TECHNICAL FIELD

Systems and methods disclosed herein relate to robotic medical systems, and more particularly, to axial motion drive devices and related systems and methods for driving axial motion of elongated shafts of medical instruments in robotic medical systems.

BACKGROUND

Medical procedures, such as endoscopy, may involve accessing and visualizing the inside of a patient's anatomy for diagnostic and/or therapeutic purposes. For example, gastroenterology, urology, and bronchology involve medical procedures that allow a physician to examine patient lumens, such as the ureter, gastrointestinal tract, and airways (bronchi and bronchioles). During these procedures, a thin, flexible tubular tool or instrument, known as an endoscope, is inserted into the patient through an orifice (such as a natural orifice) and advanced towards a tissue site identified for subsequent diagnosis and/or treatment. The medical instrument can be controllable and articulable to facilitate navigation through the anatomy.

SUMMARY

In a first aspect, a robotic medical system, is disclosed that comprises: a medical instrument comprising an instrument base and an elongated shaft configured for insertion into a patient; a first robotic arm, wherein the instrument base of the medical instrument is attached to the first robotic arm and the first robotic arm is articulable to move the instrument base; a second robotic arm; a drive device attached to the second robotic arm and distal relative to the instrument base, wherein the drive device is engaged with and configured to drive axial motion of the elongated shaft of the medical instrument; and a processor configured to, during a first period of axial motion drive axial motion of the elongated shaft of the medical instrument with the drive device at a first axial motion rate that is greater than a movement rate of the first robotic arm.

The robotic medical system may include one or more of the following features in any combination: (a) wherein, during the first period of axial motion, a portion of the elongated shaft of the medical instrument between the instrument base and the drive device has a length greater than a distance between the instrument base and the drive device such that the portion of the elongated shaft forms a service loop; (b) wherein, during the first period of axial motion, a rate of change of a length of the service loop is greater than a rate of change of the distance between the between the instrument base and the drive device; (c) wherein the axial motion comprises at least one of retraction or insertion of the elongated shaft; (d) wherein the processor is configured to drive axial motion of the elongated shaft at the first axial motion rate when a distal tip of the elongated shaft is positioned within an access sheath; (e) wherein the processor is configured to, during a second period of axial motion, drive axial motion of the elongated shaft of the medical instrument with the drive device at a second axial motion rate that is equal to or less than the movement rate of the first robotic arm; (f) wherein, during the second period of axial motion, a portion of the elongated shaft of the medical instrument between the instrument base and the drive device has a length substantially equal to a distance between the instrument base and the drive device such that the portion of the elongated shaft does not form a service loop; (g) wherein, during the second period of axial motion, a portion of the elongated shaft of the medical instrument between the instrument base and the drive device has a length greater than a distance between the instrument base and the drive device such that the portion of the elongated shaft forms a service loop; (h) wherein, during the second period of axial motion, a rate of change of the length is equal to or less than a rate of change of the distance between the between the instrument base and the drive device; (i) wherein the processor is configured to drive axial motion of the elongated shaft at the second axial motion rate when a distal tip of the elongated shaft is positioned beyond an access sheath; (j) wherein the drive device is configured to attach to an access sheath configured to be inserted into the patient, and the elongated shaft is configured to be inserted into the patient through the access sheath; (k) wherein the drive device comprises a clip configured to attach to a proximal end of the access sheath; (l) wherein the drive device is configured to withdraw a distal tip of the elongated shaft from a proximal end of the access sheath, and reinsert the distal tip of the elongated shaft into the proximal end of the access sheath; (m) an instrument driver comprising a plurality of drive outputs positioned at a distal end of the second robotic arm, wherein the drive device comprises a plurality of drive inputs configured to engage the plurality of drive outputs of the instrument driver; (n) a sterile adapter positioned between the instrument driver and the drive device; (o) wherein the drive device comprises a pair of opposing rollers configured to drive axial motion of the elongated shaft; (p) wherein the drive device comprises a body comprising a channel configured to receive the elongated shaft of the medical instrument, a roller configured to engage with the elongated shaft, wherein the second robotic arm is configured to rotate the roller to drive axial motion of the elongated shaft received in the channel, and a pivotable carrier supporting the roller, wherein the second robotic arm is configured to pivot the carrier to selectively engage or disengage the roller with the elongated shaft; (q) wherein, based on receiving a roll command to roll the elongated shaft, the processor is configured to cause the first robotic arm to rotate the elongated shaft about a longitudinal axis of the elongated shaft, and the second robotic arm to disengage the drive device from the elongated shaft; and/or other features as described throughout this application.

