed by the one or more processors, cause the one or more processors to: in accordance with a determination that a first user command to execute the recommended adjustment has been received, adjust the pose of the kinematic chain in accordance with the recommended adjustment.

In some embodiments, the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to: in accordance with a determination that a user command to execute the recommended adjustment has not been received, forgo adjusting the pose of the kinematic chain.

In some embodiments, the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to receive a second user command while adjusting the pose of the kinematic chain. The memory also stores instructions that, when executed by the one or more processors, cause the one or more processors to: in accordance with a determination that the second user command corresponds to a command to abort the recommended adjustment, terminate the adjustment.

In some embodiments, the one or more conditions comprises a pose-recognition of the kinematic chain.

In some embodiments, the kinematic chain comprises a robotic arm and an underlying arm support.

In some embodiments, the one or more conditions comprise a joint of the kinematic chain reaching a threshold range of a joint limit.

In some embodiments, the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.

In some embodiments, generating a recommended adjustment of the kinematic chain comprises generating the recommended adjustment in response to the user request.

In some embodiments, generating the recommended adjustment of the kinematic chain further comprises generating a movement trajectory of one or more joints of the kinematic chain.

In some embodiments, the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain. The memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to display the recommended adjustment as a visualization that compares the recommended pose of the kinematic chain to an actual pose of the kinematic chain.

In some embodiments, the recommended adjustment of the kinematic chain is generated based on a pre-planning of a procedure.

In some embodiments, the recommended adjustment of the kinematic chain is generated based on a pre-determined rule.

In some embodiments, the memory further includes instructions that, when executed by the one or more processors, cause the processors to determine the recommended adjustment of the kinematic chain via optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.

In accordance with some embodiments of the present disclosure, a method is performed at a robotic system. The robotic system includes a kinematic chain, one or more processors, and memory. The memory stores one or more programs configured for execution by the one or more processors. The method includes detecting one or more conditions encountered by the kinematic chain. The one or more conditions correspond to a respective adjustment to a pose of the kinematic chain. The method also includes presenting a notification of the detected one or more conditions. The method also includes receiving a first user input that comprises a decision regarding whether to make an adjustment to the kinematic chain. In response to the first user input, the robotic system generates a recommended adjustment to the kinematic chain. The robotic system receives a second user input comprising user confirmation to execute the recommended adjustment. In response to the second user input, the robotic system adjusts a pose of the kinematic chain in accordance with the recommended adjustment.

In some embodiments, the first user input is unprompted by the system.

In some embodiments, the first user input and the second user input are the same user input.

In some embodiments, the one or more conditions comprises a pose-recognition of the kinematic chain.

In some embodiments, the one or more conditions comprises a joint of the kinematic chain reaching a threshold range of a joint limit.

In some embodiments, the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.

In some embodiments, adjusting the pose of the kinematic chain in accordance with the recommended adjustment comprises adjusting the pose of the kinematic chain concurrently with teleoperation of the kinematic chain.

In some embodiments, adjusting a pose of the kinematic chain in accordance with the recommended adjustment comprises halting teleoperation prior to the adjusting.

In some embodiments, the recommended adjustment includes at least one movement trajectory for the kinematic chain.

In some embodiments, the recommended adjustment is based on heuristics, optimization of a pre-determined objective, and/or a pre-planned procedure.

In some embodiments, the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain. Generating the recommended adjustment further comprises generating a visualization that compares the recommended pose to an actual pose of the kinematic chain. Displaying the recommended adjustment further comprises displaying the visualization on a user interface of the robotic system.

In some embodiments, the recommended adjustment is based on a pre-planning of a procedure to be performed on the robotic system.

In some embodiments, the recommended adjustment is based on a pre-determined rule.

In some embodiments, the recommended adjustment is based on optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.

In some embodiments, a robotic system comprises a kinematic chain, one or more processors, and memory. The memory stores one or more programs that, when executed by the one or more processors, cause the one or more processors to perform any of the methods described herein.

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.

BRIEF DESCRIPTION OF THE DRAWINGS

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.

FIG. 1 illustrates an embodiment of a cart-based robotic system arranged for diagnostic and/or therapeutic bronchoscopy procedure(s).

FIG. 2 depicts further aspects of the robotic system of FIG. 1.

FIG. 3 illustrates an embodiment of the robotic system of FIG. 1 arranged for ureteroscopy.

FIG. 4 illustrates an embodiment of the robotic system of FIG. 1 arranged for a vascular procedure.

FIG. 5 illustrates an embodiment of a table-based robotic system arranged for a bronchoscopy procedure.

FIG. 6 provides an alternative view of the robotic system of FIG. 5.

FIG. 7 illustrates an example system configured to stow robotic arm(s).

FIG. 8 illustrates an embodiment of a table-based robotic system configured for a ureteroscopy procedure.

FIG. 9 illustrates an embodiment of a table-based robotic system configured for a laparoscopic procedure.

FIG. 10 illustrates an embodiment of the table-based robotic system of FIGS. 5-9 with pitch or tilt adjustment.

FIG. 11 provides a detailed illustration of the interface between the table and the column of the table-based robotic system of FIGS. 5-10.

FIG. 12 illustrates an alternative embodiment of a table-based robotic system.

FIG. 13 illustrates an end view of the table-based robotic system of FIG. 12.

FIG. 14 illustrates an end view of a table-based robotic system with robotic arms attached thereto.

FIG. 15 illustrates an exemplary instrument driver.

FIG. 16 illustrates an exemplary medical instrument with a paired instrument driver.

FIG. 17 illustrates an alternative design for an instrument driver and instrument where the axes of the drive units are parallel to the axis of the elongated shaft of the instrument.

FIG. 18 illustrates an instrument having an instrument-based insertion architecture.

FIG. 19 illustrates an exemplary controller.

FIG. 20 depicts a block diagram illustrating a localization system that estimates a location of one or more elements of the robotic systems of FIGS. 1-10, such as the location of the instrument of FIGS. 16-18, in accordance to an example embodiment.

FIG. 21 illustrates an exemplary robotic system according to some embodiments.

FIG. 22 illustrates another view of an exemplary robotic system according to some embodiments.

FIGS. 23A to 23C illustrate different views of an exemplary robotic arm according to some embodiments.

FIG. 24 illustrates an exemplary workflow for intra-operative procedure adjustment in accordance with some embodiments.

FIG. 25 illustrates a visualization that is generated by one or more processors of a robotic system in accordance with some embodiments.

FIG. 26 illustrates an exemplary coordinate system for describing a robotic system in accordance with some embodiments.

FIGS. 27A to 27D illustrate exemplary scenarios for intra-operative setup adjustment in accordance with some embodiments.

FIGS. 28A and 28B illustrate a flowchart diagram for a method for detecting one or more conditions for adjusting a procedure setup and generating an adjustment for execution, in accordance with some embodiments.

FIG. 29 illustrates a flowchart diagram for a method for detecting one or more conditions for adjusting a procedure setup and generating an adjustment for execution, in accordance with some embodiments.

DETAILED DESCRIPTION

1. Overview.

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.

A. Robotic System—Cart.

The robotically-enabled medical system may be configured in a variety of ways depending on the particular procedure. FIG. 1 illustrates an embodiment of a cart-based robotically-enabled system 10 arranged for a diagnostic and/or therapeutic bronchoscopy procedure. During a bronchoscopy, the system 10 may comprise a cart 11 having one or more robotic arms 12 to deliver a medical instrument, such as a steerable endoscope 13, which may be a procedure-specific bronchoscope for bronchoscopy, to a natural orifice access point (i.e., the mouth of the patient positioned on a table in the present example) to deliver diagnostic and/or therapeutic tools. As shown, the cart 11 may be positioned proximate to the patient's upper torso in order to provide access to the access point. Similarly, the robotic arms 12 may be actuated to position the bronchoscope relative to the access point. The arrangement in FIG. 1 may also be utilized when performing a gastro-intestinal (GI) procedure with a gastroscope, a specialized endoscope for GI procedures. FIG. 2 depicts an example embodiment of the cart in greater detail.

With continued reference to FIG. 1, once the cart 11 is properly positioned, the robotic arms 12 may insert the steerable endoscope 13 into the patient robotically, manually, or a combination thereof. As shown, the steerable endoscope 13 may comprise at least two telescoping parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument driver from the set of instrument drivers 28, each instrument driver coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers 28, which facilitates coaxially aligning the leader portion with the sheath portion, creates a “virtual rail” 29 that may be repositioned in space by manipulating the one or more robotic arms 12 into different angles and/or positions. The virtual rails described herein are depicted in the Figures using dashed lines, and accordingly the dashed lines do not depict any physical structure of the system. Translation of the instrument drivers 28 along the virtual rail 29 telescopes the inner leader portion relative to the outer sheath portion or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 29 may be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and position of the virtual rail 29 as shown represents a compromise between providing physician access to the endoscope 13 while minimizing friction that results from bending the endoscope 13 into the patient's mouth.

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.

FIG. 2 provides a detailed illustration of an embodiment of the cart from the cart-based robotically-enabled system shown in FIG. 1. The cart 11 generally includes an elongated support structure 14 (often referred to as a “column”), a cart base 15, and a console 16 at the top of the column 14. The column 14 may include one or more carriages, such as a carriage 17 (alternatively “arm support”) for supporting the deployment of one or more robotic arms 12 (three shown in FIG. 2). The carriage 17 may include individually configurable arm mounts that rotate along a perpendicular axis to adjust the base of the robotic arms 12 for better positioning relative to the patient. The carriage 17 also includes a carriage interface 19 that allows the carriage 17 to vertically translate along the column 14.

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.

FIG. 3 illustrates an embodiment of a robotically-enabled system 10 arranged for ureteroscopy. In a ureteroscopic procedure, the cart 11 may be positioned to deliver a ureteroscope 32, a procedure-specific endoscope designed to traverse a patient's urethra and ureter, to the lower abdominal area of the patient. In a ureteroscopy, it may be desirable for the ureteroscope 32 to be directly aligned with the patient's urethra to reduce friction and forces on the sensitive anatomy in the area. As shown, the cart 11 may be aligned at the foot of the table to allow the robotic arms 12 to position the ureteroscope 32 for direct linear access to the patient's urethra. From the foot of the table, the robotic arms 12 may insert the ureteroscope 32 along the virtual rail 33 directly into the patient's lower abdomen through the urethra.

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.

FIG. 4 illustrates an embodiment of a robotically-enabled system similarly arranged for a vascular procedure. In a vascular procedure, the system 10 may be configured such that the cart 11 may deliver a medical instrument 34, such as a steerable catheter, to an access point in the femoral artery in the patient's leg. The femoral artery presents both a larger diameter for navigation as well as a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in a ureteroscopic procedure, the cart 11 may be positioned towards the patient's legs and lower abdomen to allow the robotic arms 12 to provide a virtual rail 35 with direct linear access to the femoral artery access point in the patient's thigh/hip region. After insertion into the artery, the medical instrument 34 may be directed and inserted by translating the instrument drivers 28. Alternatively, the cart may be positioned around the patient's upper abdomen in order to reach alternative vascular access points, such as, for example, the carotid and brachial arteries near the shoulder and wrist.