In another aspect, a robotic medical system is disclosed that comprises: a medical instrument comprising an instrument base and a flexible shaft configured for insertion into a patient; a first robotic arm attachable to the instrument base of the medical instrument; a drive device configured to engage the flexible shaft; and a second robotic arm attachable to the drive device, wherein the second robotic arm is configured to operate the drive device to drive axial motion of the flexible shaft, and wherein the first robotic arm is configured to move in coordination with operation of the drive device.

The robotic medical system may include one or more of the following features in any combination: (a) wherein the second robotic arm is configured to disengage the drive device from the flexible shaft while retaining the flexible shaft in the drive device with a robotically-actuated cover; (b) wherein the second robotic arm is configured to control a rate of the axial motion based on a position of a tip of the flexible shaft relative to an access sheath; (c) wherein the second robotic arm is configured to expand or contract a service loop in a portion of the flexible shaft between the first and second robotic arms; (d) wherein the medical instrument is an endoscope; and/or other features as described throughout this application.

In another aspect, a robotic medical system is disclosed that comprises: a first robotic arm configured to support an instrument base of a medical instrument, the medical instrument comprising an elongated shaft extending from the instrument base; and a second robotic arm configured to operate one or more rollers engageable with the elongated shaft to drive axial motion of the elongated shaft.

The robotic medical system may include one or more of the following features in any combination: (a) wherein the one or more rollers comprise a pair of opposing rollers of a drive device attached to the second robotic arm and configured to drive axial motion of the flexible shaft; (b) wherein the second robotic arm is configured to disengage the drive device from the flexible shaft and retain the flexible shaft in the drive device with a robotically-actuated cover; and/or other features as described throughout this application.

In another aspect, a method is disclosed that comprises: supporting, with a first robotic arm, an instrument base of a medical instrument; driving, with a second robotic arm, axial motion of an elongated shaft of the medical instrument; and moving the first robotic arm in concert with driving the axial motion.

The method may include one or more of the following features in any combination: (a) wherein driving the axial motion comprises operating a pair of opposing rollers with the second robotic arm; (b) wherein the first robotic arm moves at a rate slower than the axial motion of the elongated shaft; (c) wherein the second robotic arm is configured to disengage a drive device from the elongated shaft while retaining the elongated shaft in the drive device with a robotically-actuated cover; and/or other features as described throughout this application.

In another aspect, a drive device configured to facilitate axial motion of an elongated shaft of a medical instrument is disclosed that comprises: a housing comprising a lower surface configured to mount to a robotic arm and an upper surface with a channel formed therein, the channel configured to receive the elongated shaft of the medical instrument; a first roller positioned within the housing on a first side relative to the channel; and a second roller positioned within the housing on a second side relative to the channel; wherein the first and second rollers are movable between a first position and a second position; wherein, in the first position, the first and second rollers are configured to engage with the elongated shaft such that when rotated in a first direction, the first and second rollers drive insertion of the elongated shaft, and when rotated in a second direction, the first and second rollers drive retraction of the elongated shaft; and wherein, in the second position, the first and second rollers are spaced apart from the elongated shaft.