B. Robotic System—Table.

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. FIG. 5 illustrates an embodiment of such a robotically-enabled system arranged for a bronchoscopy procedure. System 36 includes a support structure or column 37 for supporting platform 38 (shown as a “table” or “bed”) over the floor. Much like in the cart-based systems, the end effectors of the robotic arms 39 of the system 36 comprise instrument drivers 42 that are designed to manipulate an elongated medical instrument, such as a bronchoscope 40 in FIG. 5, through or along a virtual rail 41 formed from the linear alignment of the instrument drivers 42. In practice, a C-arm for providing fluoroscopic imaging may be positioned over the patient's upper abdominal area by placing the emitter and detector around table 38.

FIG. 6 provides an alternative view of the system 36 without the patient and medical instrument for discussion purposes. As shown, the column 37 may include one or more carriages 43 shown as ring-shaped in the system 36, from which the one or more robotic arms 39 may be based. The carriages 43 may translate along a vertical column interface 44 that runs the length of the column 37 to provide different vantage points from which the robotic arms 39 may be positioned to reach the patient. The carriage(s) 43 may rotate around the column 37 using a mechanical motor positioned within the column 37 to allow the robotic arms 39 to have access to multiples sides of the table 38, such as, for example, both sides of the patient. In embodiments with multiple carriages, the carriages may be individually positioned on the column and may translate and/or rotate independent of the other carriages. While carriages 43 need not surround the column 37 or even be circular, the ring-shape as shown facilitates rotation of the carriages 43 around the column 37 while maintaining structural balance. Rotation and translation of the carriages 43 allows the system to align the medical instruments, such as endoscopes and laparoscopes, into different access points on the patient. In other embodiments (not shown), the system 36 can include a patient table or bed with adjustable arm supports in the form of bars or rails extending alongside it. One or more robotic arms 39 (e.g., via a shoulder with an elbow joint) can be attached to the adjustable arm supports, which can be vertically adjusted. By providing vertical adjustment, the robotic arms 39 are advantageously capable of being stowed compactly beneath the patient table or bed, and subsequently raised during a procedure.

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 FIG. 6), on opposite sides of table 38 (as shown in FIG. 9), or on adjacent sides of the table 38 (not shown).

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 FIG. 2, housing heavier components to balance the table/bed 38, the column 37, the carriages 43, and the robotic arms 39. The table base 46 may also incorporate rigid casters to provide stability during procedures. Deployed from the bottom of the table base 46, the casters may extend in opposite directions on both sides of the base 46 and retract when the system 36 needs to be moved.

Continuing with FIG. 6, the system 36 may also include a tower (not shown) that divides the functionality of system 36 between table and tower to reduce the form factor and bulk of the table. As in earlier disclosed embodiments, the tower may provide a variety of support functionalities to table, such as processing, computing, and control capabilities, power, fluidics, and/or optical and sensor processing. The tower may also be movable to be positioned away from the patient to improve physician access and de-clutter the operating room. Additionally, placing components in the tower allows for more storage space in the table base for potential stowage of the robotic arms. The tower may also include a master controller or console that provides both a user interface for user input, such as keyboard and/or pendant, as well as a display screen (or touchscreen) for pre-operative and intra-operative information, such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also contain holders for gas tanks to be used for insufflation.

In some embodiments, a table base may stow and store the robotic arms when not in use. FIG. 7 illustrates a system 47 that stows robotic arms in an embodiment of the table-based system. In system 47, carriages 48 may be vertically translated into base 49 to stow robotic arms 50, arm mounts 51, and the carriages 48 within the base 49. Base covers 52 may be translated and retracted open to deploy the carriages 48, arm mounts 51, and arms 50 around column 53, and closed to stow to protect them when not in use. The base covers 52 may be sealed with a membrane 54 along the edges of its opening to prevent dirt and fluid ingress when closed.

FIG. 8 illustrates an embodiment of a robotically-enabled table-based system configured for a ureteroscopy procedure. In a ureteroscopy, the table 38 may include a swivel portion 55 for positioning a patient off-angle from the column 37 and table base 46. The swivel portion 55 may rotate or pivot around a pivot point (e.g., located below the patient's head) in order to position the bottom portion of the swivel portion 55 away from the column 37. For example, the pivoting of the swivel portion 55 allows a C-arm (not shown) to be positioned over the patient's lower abdomen without competing for space with the column (not shown) below table 38. By rotating the carriage 35 (not shown) around the column 37, the robotic arms 39 may directly insert a ureteroscope 56 along a virtual rail 57 into the patient's groin area to reach the urethra. In a ureteroscopy, stirrups 58 may also be fixed to the swivel portion 55 of the table 38 to support the position of the patient's legs during the procedure and allow clear access to the patient's groin area.

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. FIG. 9 illustrates an embodiment of a robotically-enabled table-based system configured for a laparoscopic procedure. As shown in FIG. 9, the carriages 43 of the system 36 may be rotated and vertically adjusted to position pairs of the robotic arms 39 on opposite sides of the table 38, such that instrument 59 may be positioned using the arm mounts 45 to be passed through minimal incisions on both sides of the patient to reach his/her abdominal cavity.

To accommodate laparoscopic procedures, the robotically-enabled table system may also tilt the platform to a desired angle. FIG. 10 illustrates an embodiment of the robotically-enabled medical system with pitch or tilt adjustment. As shown in FIG. 10, the system 36 may accommodate tilt of the table 38 to position one portion of the table at a greater distance from the floor than the other. Additionally, the arm mounts 45 may rotate to match the tilt such that the arms 39 maintain the same planar relationship with table 38. To accommodate steeper angles, the column 37 may also include telescoping portions 60 that allow vertical extension of column 37 to keep the table 38 from touching the floor or colliding with base 46.

FIG. 11 provides a detailed illustration of the interface between the table 38 and the column 37. Pitch rotation mechanism 61 may be configured to alter the pitch angle of the table 38 relative to the column 37 in multiple degrees of freedom. The pitch rotation mechanism 61 may be enabled by the positioning of orthogonal axes 1, 2 at the column-table interface, each axis actuated by a separate motor 3, 4 responsive to an electrical pitch angle command. Rotation along one screw 5 would enable tilt adjustments in one axis 1, while rotation along the other screw 6 would enable tilt adjustments along the other axis 2. In some embodiments, a ball joint can be used to alter the pitch angle of the table 38 relative to the column 37 in multiple degrees of freedom.

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.

FIGS. 12 and 13 illustrate isometric and end views of an alternative embodiment of a table-based surgical robotics system 100. The surgical robotics system 100 includes one or more adjustable arm supports 105 that can be configured to support one or more robotic arms (see, for example, FIG. 14) relative to a table 101. In the illustrated embodiment, a single adjustable arm support 105 is shown, though an additional arm support can be provided on an opposite side of the table 101. The adjustable arm support 105 can be configured so that it can move relative to the table 101 to adjust and/or vary the position of the adjustable arm support 105 and/or any robotic arms mounted thereto relative to the table 101. For example, the adjustable arm support 105 may be adjusted one or more degrees of freedom relative to the table 101. The adjustable arm support 105 provides high versatility to the system 100, including the ability to easily stow the one or more adjustable arm supports 105 and any robotics arms attached thereto beneath the table 101. The adjustable arm support 105 can be elevated from the stowed position to a position below an upper surface of the table 101. In other embodiments, the adjustable arm support 105 can be elevated from the stowed position to a position above an upper surface of the table 101.

The adjustable arm support 105 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment of FIGS. 12 and 13, the arm support 105 is configured with four degrees of freedom, which are illustrated with arrows in FIG. 12. A first degree of freedom allows for adjustment of the adjustable arm support 105 in the z-direction (“Z-lift”). For example, the adjustable arm support 105 can include a carriage 109 configured to move up or down along or relative to a column 102 supporting the table 101. A second degree of freedom can allow the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 can include a rotary joint, which can allow the adjustable arm support 105 to be aligned with the bed in a Trendelenburg position. A third degree of freedom can allow the adjustable arm support 105 to “pivot up,” which can be used to adjust a distance between a side of the table 101 and the adjustable arm support 105. A fourth degree of freedom can permit translation of the adjustable arm support 105 along a longitudinal length of the table.

The surgical robotics system 100 in FIGS. 12 and 13 can comprise a table supported by a column 102 that is mounted to a base 103. The base 103 and the column 102 support the table 101 relative to a support surface. A floor axis 131 and a support axis 133 are shown in FIG. 13.

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 FIG. 13) can be provided that mechanically constrains the third joint 117 to maintain an orientation of the rail 107 as the rail connector 111 is rotated about a third axis 127. The adjustable arm support 105 can include a fourth joint 121, which can provide a fourth degree of freedom (translation) for the adjustable arm support 105 along a fourth axis 129.

FIG. 14 illustrates an end view of the surgical robotics system 140A with two adjustable arm supports 105A, 105B mounted on opposite sides of a table 101. A first robotic arm 142A is attached to the bar or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A attached to the rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can attach to one or more robotic medical instruments or tools. Similarly, the second robotic arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to attach to one or more robotic medical instruments or tools.

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.

C. Instrument Driver & Interface.

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.

FIG. 15 illustrates an example instrument driver. Positioned at the distal end of a robotic arm, instrument driver 62 comprises of one or more drive units 63 arranged with parallel axes to provide controlled torque to a medical instrument via drive shafts 64. Each drive unit 63 comprises an individual drive shaft 64 for interacting with the instrument, a gear head 65 for converting the motor shaft rotation to a desired torque, a motor 66 for generating the drive torque, an encoder 67 to measure the speed of the motor shaft and provide feedback to the control circuitry, and control circuitry 68 for receiving control signals and actuating the drive unit. Each drive unit 63 being independent controlled and motorized, the instrument driver 62 may provide multiple (four as shown in FIG. 15) independent drive outputs to the medical instrument. In operation, the control circuitry 68 would receive a control signal, transmit a motor signal to the motor 66, compare the resulting motor speed as measured by the encoder 67 with the desired speed, and modulate the motor signal to generate the desired torque.

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).

D. Medical Instrument.

FIG. 16 illustrates an example medical instrument with a paired instrument driver. Like other instruments designed for use with a robotic system, medical instrument 70 comprises an elongated shaft 71 (or elongate body) and an instrument base 72. The instrument base 72, also referred to as an “instrument handle” due to its intended design for manual interaction by the physician, may generally comprise rotatable drive inputs 73, e.g., receptacles, pulleys or spools, that are designed to be mated with drive outputs 74 that extend through a drive interface on instrument driver 75 at the distal end of robotic arm 76. When physically connected, latched, and/or coupled, the mated drive inputs 73 of instrument base 72 may share axes of rotation with the drive outputs 74 in the instrument driver 75 to allow the transfer of torque from drive outputs 74 to drive inputs 73. In some embodiments, the drive outputs 74 may comprise splines that are designed to mate with receptacles on the drive inputs 73.

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 FIG. 16, the drive shaft axes, and thus the drive input axes, are orthogonal to the axis of the elongated shaft. This arrangement, however, complicates roll capabilities for the elongated shaft 71. Rolling the elongated shaft 71 along its axis while keeping the drive inputs 73 static results in undesirable tangling of the tendons as they extend off the drive inputs 73 and enter pull lumens within the elongated shaft 71. The resulting entanglement of such tendons may disrupt any control algorithms intended to predict movement of the flexible elongated shaft during an endoscopic procedure.

FIG. 17 illustrates an alternative design for an instrument driver and instrument where the axes of the drive units are parallel to the axis of the elongated shaft of the instrument. As shown, a circular instrument driver 80 comprises four drive units with their drive outputs 81 aligned in parallel at the end of a robotic arm 82. The drive units, and their respective drive outputs 81, are housed in a rotational assembly 83 of the instrument driver 80 that is driven by one of the drive units within the assembly 83. In response to torque provided by the rotational drive unit, the rotational assembly 83 rotates along a circular bearing that connects the rotational assembly 83 to the non-rotational portion 84 of the instrument driver. Power and controls signals may be communicated from the non-rotational portion 84 of the instrument driver 80 to the rotational assembly 83 through electrical contacts and may be maintained through rotation by a brushed slip ring connection (not shown). In other embodiments, the rotational assembly 83 may be responsive to a separate drive unit that is integrated into the non-rotatable portion 84, and thus not in parallel to the other drive units. The rotational mechanism 83 allows the instrument driver 80 to rotate the drive units, and their respective drive outputs 81, as a single unit around an instrument driver axis 85.

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 FIG. 16.

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.

FIG. 18 illustrates an instrument having an instrument based insertion architecture in accordance with some embodiments. The instrument 150 can be coupled to any of the instrument drivers discussed above. The instrument 150 comprises an elongated shaft 152, an end effector 162 connected to the shaft 152, and a handle 170 coupled to the shaft 152. The elongated shaft 152 comprises a tubular member having a proximal portion 154 and a distal portion 156. The elongated shaft 152 comprises one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180 therethrough. One or more cables 180 thus run along an outer surface of the elongated shaft 152. In other embodiments, cables 180 can also run through the elongated shaft 152. Manipulation of the one or more cables 180 (e.g., via an instrument driver) results in actuation of the end effector 162.

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.

E. Controller.

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.

FIG. 19 is a perspective view of an embodiment of a controller 182. In the present embodiment, the controller 182 comprises a hybrid controller that can have both impedance and admittance control. In other embodiments, the controller 182 can utilize just impedance or passive control. In other embodiments, the controller 182 can utilize just admittance control. By being a hybrid controller, the controller 182 advantageously can have a lower perceived inertia while in use.

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 FIG. 19, each positioning platform 188 includes a SCARA arm (selective compliance assembly robot arm) 198 coupled to a column 194 by a prismatic joint 196. The prismatic joints 196 are configured to translate along the column 194 (e.g., along rails 197) to allow each of the handles 184 to be translated in the z-direction, providing a first degree of freedom. The SCARA arm 198 is configured to allow motion of the handle 184 in an x-y plane, providing two additional degrees of freedom.

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.

F. Navigation and 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.

FIG. 20 is a block diagram illustrating a localization system 90 that estimates a location of one or more elements of the robotic system, such as the location of the instrument, in accordance with an example embodiment. The localization system 90 may be a set of one or more computer devices configured to execute one or more instructions. The computer devices may be embodied by a processor (or processors) and computer-readable memory in one or more components discussed above. By way of example and not limitation, the computer devices may be in the tower 30 shown in FIG. 1, the cart shown in FIGS. 1-4, the beds shown in FIGS. 5-14, etc.

As shown in FIG. 20, the localization system 90 may include a localization module 95 that processes input data 91-94 to generate location data 96 for the distal tip of a medical instrument. The location data 96 may be data or logic that represents a location and/or orientation of the distal end of the instrument relative to a frame of reference. The frame of reference can be a frame of reference relative to the anatomy of the patient or to a known object, such as an EM field generator (see discussion below for the EM field generator).

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 FIG. 20 shows, a number of other input data can be used by the localization module 95. For example, although not shown in FIG. 20, an instrument utilizing shape-sensing fiber can provide shape data that the localization module 95 can use to determine the location and shape of the instrument.

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.

2. Systems, Devices, and Methods for Intra-Operative Procedure Setup Adjustment

Embodiments of the disclosure relate to systems, methods, and devices for intra-operative procedural setup adjustment. Intra-operative procedural setup adjustment can refer to an adjustment that is made to the setup of a robotic medical system or a portion thereof, during execution of a medical procedure by the robotic system. Due to the kinematic complexities of a robotic medical system, it is not uncommon to encounter situations that require adjustments to the system setup while the robotic medical system is executing a procedure. The kinematic complexities of the hardware can pose challenges to users of robotic systems such as surgeons and medical assistants, who may not have deep knowledge on robotics and/or be familiar with the particular medical system in use, both in terms of identifying when the surgical platform should be adjusted when a procedure is ongoing, and how to properly adjust the surgical platform intra-operatively and let procedure proceed without unnecessary interruptions.

In accordance with some embodiments of the present disclosure, an intra-operative adjustment comprises two portions of a task to be performed (e.g., by a robotic system and a user). First, the robotic system detects conditions that correspond to an intra-operative adjustment and the user can decide to adjust the robotic system or a portion thereof in accordance with the detected conditions. Second, the robotic system generates a recommended adjustment and executes the adjustment. In some embodiments, the user confirms that the recommended adjustment prior to the execution of the adjustment by the robotic system. This advantageously allows the user to focus on decision-making and supervision of the system, including deciding whether to make adjustments and confirming continuous activation or execution.

In accordance with some embodiments of the present disclosure, a robotic medical system comprises a kinematic chain that includes a robotic arm. For example, the kinematic chain can include a robotic arm, or a robotic arm with its underlying bar, or two or more robotic arms and their corresponding bar. The robotic system detects one or more conditions encountered by the kinematic chain, the one or more conditions corresponding to a respective adjustment to a pose (e.g., position and/or orientation) of the kinematic chain. In some embodiments, in response to detecting the one or more conditions, or upon user request, the robotic system generates a recommended adjustment of the kinematic chain in accordance with the one or more conditions. For example, the recommended adjustment can be based on a pre-planning of a procedure to be performed on the robotic system, based on a pre-determined rule, and/or based on optimization of a pre-determined objective function. The robotic system presents a notification of the recommended adjustment of the kinematic chain to a user, in accordance with some embodiments. In accordance with a determination that a user command to execute the recommended adjustment has been received, the robotic system adjusts the pose of the kinematic chain in accordance with the recommended adjustment, in accordance with some embodiments.

In accordance with some embodiments of the present disclosure, the robotic system adjusts the pose of the kinematic chain concurrently with teleoperation of the kinematic chain. In some embodiments, teleoperation is halted prior to the adjusting.

In accordance with some embodiments of the present disclosure, the robotic system generates and displays a recommended adjustment as a planned motion (e.g., a planned motion of a kinematic chain from an actual pose to a recommended pose) along a system-generated trajectory. For example, the recommended adjustment can be displayed in a user interface of the robotic system. In some embodiments, the recommended adjustment is displayed as a visual feedback that compares an actual pose and a recommended pose of the kinematic chain.

In accordance with some embodiments of the present disclosure, the systems, methods and devices disclosed herein take the cognitive loads (e.g., relating to when and how to properly adjust the surgical platform) off a user while performing surgery. This advantageously allows the user to focus on decision-making and supervision of the system, including deciding whether to make adjustments and confirming continuous activation or execution.

A. Robotic System

FIG. 21 illustrates an exemplary robotic system 200 according to some embodiments. In some embodiments, the robotic system 200 is a robotic medical system (e.g., robotic surgery system). In the example of FIG. 21, the robotic system 200 comprises a patient support platform 202 (e.g., a patient platform, a table, a bed, etc.). The two ends along the length of the patient support platform 202 are respectively referred to as “head” and “leg.” The two sides of the patient support platform 202 are respectively referred to as “left” and “right.” The patient support platform 202 includes a support 204 (e.g., a rigid frame) for the patient support platform 202.

The robotic system 200 also includes a base 206 for supporting the robotic system 200. The base 206 includes wheels 208 that allow the robotic system 200 to be easily movable or repositionable in a physical environment. In some embodiments, the wheels 208 are omitted from the robotic 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 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 FIGS. 1-20, in accordance with some embodiments. Although FIG. 21 shows five robotic arms 210, it should be appreciated that the robotic system 200 may include any number of robotic arms, including less than five or six or more, in accordance with some embodiments.

The robotic 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 FIG. 12, bar 220 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In some embodiments, each of the robotic arms 210 and/or the adjustable arm supports 220 is also referred to as a respective kinematic chain.

FIG. 21 shows three robotic arms 210 supported by the bar 220 that is in the field of view of the figure. The two remaining robotic arms are supported by another bar that is located across the other length of the patient support platform 202.

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 (e.g., via manual manipulation, teleoperation, and/or power-assisted motion, etc.) 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., FIG. 23).

In some embodiments, the adjustable arm support 220 can be translated by the system 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 FIG. 21, the adjustable arm support 220 is located along a partial length of the patient support platform 202. In some embodiments, the adjustable arm support 220 may extend across an entire length of the patient support platform 202, and/or across a partial or full width of the patient support platform 202.

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 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.

FIG. 22 illustrates another view of the exemplary robotic system 200 in FIG. 21 according to some embodiments. In this example, the robotic medical system 200 includes six robotic arms 210-1, 210-2, 210-3, 210-4, 210-5, and 210-6. The patient platform 202 is supported by a column 214 that extends between the base 206 and the patient platform 202. In some embodiments, the patient platform 202 comprises a tilt mechanism 216. The tilt mechanism 216 can be positioned between the column 214 and the patient platform 202 to allow the patient platform to pivot, rotate, or tilt relative to the column 214. The tilt mechanism 216 can be configured to allow for lateral and/or longitudinal tilt of the patient platform 202. In some embodiments, the tilt mechanism 216 allows for simultaneous lateral and longitudinal tilt of the patient platform 202.

FIG. 22 shows the patient platform 202 in an untilted state or position. In some embodiments, the untilted state or position may be a default position or state of the patient platform 202. In some embodiments, the default position of the patient platform 202 is a substantially horizontal position as shown. As illustrated, in the untilted state, the patient platform 202 can be positioned horizontally or parallel to a surface that supports the robotic medical system 200 (e.g., the ground or floor). In some embodiments, the term “untilted” may refer to a state where the angle between the default state and the current state is less than a threshold angular amount (e.g., less than 5 degrees, less than an amount that would cause the patient to shift on the patient platform, etc.). In some embodiments, the term “untilted” may refer to a state where the patient platform is substantially perpendicular to the direction of gravity, irrespective of the angle of the surface that supports the robotic medical system relative to gravity.

With continued reference to FIG. 22, in the illustrated example of the robotic system 200, the patient platform 202 comprises a support 204. In some embodiments, the support 204 comprises a rigid support structure or frame, and can support one or more surfaces, pads, or cushions 222. An upper surface of the patient platform 202 can comprise a support surface 224. During a medical procedure, a patient can be placed on the support surface 224.

FIG. 22 shows the robotic arms 210 and the adjustable arm supports 220 in an exemplary deployed configuration in which the robotic arms 210 reach above the patient platform 202. In some embodiments, due to the configuration of the robotic system 200, which enables stowage of different components beneath the patient platform 202, the robotic arms 210 and the arm supports 220 can occupy a space underneath the patient platform 202. Thus, in some embodiments, it may be advantageous to configure the tilt mechanism 216 to have a low-profile and/or low volume to maximize the space available for storage below.