The drive may include one or more of the following features in any combination: (a) a proximal clip positioned at a proximal end of the channel; (b) a distal clip positioned at a distal end of the channel; (c) wherein the proximal and distal clips are configured to retain the elongated shaft within the channel; (d) a cover, wherein the cover is operable to close the channel when the first and second rollers are in the first position and to open the channel when the first and second rollers are in the second position; (e) wherein movement of the cover is mechanically linked to movement of one of the first roller and the second roller such that the cover opens and closes as the first and second rollers move between the second and first positions; (f) wherein, at an intermediate position between the first and the second positions, the cover remains closed and the first and second rollers disengage from the elongated shaft; (g) a collector distal to the channel for depositing objects retrieved from within the patient using the medical instrument; (h) a clip configured to support a proximal end of an access sheath; (i) a space for depositing objects retrieved from within the patient using the medical instrument between the clip and the channel; (j) a first spring positioned within the housing and configured to bias the first roller toward the first position, and a second spring positioned within the housing and configured to bias the second roller towards the first position; (k) wherein the first and second springs comprise torsion springs; (l) a first carrier plate positioned within the housing and configured to rotate about a first axis, wherein the first roller is mounted to the first carrier plate and rotation of the first carrier plate moves the first roller between the first position and the second position, and a second carrier plate positioned within the housing and configured to rotate about a second axis, wherein the second roller is mounted to the second carrier plate and rotation of the second carrier plate moves the second roller between the first position and the second position; (m) a first roller drive input positioned on the lower surface of the housing, a first gear mounted on the first carrier plate and driven by the first roller drive input, a first orbital gear mounted on the first carrier plate and driven by the first gear, wherein rotation of the first orbital gear drives rotation of the first roller, a second roller drive input positioned on the lower surface of the housing, a second gear mounted on the second carrier plate and driven by the second roller drive input, and a second orbital gear mounted on the second carrier plate and driven by the second gear, wherein rotation of the second orbital gear drives rotation of the second roller; (n) wherein the first axis about which the first carrier plate rotates is coaxial with an axis of the first roller input, and the second axis about which the second carrier plate rotates is coaxial with an axis of the second roller input; (o) wherein the first carrier plate and the second carrier plate are geared together such that rotation of one of the first carrier plate and the second carrier plate causes rotation of the other of the first carrier plate and the second carrier plate; (p) a carrier plate rotation drive input configured to rotate one of the first carrier plate or the second carrier plate; (q) an off-axis protrusion coupled to the rotation drive input and configured to contact a pocket of the carrier plate to cause rotation of the first carrier plate; and/or other features as described through this application.

In another aspect, a drive device configured to facilitate axial motion of an elongated shaft of a medical instrument is disclosed that comprises: a body comprising a channel configured to receive the elongated shaft of the medical instrument; a roller configured to engage with the elongated shaft such that, when rotated, the roller drives axial motion of the elongated shaft received in the channel; a first drive input coupled to the body, wherein the first drive input is operable by a robotic system to rotate the roller; a cover configured to selectively open or close the channel; and a second drive input coupled to the body, wherein the second drive input is operable to actuate the cover.

The drive device may include one or more of the following features in any combination: (a) wherein the second drive input is operable to actuate the cover between a first position, where the cover retains the elongated shaft in the channel, and a second position, where the cover permits loading or unloading of the elongated shaft in the channel; (b) a carrier supporting the roller, wherein the carrier is pivotable by a drive input coupled to the body to engage or disengage the elongated shaft received in the channel; (c) wherein the body is configured to attach to an access sheath to align the channel to the access sheath; (d) wherein the second drive input is operatively coupled to the cover via a cam; (e) one or more clips in the channel; (f) wherein the roller is a first roller, and the drive device further comprises a second roller opposing the first roller; and/or other features as described throughout this application.

In another aspect, a robotic medical system is disclosed that comprises: a drive device comprising a channel configured to receive an elongated shaft, one or more rollers configured to engage the elongated shaft received in the channel, and a cover configured to selectively close or open the channel; and a driver configured to: actuate the drive device to a first state, where the one or more rollers are disengaged from the elongated shaft and the cover is open; actuate the drive device to a second state, where the one or more rollers are disengaged from the elongated shaft and the cover is closed; and actuate the drive device to a third state, where the one or more rollers are engaged with the elongated shaft and the cover is closed.

The robotic medical system may include one or more of the following features in any combination: (a) wherein the driver is configured to actuate the drive device to the first state based on a command to load or unload the elongated shaft; (b) wherein the driver is configured to actuate the drive device to the second state based on a command to roll the elongated shaft; (c) wherein the driver is arranged at an end of a robotic arm, and wherein the driver is configured to actuate the drive device to the second state based on a command to move the robotic arm; (d) wherein the driver is configured to actuate the drive device in the third state to insert or retract the elongated shaft; (e) wherein the driver is configured to operate a first drive input of the drive device to rotate the rollers against the elongated shaft, and operate a second drive input of the drive device to disengage the rollers from the elongated shaft; and/or other features as described throughout this application.

In another aspect, a method for a robotic medical procedure is disclosed the comprises: driving insertion of an flexible shaft of a medical instrument with a drive device at a first rate during a first insertion period wherein a distal tip of the flexible shaft is positioned within an access sheath inserted into a patient; and transitioning to driving insertion of the flexible shaft of the medical instrument with the drive device at a second rate that is slower than the first rate during a second insertion period when the distal tip of the flexible shaft is positioned beyond a distal tip of the access sheath.