FIG. 22 also illustrates an example, x, y, and z coordinate system that may be used to describe certain features of the embodiments disclosed herein. It will be appreciated that this coordinate system is provided for purposes of example and explanation only and that other coordinate systems may be used. In the illustrated example, the x-direction or x-axis extends in a lateral direction across the patient platform 202 when the patient platform 202 is in an untilted state. That is, the x-direction extends across the patient platform 202 from one lateral side (e.g., the right side) to the other lateral side (e.g., the left side) when the patient platform 202 is in an untilted state. The y-direction or y-axis extends in a longitudinal direction along the patient platform 202 when the patient platform 202 is in an untilted state. That is, the y-direction extends along the patient platform 202 from one longitudinal end (e.g., the head end) to the other longitudinal end (e.g., the legs end) when the patient platform 202 is in an untilted state. In an untilted state, the patient platform 202 can lie in or be parallel to the x-y plane, which can be parallel to the floor or ground. In the illustrated example, the z-direction or z-axis extends along the column 214 in a vertical direction. In some embodiments, the tilt mechanism 216 is configured to laterally tilt the patient platform 202 by rotating the patient platform 202 about a lateral tilt axis that is parallel to the y-axis. The tilt mechanism 216 can further be configured to longitudinally tilt the patient platform 202 by rotating the patient platform 202 about a longitudinal tilt axis that is parallel to the x-axis.

B. Robotic Arm

FIGS. 23A to 23C illustrate different views of an exemplary robotic arm 210 according to some embodiments.

FIG. 23A illustrates that the robotic arm 210 includes a plurality of links 302 (e.g., linkages). The links 302 are connected by one or more joints 304. Each of the joints 304 includes one or more degrees of freedom (DoFs).

In FIG. 23A, the joints 304 include a first joint 304-1 (e.g., a base joint or an A0 joint) that is located at or near a base 306 of the robotic arm 210. In some embodiments, the base joint 304-1 comprises a prismatic joint that allows the robotic arm 210 to translate along the bar 220 (e.g., along the y-axis). The joints 304 also include a second joint 304-2 (e.g., an A1 joint). In some embodiments, the second joint 304-2 rotates with respect to the base joint 304-1. The joints 304 also include a third joint 304-3 (e.g., an A2 joint) that is connected to one end of link 302-2. In some embodiments, the joint 304-3 includes multiple DoFs and facilitates both tilt and rotation of the link 302-2 tilt with respect to the joint 304-3.

FIG. 23A also shows a fourth joint 304-4 (e.g., an A3 joint) that is connected to the other end of the link 302-2. In some embodiments, the joint 304-4 comprises an elbow joint that connects the link 302-2 and the link 302-3. The joints 304 further comprise a pair of joints 304-5 (e.g., a wrist roll joint or an A4 joint) and 304-6 (e.g., a wrist pitch joint or an A5 joint), which is located on a distal portion of the robotic arm 210.

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 212 (e.g., a tool, a scope, etc.).

The robotic arm 210 can also include a cannula sensor 310 (e.g., via detection mechanisms such as contact, deformation, compression, weight, load, light, etc.) 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 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 FIG. 23A, the robotic arm 210 includes an input or button 312 (e.g., a donut-shaped button, or other types of controls, etc.) that can be used to place the robotic arm 210 in an admittance mode (e.g., by depressing the button 312). The admittance mode is also referred to as an admittance scheme or admittance control. In the admittance mode, the robotic system 210 measures forces and/or torques (e.g., imparted on the robotic arm 210) and outputs corresponding velocities and/or positions. In some embodiments, the robotic arm 210 can be manually manipulated by a user (e.g., during a set-up procedure, or in between procedures, etc.) in the admittance mode. In some instances, by using admittance control, the operator need not overcome all of the inertia in the robotic system 200 to move the robotic arm 210. For example, under admittance control, when the operator imparts a force on the arm, the robotic system 200 can measure the force and assist the operator in moving the robotic arm 210 by driving one or more motors associated with the robotic arm 210, thereby resulting in desired velocities and/or positions of the robotic arm 210.

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.

FIG. 23B illustrates a front view of the robotic arm 210. FIG. 23C illustrates a perspective view of the robotic arm 210. In some embodiments, the robotic arm 210 includes a second input or button 314 (e.g., a push button) that is distinct from the button 312 in FIG. 23A, for placing the robotic arm 210 in an impedance mode (e.g., by a single press or continuous press and hold of the button 314). In this example, the button 314 is located between the A4 joint 304-5 and the A5 joint 304-6. The impedance mode is also referred to as impedance scheme or impedance control. In the impedance mode, the robotic system 200 measures displacements (e.g., changes in position and velocity) and outputs forces to facilitate manual movement of the robotic arm. In some embodiments, the robotic arm 210 can be manually manipulated by a user (e.g., during a set-up procedure) in the impedance mode. In some embodiments, under the impedance mode, the operator's movement of one part of a robotic arm 210 may back drive other parts of the robotic arm 210.

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 comprises a single button that can be used to place the robotic arm 210 in the admittance mode and 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.

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 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 space in 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 the ADM 308 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 in FIG. 12, the bar 220 (e.g., adjustable arm support) can provide several degrees of freedom, including lift, lateral translation, tilt, etc. Thus, depending on the embodiment, a robotic medical system can have many more robotically controlled degrees of freedom beyond just those in the robotic arms 210 to provide for null space movement and collision avoidance. In a respective embodiment of these embodiments, the end effectors of one or more robotic arms (and any tools or instruments coupled thereto) and a remote center along the axis of the tool can advantageously maintain in pose and/or position within a patient.

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 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 system 200 can be configured to detect the collision or impending collision (e.g., via kinematics). Accordingly, the robotic 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.

C. Setup Workflow

FIG. 24 illustrates an exemplary workflow 400 for intra-operative procedure adjustment in accordance with some embodiments.

In some embodiments, the workflow 400 is executed during teleoperation of the robotic system 200. FIG. 24 shows that steps 402, 406, and 410 of the workflow 400 are performed by one or more processors of a robotic system 200. Steps 404 and 408 are performed by a user 430 (e.g., a surgeon) of the robotic system 200.

In accordance with some embodiments, the robotic system 200 (e.g., via the one or more processors) intra-operatively detects (402) a need to adjust a procedure setup. As used herein, “intra-operation” corresponds to when a surgeon commences an operation to when the operation is completed in accordance with some embodiments. In some embodiments, in accordance with detecting a need for setup adjustment, the robotic system 200 notifies (402) the user 430.

In some embodiments, adjusting the procedural setup includes adjusting a pose (e.g., position and/or orientation) of a robotic arm (e.g., a robotic manipulator, such as the robotic arm/manipulator 210 in FIGS. 21. 22, and 23), or adjusting a translation, tilt, and/or rotation of an underlying bar (e.g., bar 220, FIGS. 21 and 22). In some embodiments, the robotic system 200 detects the need for intra-operative procedure setup adjustment by monitoring a pose of a robotic arm. As discussed in FIG. 23A, a robotic arm can include a plurality of links (e.g., links 302) that are connected by one or more joints (e.g., joints 304). In some embodiments, the robotic system 200 can detect the need for intra-operative procedure setup adjustment by monitoring the conditions of one or more joints individually. The robotic system 200 can also detect the need for intra-operative procedure setup adjustment by monitoring the conditions of the joints combinatorially, in accordance with some embodiments. The term “combinatorial” refers to circumstances in which the robotic system 200 comprises multiple robotic arms with multiple joints, and the robotic system can detect a compounded condition that might warrant an adjustment.

In some embodiments, the robotic system 200 performs the intra-operative detection in step 402 by combining procedure development knowledge of pre-planned intra-operative procedure set-up adjustment. For example, the robotic system 200 can detect procedure progress by monitoring the target clinical sites and activities via end-effector kinematic information, surgeon inputs (via a console, a viewing tower, a bed pendant, etc.), other system status, or a combination of them. The robotic system 200 can then notify the user 430 when a pre-planned step of a procedure is reached.

In some embodiments, upon detecting a need for adjustment, the robotic system 200 can notify (402) the user of the need for adjustment. For example, the robotic system can present the notification to the user via feedback, such as visual feedback that is displayed on a display interface of a display tower or a bed pendant of the robotic system. In some embodiments, the visual notification can comprise a “sticky” (e.g., latched) notification that remains on the display interface until it is acknowledged, cleared, etc. by a user, even if an adjustment condition disappears. In some embodiments, the notification disappears upon system adjustment (e.g., does not “latch” onto the display interface).

Referring again to FIG. 24, in some embodiments, in accordance with the notification by the robotic system 200, the user 430 decides (404) whether to make an adjustment to the procedure setup and provides a corresponding user input. The robotic system 200 receives a user input comprising a decision (e.g., from the user 430) regarding whether to make an adjustment to the procedural setup (e.g., the input is a user input indicating acceptance of a recommendation provided by the system, or an absence of a user input rejecting the recommendation provided by the system, or a user input selecting one of multiple recommendations provided by the system, or a user input allowing the system to select one of multiple recommendations, etc.). In some embodiments, the user input is provided in the form of a voice command, a gesture input, a touch input, an activation or actuation of a user interface element or control, etc. that is detected by the system.

In some embodiments, in response to the user input, the robotic system 200 generates (406) one or more recommended adjustments to the procedural setup, such as recommended adjustments to a pose of a robotic arm, a position of one or more joints and/or links of a robotic arm, a translation, tilt, and/or orientation of an underlying bar, etc. In some embodiments, the robotic system also generates (406) planned movement trajectory that depicts how the robotic system would execute movement to move the robotic arm and/or bar from the actual position to the recommended position.

In some embodiments the robotic system 200 generates the recommended adjustment based on heuristics, whereby there are pre-determined rules on how to generate a corresponding upon a detected condition.

In some embodiments, the robotic system 200 generates the recommended adjustment based on an optimization of a pre-determined objective function (e.g., pre-determined task). The pre-determined objective function can be associated with bar pose optimization, collision avoidance etc. For example, in some embodiments, the robotic system 200 leverages upon bar optimization algorithms to optimize a pose of an underlying bar. As described in FIG. 21, each of the robotic arms and/or the adjustable arm supports (e.g., bars) can be referred to as a respective kinematic chain. In some embodiments, a robotic arm and its underlying bar can be considered as one kinematic chain. For example, in FIG. 22, the robotic arm 210-1 and its underlying bar 220-1 can be part of the same kinematic chain, in accordance with some embodiments. In some embodiments, bar optimization comprises optimizing/changing with the goal of improving a pose (e.g., position and/or orientation) of the underlying bar (e.g., bar 220-1) that supports the robotic arm (e.g., robotic arm 210-1) while moving the robotic arm in null space so as to maintain the end effector (e.g., ADM 308) of the robotic arm 210 and/or a remote center of motion (RCM) of the tool 212 coupled thereto in a static pose.

In some embodiments, the robotic system 200 generates the recommended adjustment based on a pre-planning of a procedure to be performed on the robotic system. Stated another way, the robotic system generates the recommended adjustment to match the detection of a particular procedure step or progress, which is akin to the procedure development's pre-planning package. In some embodiments, in accordance with the pre-planning, the user 430 can directly select and initiate a proper adjustment as the procedure proceeds to the step, without system detection.

In some embodiments, the robotic system 200 can provide visual feedback the user 430 that shows (e.g., compares) actual positions (e.g., locations) of arms and/or bars of the robotic system and recommended positions (e.g., locations) of the arms and/or bars. FIG. 25 illustrates a visualization 500 that is generated by one or more processors of a robotic system (e.g., robotic system 200) in accordance with some embodiments. In some embodiments, the visualization 500 is displayed on a user interface of the robotic system 200. In the example of FIG. 25, the visualization 500 shows (e.g., compares) the actual arm poses 510 and the recommended arm poses 520, as well as the actual bar pose 530 and the recommended bar pose 540. In some embodiments, the current poses are displayed in a color that is different from a color of the recommended poses. In some embodiments, the visualization also displays a projected trajectory (e.g., a simulated trajectory) showing how bar and/or arm poses will transition from the current poses to the recommended poses. In some embodiments, the robotic system 200 can generate a single recommended trajectory. In some embodiments, the robotic system 200 can generate multiple recommended trajectories. In some embodiments, the user 430 can determine system adjustments without the detection or full guidance of the robotic system 200.

Referring again to FIG. 24, in some embodiments, in response to the visual feedback, the user 430 can provide input comprising user confirmation (408) to execute the adjustment. In response to the user confirmation, the robotic system 200 executes (410) the adjustment in accordance with the recommended adjustment and notifies the user 430 upon completion of the adjustment.

In some embodiments, the robotic system 200 executes an adjustment that comprises an adjustment to a pose of the arm and/or bar. In some embodiments, the robotic system 200 adjusts the pose of the arm and/or bar concurrently with (e.g., during, while teleoperation if ongoing) teleoperation of the arm and/or bar. That is to say, in some circumstances, a surgeon's assistant or staff could handle the entire intra-operative set-up adjustment without interrupting the surgeon's teleoperative control. In other embodiments, the surgeon may choose to halt or temporarily interrupt teleoperation prior to execution of the adjustment by the robotic system 200.

In some embodiments, in accordance with a determination a user input (e.g., user command) to execute the recommended adjustment has not been received, the robotic system 200 forgoes executing the adjustment. For example, in some embodiments, the robotic system does not perform the recommended adjustment unless an explicit input corresponding to a request to execute the recommended adjustment is received from the user.

In some embodiments, while adjusting the pose of the kinematic chain, the robotic system 200 receives a user input to abort the recommended adjustment. In some embodiments, in accordance with the user input, the robotic system 200 terminates the adjustment.

As illustrated in the workflow 400, in some embodiments, the robotic system 200 takes all cognitive loads off the user by detecting intra-operatively (e.g., automatically and without user intervention, while a medical procedure is ongoing) a need to adjust a procedure setup. This advantageously allows the user to focus on decision-making and supervision of the robotic system, including providing input(s) that cause the robotic system 200 to execute the adjustments and/or confirm continuous activation or execution of adjustments by the robotic system.

D. Exemplary Scenarios

FIG. 26 illustrates an exemplary coordinate system for describing a robotic system 200 in accordance with some embodiments. The coordinate system comprises a coordinate frame whose origin is at a bottom plate of a bed base at the center of a column of the robotic system (e.g., column 214, FIG. 22). The z-direction or z-axis extends along the column 214 in a vertical direction (e.g., in a direction out of a plane of the paper). The x-direction extends across the patient platform (e.g., patient platform 202 from one lateral side (e.g., the right side) to the other lateral side (e.g., the left side) when the patient platform 202 is in an untilted state. The y-direction or y-axis extends in a longitudinal direction along the patient platform 202 when the patient platform 202 is in an untilted state. That is, the y-direction extends along the patient platform 202 from one longitudinal end (e.g., the head end) to the other longitudinal end (e.g., the legs end) when the patient platform 202 is in an untilted state. In some embodiments, each of the robotic arms 210 is color-coded to identify the respective arm.

FIGS. 27A to 27D illustrate exemplary scenarios for intra-operative setup adjustment in accordance with some embodiments. In some embodiments, the exemplary scenarios depict conditions encountered by a robotic system 200 which correspond to respective adjustments to a portion of the robotic system (e.g., a robotic arm, an underlying bar, etc. of the robotic system).

FIG. 27A illustrates an exemplary scenario 710 wherein the robotic arm 210-2 or the robotic arm 210-4 travels toward an end of its corresponding underlying bar 220 during a medical procedure of the robotic system 200, in accordance with some embodiments. In some circumstances, scenario 710 occurs when a robotic arm (e.g., robotic arm 210-2) translates along the underlying bar 220 to avoid colliding with an adjacent robotic arm (e.g., robotic arm 210-1 or robotic arm 210-3, FIG. 26).

FIG. 27A shows the robotic arm 210-2 moving 712 (e.g., translating) toward an end 714 of the bar 220-1 via its A0 joint 304-1. Even though FIG. 26 shows that the robotic arm 210-2 is centrally located on bar 220-1 with robotic arms 210-1 and 210-3 on either side, in some embodiments, the robotic arm 210-2 can travel “towards the end of the bar” when an end robotic arm (e.g., robotic arm 210-1 or robotic arm 210-3) is removed from the setup. Alternatively, in some circumstances, even when the end robotic arm (e.g., robotic arm 210-1 or robotic arm 210-3) is not removed, the robotic arm 210-2 can still travel toward and reach a threshold limit near an end robotic arm.

In some embodiments, the robotic system 200 determines (e.g., detects) one or more conditions encountered by the robotic arm and/or underlying bar, the one or more conditions corresponding to a respective adjustment to the intra-operative procedure setup. For example, in FIG. 27A, the robotic system 200 determines (e.g., detects) whether a joint (A1 joint 304-1) of the robotic arm 210-2 has reached a threshold range of a joint limit (e.g., A0 joint position is within 4 cm, 5 cm, or 6 cm, etc., from an end 714 of the bar 220-1). In some embodiments, the robotic system 200 determines whether the joint of the robotic arm has remained in the threshold range of the joint limit for at least a specified period of time (e.g., A0 joint position is within 4 cm, 5 cm, or 6 cm from the end 714 of the bar 220 for about 60% of the time within the past 5 seconds, 8 seconds, etc.). For example, the robotic system 200 can check (e.g., probe) the robotic arm at a regular interval (e.g., every 10 seconds for 60 seconds, every 15 seconds for minute, etc.) to determine whether the robotic arm has remained in the threshold range of the joint limit for at least a specified period of time.

In some embodiments, in accordance with a determination that a joint of the robotic arm (e.g., robotic arm 210-2 or 210-4) has reached a threshold range of a joint limit, and/or has remained in the threshold range of the joint limit for at least a specified period of time, the robotic system 200 notifies the user (e.g., via visual and/or audible feedback as described with respect to FIGS. 24 and 25) that the robotic system 200 has detected a condition that calls for an adjustment to a pose of a robotic arm and/or underlying bar.

In some embodiments, upon user confirmation to make an adjustment to the robotic arm (e.g., step 404 in FIG. 24), the robotic system 200 can provide (e.g., generate) a recommended adjustment that comprises a translation of the underlying bar for a predetermined distance (e.g., moving the bar by 6 cm, 8 cm, 10 cm, etc.) (e.g., step 406 in FIG. 24). The robotic system 200 executes the recommended adjustment upon user confirmation to proceed with the recommended adjustment in accordance with some embodiments.

In some embodiments, the robotic system 200 generates the recommended adjustment based on heuristics. In some embodiments, the robotic system 200 generates the recommended adjustment based on an optimization of the robotic system, such as bar pose optimization.

FIG. 27B illustrates an exemplary scenario 720 in accordance with some embodiments. In this example, a robotic arm 210-4 is pulling sutures in a direction that is represented by arrow 722 (e.g., along the y-axis, parallel to a length of the table top 202, etc.). FIG. 27B shows that the ADM 308 of the robotic arm 210-4 is coupled to a suturing tool 724. In this example, the ADM 308 is rolling around a distal link 302-4 of the robotic arm 210-4 with respect to its A5 joint 304-6. In some circumstances, scenario 720 depicts a situation whereby the robotic arm 210-4 is close to attaining kinematic singularity. In general, the number of joints of a robotic arm will determine the DOF of its end effector. Kinematic singularity occurs when a robotic arm experiences certain kinematic conditions such that the robotic arm is unable to execute motion in certain DOF. In the example of FIG. 27B, the robotic arm is close to singularity because the joint angle 732 (e.g., A5 joint angle) is at almost 90 degrees with respect to the distal link 302-4, resulting in the A4 joint (represented by line 728) and the ADM 308 (represented by line 730) becoming almost parallel to each other. When this occurs, there is poor rotational capability of the joints in one of the directions. As a result, the distal end of the robotic arm (e.g., identified by circle 726) is unable to freely move the end effector in certain DOF. In some embodiments, when the robotic arm 210-4 is close to singularity, the user will feel “bumps” while the robotic arm 210-4 moves laterally.

In some embodiments, the robotic system 200 determines (e.g., detects) whether one or more joint angles of the robotic arm have reached a threshold condition, e.g., an angle of the A5 joint (e.g., joint 304-6) is within 10 degrees from joint limit, an angle of the A4 joint (e.g., joint 304-5) is within ±15 degrees cone above the distal link, etc.

In some embodiments, the robotic system 200 determines (e.g., detects) whether one or more joint angles of the robotic arm have remained in a threshold condition for at least a specified period of time, e.g., the A5 joint angle is within 10 degrees from joint limit for about 60% of the time within the past two seconds, the A4 joint angle is within ±15 degrees cone above the distal link for about 60% of the time within the past two seconds, or the A4 and/or A5 joint enters and exits the threshold condition twice in the past 10 seconds, etc.

In some embodiments, the robotic system probes the joints at regular time intervals (e.g., every 10 seconds, every 20 seconds, etc.) to determine whether the joints have reached a threshold condition.

In some embodiments, in accordance with a determination that one or more joints of a robotic arm (e.g., A4 joint and/or A5 joint) have reached a threshold joint angle limit and/or a threshold joint angle range limit, and/or have remained in a threshold limit or threshold range limit for at least a specified period of time, the robotic system 200 generates a recommended adjustment that comprises lowering a base of the corresponding robotic arm by a known distance (e.g., 3 cm, 5 cm, 8 cm, etc.). In some embodiments, in accordance with the determination, the robotic system 200 generates a recommended adjustment that comprises lowering a base of the corresponding robotic arm by a distance that will place the joint angle (e.g., A5 joint angle) to be at least 10 degrees, 15 degrees, etc. from the threshold angle limit. In some embodiments, this can be achieved by translating the underlying bar, or by changing a tilt and/or rotation of the underlying bar (e.g., by adjusting a roll, pitch, and/or yaw of the bar).

In some embodiments, the robotic system generates the recommended adjustment upon user confirmation to make an adjustment to the robotic arm (e.g., as described with respect to steps 404 and 406 in FIG. 24).

In some circumstances, the A0 joint limit condition described in scenario 710 and the A5 joint angle condition described in scenario 720 can occur concurrently. In some embodiments, in accordance with detecting both the A0 joint limit condition and the A5 joint angle condition, the robotic system 200 may notify the user about both conditions simultaneously. In some embodiments, in accordance with detecting both conditions, the robotic system 200 may prioritize the conditions and notify the user about the higher-priority condition (e.g., the A0 joint limit condition).

FIG. 27C illustrates an exemplary scenario 740 in accordance with some embodiments. The scenario 740 can occur when a joint (e.g., A3 joint) connecting a distal link of the robotic arm and a proximal link of the robotic arm has reached its joint limit. For example, FIG. 27C shows that the A3 joint 304-4 of robotic arm 210-3 is close to (or has reached) its joint limit because the distal link 302-3 is almost fully extended and parallel to the proximal link 302-2. In some embodiments, a robotic arm (e.g., in this case the robotic arm 210-3) reaches a workspace boundary when its A3 joint limit is reached, and the arm cannot move to a location beyond the workspace limit. The scenario 740 also presents an issue when a bedside assistant needs access between the robotic arm 210-2 and the robotic arm 210-3 for stapling a patient. In some embodiments, the robotic arm 210-3 includes a camera at its end effector and the camera will lose further motion in the direction indicated by arrow 742.