The method system may include one or more of the following features in any combination: (a) wherein transitioning to driving insertion of the flexible shaft of the medical instrument with the drive device at the second rate comprises automatically detecting when the distal tip of the flexible shaft is positioned beyond a distal tip of the access; (b) driving retraction of the flexible shaft of the medical instrument with the drive device at a third rate during a first retraction period wherein the distal tip of the flexible shaft is positioned beyond the distal tip of the access sheath, and automatically transitioning to driving retraction of the flexible shaft of the medical instrument with the drive device at a fourth rate that is faster than the third rate during a second retraction period when the distal tip of the flexible shaft is positioned within the access sheath; (c) wherein automatically transitioning to driving retraction of the flexible shaft of the medical instrument with the drive device at the fourth rate comprises detecting when the distal tip of the flexible shaft is positioned within the access sheath; (d) mounting an instrument base of the medical instrument on a first robotic arm, mounting the drive device on a second robotic arm, and engaging the flexible shaft of the medical instrument with the drive device; (e) wherein engaging the flexible shaft of the medical instrument with the drive device comprises engaging opposing rollers of the drive device with the flexible shaft; (f) wherein engaging the flexible shaft of the medical instrument with the drive device further comprises inserting the flexible shaft into a channel on an upper surface of the drive device; (g) moving the instrument base towards the drive device with the first robotic arm during insertion, and moving the instrument base away from the drive device with the first robotic arm during retraction; and/or other features as described throughout this application.

In another aspect. a robotic medical system is disclosed that comprises: a drive device comprising a pair of rollers configured to engage a shaft of a medical instrument; a processor configured to: operate the rollers to drive insertion of the shaft at a first rate during a first insertion period when a distal tip of the shaft is positioned within an access sheath inserted into the patient; and operate the rollers to transition to driving insertion of the shaft at a second rate that is slower than the first rate during a second insertion period when the distal tip of the shaft is positioned beyond a distal tip of the access sheath.

The robotic medical system may include one or more of the following features in any combination: (a) wherein the processor is configured to detect when the distal tip of the shaft is positioned beyond a distal tip of the access sheath based on geometric information associated with the access sheath and the shaft; (b) wherein the processor is configured to detect when the distal tip of the shaft is positioned beyond a distal tip of the access sheath based on image information obtained with the medical instrument; (c) wherein the processor is further configured to operate the rollers to drive retraction of the shaft of the medical instrument at a third rate during a first retraction period when the distal tip of the shaft is positioned beyond the distal tip of the access sheath, and operate the rollers to transition to driving retraction of the shaft of the medical instrument at a fourth rate that is faster than the third rate during a second retraction period when the distal tip of the shaft is positioned within the access sheath; (d) a first robotic arm configured to support the medical instrument, and a second robotic arm configured to support the drive device; (e) wherein the first robotic arm is configured to move an instrument handle of the medical instrument towards the drive device during insertion, and the first robotic arm is configured to move the instrument handle away from the drive device during retraction; and/or other features as described throughout this application.

In another aspect, a robotic medical system is disclosed that comprises: an elongated flexible access sheath; a medical instrument comprising an elongated flexible shaft; and a processor configured to: drive insertion of the shaft at a first rate during a first insertion period when a distal tip of the shaft is positioned within the access sheath; and transition to driving insertion of the shaft at a second rate that is slower than the first rate during a second insertion period when the distal tip of the shaft is positioned beyond a distal tip of the access sheath.

The robotic medical system may include one or more of the following features in any combination: (a) wherein the processor is configured to detect when the distal tip of the shaft is positioned beyond a distal tip of the access sheath based on geometric information associated with the access sheath and the shaft; (b) wherein the processor is configured to detect when the distal tip of the shaft is positioned beyond a distal tip of the access sheath based on image information obtained with the medical instrument; (c) wherein the processor is further configured to drive retraction of the shaft of the medical instrument at a third rate during a first retraction period when the distal tip of the shaft is positioned beyond the distal tip of the access sheath, and transition to driving retraction of the shaft of the medical instrument at a fourth rate that is faster than the third rate during a second retraction period when the distal tip of the shaft is positioned within the access sheath; (d) wherein the processor is configured to operate a drive device to drive axial motion of the elongated flexible shaft, move an instrument handle of the medical instrument towards the drive device during insertion, and move the instrument handle away from the drive device during retraction; and/or other features as described throughout this application.