In some embodiments, the robotic system 200 determines (e.g., detects) whether the A3 joint angle has reached a threshold condition (e.g., the A3 joint angle is within 5 degrees, 10 degrees, 12 degrees, etc. from its joint limit). In some embodiments, the robotic system 200 determines (e.g., detects) whether the A3 joint angle has remained in a threshold condition for a predefined time duration (e.g., the A3 joint angle is within 5 degrees, 10 degrees, 12 degrees, etc. from its joint limit for about 60% of time within the past 5 seconds, 7 seconds, etc.).

In some embodiments, the robotic system checks the A3 joint angle at regular time intervals (e.g., every 10 seconds, every 15 seconds, etc.) to determine whether the A3 joint has reached a threshold joint angle limit (or whether the A3 joint has remained within the threshold joint angle limit).

In some embodiments, in accordance with a determination that the A3 joint has reached a threshold joint angle limit, and/or has remained in a threshold angle limit for at least a specified period of time, the robotic system 200 generates a recommended adjustment that comprises lifting a base of the corresponding robotic arm by a known distance (e.g., 3 cm, 5 cm, 8 cm, etc.). In some embodiments, the robotic system 200 generates a recommended adjustment that comprises lifting a base of the corresponding robotic arm by a distance that will place the A3 joint angle (e.g., A5 joint angle) to be at least 10 degrees, 15 degrees, etc. from the threshold A3 joint angle limit. In some embodiments, a base of a robotic arm can be lifted by lifting the underlying bar of the robotic arm, or by changing a tilt and/or rotation of the underlying bar (e.g., rolling the bar 10 degrees inward, or by whatever amount to that will place the A3 joint angle to be at least 10 degrees, 15 degrees, etc. from the threshold angle limit).

In some embodiments, the A0 joint limit condition described in scenario 710 and the A3 joint angle condition described in scenario 740 can occur concurrently. In some embodiments, in accordance with detecting both the A0 joint limit condition and the A3 joint angle condition, the robotic system 200 may notify the user about both conditions simultaneously. In some embodiments, in accordance with detecting both conditions, the robotic system 200 may prioritize the conditions and notify the user about the higher-priority condition (e.g., the A3 joint angle condition).

FIG. 27D illustrates an exemplary scenario 750 in accordance with some embodiments. FIG. 2D depicts a robotic arm 210-4 and a robotic arm 210-5 having a common underlying bar 220-2. In this example, the distal end of the robotic arm 210-4 (e.g., identified by region 752) is unable to freely move the end effector in certain DOF, a situation as described in scenario 720 in FIG. 27B. FIG. 27D also shows that the robotic arm 210-5 is close to or has reached an A3 joint angle limit (e.g., identified by region 754), a situation as described in scenario 740 in FIG. 27C.

In some embodiments, the robotic system detects occurrence of a combination scenario such as Scenario 750 by detecting each of the robotic arms individually. Referring to the example of FIG. 27D, in some embodiments, the robotic system 200 determines (e.g., detects) whether one or more joint angles (e.g., A3, A4, and/or A5 joint angles) of a robotic arm (e.g., robotic arm 210-4, robotic arm 210-5, etc.) have reached a threshold condition, and/or whether one or more joint angles of the robotic arm have remained in a threshold for at least a predefined time duration.

In some embodiments, in accordance with a determination that a combination scenario, such as scenario 750, has occurred, the robotic system 200 generates a recommended adjustment that comprises a translation, tilt and/or rotation of the underlying bar (e.g., by adjusting a roll, pitch, and/or yaw of the bar).

E. Exemplary Processes for Procedural Setup

FIGS. 28A and 28B illustrate a flowchart diagram for a method 800 for detecting one or more conditions for adjusting a procedure setup and generating an adjustment for execution, in accordance with some embodiments.

In accordance with some embodiments of the present disclosure, the method 800 is performed by one or more processors of a robotic system (e.g., the robotic medical system 200 as illustrated in FIGS. 21 and 22, or a robotic surgery platform, etc.).

The robotic system comprises a kinematic chain for performing a procedure (e.g., a surgical procedural, a teleoperative procedure etc.). In some embodiments, the kinematic chain comprises a robotic arm (e.g., the robotic arm 210 in FIGS. 21, 22, 23A, 23B, 26, and 27A to 27D), an adjustable bar (e.g., bar 220 in FIGS. 21, 22, 26, and 27A to 27D), a robotic arm coupled to an adjustable bar, two or more robotic arms coupled to an adjustable bar, etc. In some embodiments, the kinematic chain includes various poses (e.g., position and/or orientation).

The robotic system detects (802) one or more conditions encountered by the kinematic chain.

The one or more conditions correspond (804) to a respective adjustment to a pose of the kinematic chain.

In some embodiments, the robotic system detects one or more conditions via one or more sensors (e.g., position sensors, orientation sensors, contact sensors, force sensors, image sensors, six-axis load cells, etc.) of the robotic system.

In some embodiments, the one or more conditions comprise conditions that are detected or identified in accordance with one or more criteria (e.g., preset criteria on joint position thresholds, preset criteria on joint angle limits, etc.).

In some embodiments, the one or more conditions are a result of one or more robotic manipulators' motion in response to various commands of the end-effector(s) and/or null space motion(s) of the robotic manipulators. For example, as illustrated in FIGS. 27A to 27D, in some embodiments, the robotic system detects one or more joints (e.g., joints 304 in FIGS. 23A to 23C and FIGS. 27A to 27D) of the robotic arm reaching a threshold distance/angle limit, remaining in a threshold distance/angle limit for at least a specified period of time, or remaining in a threshold distance/angle range for at least a specified period of time, etc. In some embodiments, the joints may have reached a threshold joint limit/angle while executing tasks such as collision avoidance or procedure-related tasks such as suturing, holding and/or maintaining an instrument or a tool in a specific position, etc.

In some circumstances, there is an enabled portion of the kinematic chain (e.g., a robotic arm), wherein when moving that enabled portion alone is insufficient and results in unfavored one or more conditions. In some circumstances, as the procedure progresses, the robotic system detects a one or more conditions corresponding to a procedure step that involves activating the entire kinematic chain or at least a larger portion of the kinematic chain that is larger than the enabled portion.

In some embodiments, the robotic system commands a portion of an active kinematic chain to perform a task (e.g., null space adjustment). The robotic system also monitors conditions (e.g., joint conditions) of the kinematic chain, and performs an adjustment to a portion and/or the whole kinematic chain in response to one or more conditions encountered by the kinematic chain.

In some embodiments, the robotic system is configured to detect the one or more conditions while performing a medical procedure, such as during a teleoperation, or during an intra-operation. In some embodiments, the detected conditions represent (e.g., reflect, correspond to) a need to adjust a procedure set-up of the robotic system, such as adjusting a pose of the kinematic chain. For example, the robotic system can detect the need for intra-operative procedure setup adjustment by monitoring the robotic manipulators' (e.g., the robotic arms) poses via their individual joint position conditions, and the combinatorial ones among them.

In some embodiments, the one or more conditions comprises a pose-recognition of the kinematic chain. For example, in some embodiments, the robotic system detects the progress of a procedure so and applies a pre-planned kinematic chain adjustment in accordance with the progress.

In some embodiments, the one or more conditions comprise a joint (e.g., joint 304 in FIGS. 23A to 23C and FIGS. 27A to 27D) of the kinematic chain reaching a threshold range of a joint limit. An example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A0 joint position of a robotic arm 210 is within 4 cm, 5 cm, or 6 cm, etc. of a threshold distance, such as from a docked position of the robotic arm 210, or from a threshold distance that is measured with respect to an end of an underlying support bar 220 (e.g., end 714 of the bar 220-1 in FIG. 27A), etc. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A3 joint angle of a robotic arm 210 is within 10, 15, or 20 degrees of a threshold angle, etc. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A4 joint angle of a robotic arm 210 is within a 10- or 15-degrees cone above a distal link. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A5 joint angle of a robotic arm 210 is within 10, 12, or 15 degrees, etc. from the joint limit.

In some embodiments, the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time (e.g., a robotic arm 210 has an A0 joint position that is within 4 cm, 5 cm, or 6 cm of the a) joint limit for about 60% of the time within the past 5 seconds; a robotic arm 210 has an A3 joint angle that is within 10 or 15 degrees for about 60% of the time within the past 5 seconds; a robotic arm 210 has an A4 joint angle that is within 15 degrees cone above a distal link for about 60% of the time within the past 2 seconds; or a robotic arm 210 has an A5 joint angle that is within 10 degrees from joint limit for about 60% of the time within the past 2 seconds, etc.

Referring again to FIG. 28A, in some embodiments, in response to detecting the one or more conditions or upon user request, the robotic system generates (806) a recommended adjustment of the kinematic chain in accordance with the one or more conditions.

In some embodiments, the user request comprises an unprompted request (e.g., a request without any condition detected in the system). In some embodiments, the user request comprises a request that is made in response to the one or more conditions.

In some embodiments, the robotic system generates the recommended adjustment in response (808) to the user request (e.g., as an alternative to system detection).

In some embodiments, generating the recommended adjustment of the kinematic chain further comprises generating (810) a movement trajectory of one or more joints of the kinematic chain. For example, in some embodiments, the robotic system provides system-generated trajectories, and the user supervises the motion of the system. This reduces the cognitive load on the user while performing a surgery.

In some embodiments, the robotic system generates the recommended adjustment of the kinematic chain based on (812) a pre-planning of a procedure. For example, in some embodiments, the recommended adjustment can be pre-planned to match the detection of a particular step or progress of the procedure, akin to the procedure development's pre-planning package. The user can directly select and initiate a proper adjustment as the procedure progresses, without system detection.

In some embodiments, the robotic system generates the recommended adjustment of the kinematic chain based on (814) a pre-determined rule. For example, in some embodiments, the recommended adjustments described in FIGS. 27A to 27D are generated based on heuristics, wherein the robotic system has pre-determined rules on how to generate the adjustment upon each detected condition.

In some embodiments, the robotic system presents (816) a notification of the recommended adjustment of the kinematic chain to a user. In some embodiments, the robotic system presents the notification audibly (e.g., in the form of a verbal notification or alert). In some embodiments, the robotic system presents the notification as a visual display (e.g., via an interface of the robotic system).

With continued reference to FIG. 28A, in some embodiments, in accordance with a determination that a first user command to execute the recommended adjustment has been received, the robotic system adjusts (818) the pose of the kinematic chain in accordance with the recommended adjustment.

In some embodiments, in accordance with a determination that a user command to execute the recommended adjustment has not been received, the robotic system forgoes (820) adjusting the pose of the kinematic chain.

For example, in some embodiments, the robotic system does not perform the recommended adjustment unless an explicit input corresponding to a request to execute the recommended adjustment is received from the user. In some embodiments, the robotic system implements a timeout period, and if an explicit input corresponding to a request to execute the recommended adjustment is not received within the timeout period, the robotic system forgoes executing the recommended adjustment. In some embodiments, the robotic system starts preparation of the recommended adjustment irrespective whether the user's request to execute the recommended adjustment is received. In some embodiments, the robotic system does not start preparation of the recommended adjustment unless and until the user's explicit instruction for executing the recommended adjustment is received. In some embodiments, the user may ignore the recommended adjustment and continue with the procedure without having the robotic system execute the recommended adjustment. For example, the user can continue with the procedure until the kinematic chain (or a portion therefore) encounters a collision, reaches a joint limit, and/or encounters other condition(s) that prevent the user from reaching desired target area(s) (e.g., of the patient's body) to perform the procedure.

In some embodiments, the robotic system receives (822) a second user command while adjusting the pose of the kinematic chain. In accordance with a determination that the second user command corresponds to a command to abort the recommended adjustment, the robotic system terminates (824) the adjustment.

In some embodiments, in accordance to the termination of the adjustment, the robotic system returns the kinematic chain to its initial pose prior to the execution of the recommended adjustment.

In some embodiments, the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain. The robotic system displays (826) the recommended adjustment as a visualization that compares the recommended pose of the kinematic chain to an actual pose of the kinematic chain.

For example, in FIG. 25, the robotic system 200 displays the recommended adjustment as a visualization 500 that compares the actual arm poses 510 and the recommended arm poses 520, and/or compares the actual bar pose 530 and the recommended bar pose 540.

In some embodiments, the robotic system determines (828) the recommended adjustment of the kinematic chain via optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance. For example, in some embodiments, a robotic arm and its underlying bar can be considered as one kinematic chain, or part of the same kinematic chain. In some embodiments, optimization of a pre-determined objective comprises optimizing a pose (e.g., position and/or orientation) of the underlying bar (that supports the robotic arm) for surgery. For example, in some embodiments, the pose of the underlying bar can be optimized via movement of the underlying bar (e.g., by translation, and/or rotation, and/or tilt) while moving the robotic arm in null space so as to maintain the end effector (e.g., ADM) of the robotic arm and/or a remote center of motion (RCM) of the tool coupled thereto in a static pose. In some embodiments, the bar optimization task comprises using the forces sensed on the A0 force sensor to adjust a pose (e.g., position and/or orientation) of the underlying bar of the robotic arm, in accordance with some embodiments.)

FIG. 29 illustrates a flowchart diagram for a method 900 for detecting one or more conditions for adjusting a procedure setup and generating an adjustment for execution, in accordance with some embodiments.

In accordance with some embodiments of the present disclosure, the method 900 is performed by one or more processors of a robotic system (e.g., the robotic medical system 200 as illustrated in FIGS. 21 and 22, or a robotic surgery platform, etc.).

The robotic system comprises a kinematic chain. In some embodiments, the kinematic chain comprises a robotic arm (e.g., the robotic arm 210 in FIGS. 21, 22, 23A, 23B, 26, and 27A to 27D), an adjustable bar (e.g., bar 220 in FIGS. 21, 22, 26, and 27A to 27D), a robotic arm coupled to an adjustable bar, two or more robotic arms coupled to an adjustable bar, etc. In some embodiments, the kinematic chain includes various poses (e.g., position and/or orientation).

The robotic system detects (902) one or more conditions encountered by the kinematic chain.

The one or more conditions correspond (904) to a respective adjustment to a pose of the kinematic chain.

In some embodiments, the robotic system detects one or more conditions via one or more sensors (e.g., position sensors, orientation sensors, contact sensors, force sensors, image sensors, six-axis load cells, etc.) of the robotic system.

In some embodiments, the one or more conditions comprise conditions that are detected or identified in accordance with one or more criteria (e.g., preset criteria on joint position thresholds, preset criteria on joint angle limits, etc.).

In some embodiments, the one or more conditions are a result of one or more robotic manipulators' motion in response to various commands of the end-effector(s) and/or null space motion(s) of the robotic manipulators. For example, as illustrated in FIGS. 27A to 27D, in some embodiments, the robotic system detects one or more joints (e.g., joints 304 in FIGS. 23A to 23C and FIGS. 27A to 27D) of the robotic arm reaching a threshold distance/angle limit, remaining in a threshold distance/angle limit for at least a specified period of time, or remaining in a threshold distance/angle range for at least a specified period of time, etc. In some embodiments, the joints may have reached a threshold joint limit/angle while executing tasks such as collision avoidance or procedure-related tasks such as suturing, holding and/or maintaining an instrument or a tool in a specific position, etc.

In some embodiments, the one or more conditions comprise a joint (e.g., joint 304 in FIGS. 23A to 23C and FIGS. 27A to 27D) of the kinematic chain reaching a threshold range of a joint limit. An example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A0 joint position of a robotic arm 210 is within 4 cm, 5 cm, or 6 cm, etc. of a threshold distance, such as from a docked position of the robotic arm 210, or from a threshold distance that is measured with respect to an end of an underlying support bar 220 (e.g., end 714 of the bar 220-1 in FIG. 27A), etc. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A3 joint angle of a robotic arm 210 is within 10, 15, or 20 degrees of a threshold angle, etc. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A4 joint angle of a robotic arm 210 is within a 10- or 15-degrees cone above a distal link. Another example of a joint of the kinematic chain reaching a threshold range of a joint limit is when an A5 joint angle of a robotic arm 210 is within 10, 12, or 15 degrees, etc. from the joint limit.

In some embodiments, the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time (e.g., a robotic arm 210 has an A0 joint position that is within 4 cm, 5 cm, or 6 cm of the a) joint limit for about 60% of the time within the past 5 seconds; a robotic arm 210 has an A3 joint angle that is within 10 or 15 degrees for about 60% of the time within the past 5 seconds; a robotic arm 210 has an A4 joint angle that is within 15 degrees cone above a distal link for about 60% of the time within the past 2 seconds; or a robotic arm 210 has an A5 joint angle that is within 10 degrees from joint limit for about 60% of the time within the past 2 seconds, etc.

In some embodiments, the one or more conditions comprises a pose-recognition of the kinematic chain. For example, in some embodiments, the processors detect the progress of a procedure so and applies a pre-planned kinematic chain adjustment in accordance with the progress.

Referring again to FIG. 29, in some embodiments, the robotic system presents (906) a notification of the detected one or more conditions. This is illustrated in step 402 of FIG. 24. For example, in some embodiments, the notification can comprise a “sticky” (e.g., latched) notification that remains on the display interface until it is acknowledged, cleared, etc. by a user, even if an adjustment condition disappears. In some embodiments, the notification disappears upon system adjustment (e.g., does not “latch” onto the display interface).

The robotic system receives (908) a first user input, the first user input comprising a decision (e.g., step 404, FIG. 24) regarding whether to make an adjustment to the kinematic chain.

In some embodiments, in response to the first user input, the robotic system generates (910) a recommended adjustment to the kinematic chain. This is illustrated in step 406 of FIG. 24.

In some embodiments, the recommended adjustment includes at least one movement trajectory for the kinematic chain.

In some embodiments, the robotic system generates the recommended adjustment based on heuristics, optimization of a pre-determined objective (e.g., of the kinematic chain), and/or a pre-planned procedure.

In some embodiments, the robotic system generates the recommended adjustment based on a pre-planning of a procedure to be performed on the robotic system. For example, in some embodiments, the recommended adjustment can be pre-planned to match the detection of a particular step or progress of the procedure, akin to the procedure development's pre-planning package. The user can directly select and initiate a proper adjustment as the procedure progresses, without system detection.

In some embodiments, the robotic system generates the recommended adjustment based on a pre-determined rule. For example, in some embodiments, the robotic system generates the recommended adjustment based on heuristics, wherein the robotic system has pre-determined rules on how to generate the adjustment upon each detected condition. For example, the recommended adjustments described in FIGS. 27A to 27D are generated based on heuristics, wherein the robotic system has pre-determined rules on how to generate the adjustment upon each detected condition.

In some embodiments, the robotic system generates the recommended adjustment based on optimization of a pre-determined objective function (e.g., associated with bar pose optimization, collision avoidance etc.). In some embodiments, the kinematic chain comprises a robotic arm and an underlying bar. The robotic system generates the recommended adjustment based on optimization of a pose (e.g., position and/or orientation) of the underlying bar for surgery.

In some embodiments, the robotic system receives (912) a second user input comprising user confirmation to execute the recommended adjustment. In response to the second user input, the robotic system adjusts (914) a pose of the kinematic chain in accordance with the recommended adjustment.

In some embodiments, the first user input and the second user inputs are two user inputs. For example, the user may select (e.g., via a user interface, via a console, a viewing tower, a bed pendant, etc.) a first button/prompt such as “Show me the recommendation.” In response to the user selection, the robotic system presents the recommended adjustment along with another button/prompt that says “execute”, which, when selected by the user, adjusts a pose of the kinematic chain in accordance with the recommended adjustment.

In some embodiments, the first user input is unprompted (e.g., unsolicited, spontaneous without any system detection). For example, in some embodiments, the user makes a decision based on their own discretion. In some embodiments, the first user input is an input from the user that is made in response to the notification presented by the robotic system.

In some embodiments, the first user input and the second user input are the same user input. For example, in some embodiments, the user does not have to separately make a request and confirm the execution of the recommended adjustment. Once the user agrees to go ahead and make that adjustment, the system makes the recommendation and executes the request.

In some embodiments, the first user input and the second user input are part of the same user input (e.g., part of the same gesture). For example, in some embodiments, in response to user selection of a prompt (e.g., first input via a finger touch on a touchscreen display), the system displays a list of recommendations. The user can then navigate to the recommended pose while keeping their finger on the display. Liftoff of the finger (e.g., second input) causes execution of the recommended pose that is being selected.

In some embodiments, adjusting the pose of the kinematic chain in accordance with the recommended adjustment comprises adjusting the pose of the kinematic chain concurrently (916) with (e.g., during, while teleoperation if ongoing) teleoperation of the kinematic chain. For example, in some embodiments, the pose of the kinematic chain (e.g., bar pose adjustment, robotic arm pose adjustment etc.) can be executed while teleoperation is ongoing, it is possible to let patient-side staff handle the entire intra-operation setup adjustment without interrupting the surgeon's teleoperation.

In some embodiments, adjusting a pose of the kinematic chain in accordance with the recommended adjustment comprises halting (918) teleoperation prior to the adjusting. For example, in some circumstances, a patient and/or a surgeon may elect to stop teleoperation during intra-operation setup adjustment. In some circumstances, a surgeon may also choose to disrupt the teleoperation during intra-operation setup adjustment.

Referring again to FIG. 29, in some embodiments, the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain. Generating the recommended adjustment further comprises generating (920) a visualization (e.g., visualization 500, FIG. 25) that compares the recommended pose to an actual pose of the kinematic chain. In some embodiments, the robotic system further displays (922) the visualization on a user interface of the robotic system (e.g., a display interface of a display tower or a bed pendant of the robotic system). In some embodiments, generating the recommended adjustment comprises generating an audible (e.g., audio, verbal, etc.) response. Displaying the recommended adjustment comprises displaying the audible response.

3. Implementing Systems and Terminology.

Embodiments disclosed herein provide systems, methods and apparatus for intra-operative setup adjustment by a robotic medical system.

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 intra-operative setup adjustment 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.”

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:

• • a kinematic chain for performing a procedure;
  • one or more processors; and memory storing instructions that, when executed by the one or more processors, cause the one or more processors to:
  • detect one or more conditions encountered by the kinematic chain, the one or more conditions corresponding to a respective adjustment to a pose of the kinematic chain;
  • in response to detecting the one or more conditions or upon user request, generate a recommended adjustment of the kinematic chain in accordance with the one or more conditions;
  • present a notification of the recommended adjustment of the kinematic chain to a user; and in accordance with a determination that a first user command to execute the recommended adjustment has been received, adjust the pose of the kinematic chain in accordance with the recommended adjustment.Clause 2. The robotic system of clause 1, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to:
  • in accordance with a determination that a user command to execute the recommended adjustment has not been received, forgo adjusting the pose of the kinematic chain.Clause 3. The robotic system of clause 1 or 2, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to:
  • receive a second user command while adjusting the pose of the kinematic chain; and in accordance with a determination that the second user command corresponds to a command to abort the recommended adjustment, terminate the adjustment.

Clause 4. The robotic system of any of clauses 1-3, wherein the one or more conditions comprises a pose recognition of the kinematic chain.

Clause 5. The robotic system of any of clauses 1-4, wherein the kinematic chain comprises a robotic arm and an underlying arm support.

Clause 6. The robotic system of any of clauses 1-5, wherein the one or more conditions comprise a joint of the kinematic chain reaching a threshold range of a joint limit.Clause 7. The robotic system of clause 6, wherein the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.Clause 8. The robotic system of any of clauses 1-7, wherein generating a recommended adjustment of the kinematic chain comprises generating the recommended adjustment in response to the user request.Clause 9. The robotic system of any of clauses 1-8, wherein generating the recommended adjustment of the kinematic chain further comprises generating a movement trajectory of one or more joints of the kinematic chain.Clause 10. The robotic system of any of clauses 1-9, wherein:

• • the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain; and
  • the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to:
  • display the recommended adjustment as a visualization that compares the recommended pose of the kinematic chain to an actual pose of the kinematic chain.Clause 11. The robotic system of any of clauses 1-10, wherein the recommended adjustment of the kinematic chain is generated based on a pre-planning of a procedure.Clause 12. The robotic system of any of clauses 1-11, wherein the recommended adjustment of the kinematic chain is generated based on a pre-determined rule.Clause 13. The robotic system of any of clauses 1-12, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to:
  • determine the recommended adjustment of the kinematic chain via optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.Clause 14. A method, comprising:
  • at a robotic system having a kinematic chain, one or more processors, and memory storing one or more programs configured for execution by the one or more processors, the method comprising:
  • detecting one or more conditions encountered by the kinematic chain, the one or more conditions correspond to a respective adjustment to a pose of the kinematic chain;
  • presenting a notification of the detected one or more conditions;
  • receiving a first user input, the first user input comprising a decision regarding whether to make an adjustment to the kinematic chain;
  • in response to the first user input, generating a recommended adjustment to the kinematic chain;
  • receiving a second user input comprising user confirmation to execute the recommended adjustment; and
  • in response to the second user input, adjusting a pose of the kinematic chain in accordance with the recommended adjustment.Clause 15. The method of clause 14, wherein the first user input is unprompted.Clause 16. The method of clause 14 or 15, wherein the first user input and the second user input are the same user input.Clause 17. The method of any of clauses 14-16, wherein the one or more conditions comprises a pose-recognition of the kinematic chain.Clause 18. The method of any of clauses 14-17, wherein the one or more conditions comprises a joint of the kinematic chain reaching a threshold range of a joint limit.Clause 19. The method of clause 18, wherein the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.Clause 20. The method of any of clauses 14-19, wherein adjusting the pose of the kinematic chain in accordance with the recommended adjustment comprises adjusting the pose of the kinematic chain concurrently with teleoperation of the kinematic chain.Clause 21. The method of any of clauses 14-20, wherein adjusting a pose of the kinematic chain in accordance with the recommended adjustment comprises halting teleoperation prior to the adjusting.Clause 22. The method of any of clauses 14-21, wherein the recommended adjustment includes at least one movement trajectory for the kinematic chain.Clause 23. The method of any of clauses 14-22, wherein the recommended adjustment is based on heuristics, optimization of a pre-determined objective, and/or a pre-planned procedure.Clause 24. The method of any of clauses 14-23, wherein:
  • the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain;
  • generating the recommended adjustment further comprises generating a visualization that compares the recommended pose to an actual pose of the kinematic chain; and
  • displaying the recommended adjustment further comprises displaying the visualization on a user interface of the robotic system.Clause 25. The method of any of clauses 14-24, wherein the recommended adjustment is based on a pre-planning of a procedure to be performed on the robotic system.Clause 26. The method of any of clauses 14-25, wherein the recommended adjustment is based on a pre-determined rule.Clause 27. The method of any of clauses 14-26, wherein the recommended adjustment is based on optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.Clause 28. A robotic system, comprising:
  • a kinematic chain;
  • one or more processors; and
  • memory storing instructions that, when executed by the one or more processors, cause the one or more processors to:
  • detect one or more conditions encountered by the kinematic chain, the one or more conditions corresponding to a respective adjustment to a pose of the kinematic chain;
  • present a notification of the detected one or more conditions;
  • receive a first user input the first user input comprising a decision regarding whether to make an adjustment to the kinematic chain;
  • in response to the first user input, generate a recommended adjustment to the kinematic chain; receive a second user input comprising user confirmation to execute the recommended adjustment; and
  • in response to the second user input, adjust a pose of the kinematic chain in accordance with the recommended adjustment.Clause 29. The robotic system of clause 28, wherein the first user input is unprompted.Clause 30. The robotic system of clause 28 or 29, wherein the first user input and the second user input are the same user input.Clause 31. The robotic system of any of clauses 28-30, wherein the one or more conditions comprises a pose-recognition of the kinematic chain.Clause 32. The robotic system of any of clauses 28-31, wherein the one or more conditions comprises a joint of the kinematic chain reaching a threshold range of a joint limit.Clause 33. The robotic system of clause 32, wherein the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.Clause 34. The robotic system of any of clauses 28-33, wherein adjusting the pose of the kinematic chain in accordance with the recommended adjustment comprises adjusting the pose of the kinematic chain concurrently with teleoperation of the kinematic chain.Clause 35. The robotic system of any of clauses 28-34, wherein adjusting a pose of the kinematic chain in accordance with the recommended adjustment comprises halting teleoperation prior to the adjusting.Clause 36. The robotic system of any of clauses 28-35, wherein the recommended adjustment includes at least one movement trajectory for the kinematic chain.Clause 37. The robotic system of any of clauses 28-36, wherein the recommended adjustment is based on heuristics, optimization of a pre-determined objective, and/or a pre-planned procedure.Clause 38. The robotic system of any of clauses 28-37, wherein:
  • the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain;
  • generating the recommended adjustment further comprises generating a visualization that compares the recommended pose to an actual pose of the kinematic chain; and
  • displaying the recommended adjustment further comprises displaying the visualization on a user interface of the robotic system.Clause 39. The robotic system of any of clauses 28-38, wherein the recommended adjustment is based on a pre-planning of a procedure to be performed on the robotic system.Clause 40. The robotic system of any of clauses 28-39, wherein the recommended adjustment is based on a pre-determined rule.Clause 41. The robotic system of any of clauses 28-40, wherein the recommended adjustment is based on optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.

Claims

1. A robotic system, comprising: a kinematic chain for performing a procedure;one or more processors; anda memory storing instructions that, when executed by the one or more processors, cause the one or more processors to: detect one or more conditions encountered by the kinematic chain, the one or more conditions corresponding to a respective adjustment to a pose of the kinematic chain;in response to detecting the one or more conditions or upon user request, generate a recommended adjustment of the kinematic chain in accordance with the one or more conditions;present a notification of the recommended adjustment of the kinematic chain to a user; andin accordance with a determination that a first user command to execute the recommended adjustment has been received, adjust the pose of the kinematic chain in accordance with the recommended adjustment.

2. The robotic system of claim 1, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to: in accordance with a determination that a user command to execute the recommended adjustment has not been received, forgo adjusting the pose of the kinematic chain.

3. The robotic system of claim 1, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to: receive a second user command while adjusting the pose of the kinematic chain; andin accordance with a determination that the second user command corresponds to a command to abort the recommended adjustment, terminate the adjustment.

4. The robotic system of claim 1, wherein the one or more conditions comprises a pose recognition of the kinematic chain.

5. The robotic system of claim 1, wherein the kinematic chain comprises a robotic arm and an underlying arm support.

6. The robotic system of claim 1, wherein the one or more conditions comprise a joint of the kinematic chain reaching a threshold range of a joint limit.

7. The robotic system of claim 6, wherein the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.

8. The robotic system of claim 1, wherein generating a recommended adjustment of the kinematic chain comprises generating the recommended adjustment in response to the user request.

9. The robotic system of claim 1, wherein generating the recommended adjustment of the kinematic chain further comprises generating a movement trajectory of one or more joints of the kinematic chain.

10. The robotic system of claim 1, wherein: the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain; andthe memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to: display the recommended adjustment as a visualization that compares the recommended pose of the kinematic chain to an actual pose of the kinematic chain.

11. The robotic system of claim 1, wherein the recommended adjustment of the kinematic chain is generated based on a pre-planning of a procedure.

12. The robotic system of claim 1, wherein the recommended adjustment of the kinematic chain is generated based on a pre-determined rule.

13. The robotic system of claim 1, wherein the memory further includes instructions that, when executed by the one or more processors, cause the one or more processors to: determine the recommended adjustment of the kinematic chain via optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.

14. A method performed by a robotic system having a kinematic chain, one or more processors, and a memory storing one or more programs configured for execution by the one or more processors, the method comprising: detecting one or more conditions encountered by the kinematic chain, the one or more conditions correspond to a respective adjustment to a pose of the kinematic chain;presenting a notification of the detected one or more conditions;receiving a first user input, the first user input comprising a decision regarding whether to make an adjustment to the kinematic chain;in response to the first user input, generating a recommended adjustment to the kinematic chain;receiving a second user input comprising user confirmation to execute the recommended adjustment; andin response to the second user input, adjusting a pose of the kinematic chain in accordance with the recommended adjustment.

15. The method of claim 14, wherein the first user input is unprompted.

16. The method of claim 14, wherein the first user input and the second user input are the same user input.

17. The method of claim 14, wherein the one or more conditions comprises a pose recognition of the kinematic chain.

18. The method of claim 14, wherein the one or more conditions comprises a joint of the kinematic chain reaching a threshold range of a joint limit.

19. The method of claim 18, wherein the one or more conditions comprise the joint of the kinematic chain remaining in the threshold range of the joint limit for at least a specified period of time.

20. The method of claim 14, wherein adjusting the pose of the kinematic chain in accordance with the recommended adjustment comprises adjusting the pose of the kinematic chain concurrently with teleoperation of the kinematic chain.

21. The method of claim 14, wherein adjusting a pose of the kinematic chain in accordance with the recommended adjustment comprises halting teleoperation prior to the adjusting.

22. The method of claim 14, wherein the recommended adjustment includes at least one movement trajectory for the kinematic chain.

23. The method of claim 14, wherein the recommended adjustment is based on heuristics, optimization of a pre-determined objective, and/or a pre-planned procedure.

24. The method of claim 14, wherein: the recommended adjustment of the kinematic chain comprises a recommended pose of the kinematic chain;generating the recommended adjustment further comprises generating a visualization that compares the recommended pose to an actual pose of the kinematic chain; anddisplaying the recommended adjustment further comprises displaying the visualization on a user interface of the robotic system.

25. The method of claim 14, wherein the recommended adjustment is based on a pre-planning of a procedure to be performed on the robotic system.

26. The method of claim 14, wherein the recommended adjustment is based on a pre-determined rule.

27. The method of claim 14, wherein the recommended adjustment is based on optimization of a pre-determined objective function associated with a bar pose optimization and/or collision avoidance.

28.-41. (canceled)