SYSTEM AND METHOD FOR DRIVING MEDICAL INSTRUMENT

• US 20190246882A1
• Filed: 02/12/2019
• Published: 08/15/2019
• Est. Priority Date: 02/13/2018
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Auris Health, Inc. (Johnson & Johnson)
• Inventors: Graetzel, Chauncey F., Sheehy, Alexander James
• Granted Patent: US 10,765,303 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 1/00006 of control signals
• CPC Class Codes: A61B 1/0002 provided with data storages
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/0016 using motor drive units
• CPC Class Codes: A61B 1/0057 Constructional details of force transmission elements, e.g. control wires
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 1/2736 Gastroscopes
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2061 using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras

Abstract

Certain aspects relate to systems and techniques for driving a medical instrument having an inner body and an outer body. In one aspect, a system includes a medical instrument comprising an outer body and an inner body configured to be driven through a lumen in the outer body. The system may further include a set of one or more instrument manipulators configured to control movement of the outer and inner bodies and a set of one or more processors configured to: receive a change drive mode command, and in response to receiving the change drive mode command, change a drive mode of the medical instrument from a paired drive mode to an unpaired drive mode.

Claims

1. A robotic surgical system, comprising:

a medical instrument comprising an outer body and an inner body configured to be driven through a lumen in the outer body;

a set of one or more instrument manipulators configured to control movement of the outer and inner bodies;

a set of one or more user input devices;

a set of one or more processors; and

at least one computer-readable memory in communication with the set of processors and having stored thereon computer-executable instructions to cause the set of processors to;

receive, via the set of user input devices, a change drive mode command; and

in response to receiving the change drive mode command, change a drive mode of the medical instrument from a paired drive mode to an unpaired drive mode, wherein a distance between a distal end of the inner body and a distal end of the outer body is maintained at a predetermined distance in response to receiving a drive command from the set of input devices while in the paired drive mode.

2. The robotic surgical system of claim 1, wherein each of the distal ends of the inner body and the outer body are chamfered.

3. The robotic surgical system of claim 1, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that the distance between the distal end of the inner body and the distal end of the outer body is not equal to the predetermined distance;

in response to determining that the distance between the distal end of the inner body and the distal end of the outer is not equal to the predetermined distance, change the drive mode of the medical instrument into the unpaired drive mode; and

advance one of the outer and inner bodies until the distance between the distal end of the inner body and the distal end of the outer body is within the predetermined distance.

4. The robotic surgical system of claim 1, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that the distal end of the inner body extends from the distal end of the outer body by less than the predetermined distance;

in response to determining that the distal end of the inner body extends from a distal end of the outer by less than the predetermined distance, change the drive mode of the medical instrument into an inner body drive mode;

advance the inner body until the distal end of the inner body extends from the distal end of the outer body by the predetermined distance; and

change the drive mode of the medical instrument into the paired drive mode.

5. The robotic surgical system of claim 1, wherein the memory further stores computer-executable instructions to cause the set of processors to:

prior to entering the paired mode, determine that the distal end of the inner body extends from the distal end of the outer body by greater than the predetermined distance;

in response to determining that the distal end of the inner body extends from a distal end of the outer by greater than the predetermined distance, change the drive mode of the medical instrument into an outer body drive mode;

advance the outer body until the distal end of the inner body extends from the distal end of the outer body by the predetermined distance; and

change the drive mode of the medical instrument into the paired drive mode.

6. The robotic surgical system of claim 1, wherein the memory further stores computer-executable instructions to cause the set of processors to:

change the drive mode of the medical instrument to an inner body drive mode in which the inner body is advanced or retracted while the outer body remains stationary.

7. The robotic surgical system of claim 1, wherein the memory further stores computer-executable instructions to cause the set of processors to:

change the drive mode of the medical instrument to an outer body drive mode in which the outer body is advanced or retracted while the inner body remains stationary.

8. The robotic surgical system of claim 6, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices in the inner body drive mode, a retraction command to retract;

in response to receiving the retraction command, retract via the set of instrument manipulators, the inner body;

determine that;

(a) the distance between the distal end of the inner body and the distal end of the outer body is within a tolerance range of the predetermined distance, and (b) a timing condition has been satisfied; and

in response to determining that the distance between the distal end of the inner body and the distal end of the outer body is within the tolerance range of the predetermined distance and that the timing condition has been satisfied, change the drive mode of the medical instrument to the paired drive mode.

9. The robotic surgical system of claim 7, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices in the outer body drive mode, an advancement instruction to advance;

in response to receiving the advancement instruction, advance via the set of instrument manipulators, the outer body;

determine that;

(a) the distance between the distal end of the inner body and the distal end of the outer body is within a tolerance range of the predetermined distance, and (b) the timing condition has been satisfied; and

in response to determining that the distance between the distal end of the inner body and the distal end of the outer body is within the tolerance range of the predetermined distance and the timing condition has been satisfied, change the drive mode of the medical instrument to the paired driving mode.

10. The robotic surgical system of claim 6, wherein the memory further stores computer-executable instructions to cause the set of processors to:

change the drive mode of the medical instrument to an outer body drive mode in which the outer body is advanced or retracted while the inner body remains stationary;

receive, via the set of user input devices, a toggle drive mode command to toggle the drive mode of the medical instrument;

determine, in response to receiving the toggle drive mode command, that the distance between the distal end of the inner body and the distal end of the outer body is not within a tolerance range of the predetermined distance; and

in response to the toggle drive mode command and determining that the distance between the distal end of the inner body and the distal end of the outer body is not within the tolerance range of the predetermined distance, toggle the drive mode of the medical instrument between the inner body drive mode and the outer body drive mode.

11. The robotic surgical system of claim 6, wherein the memory further stores computer-executable instructions to cause the set of processors to:

change the drive mode of the medical instrument to an outer body drive mode in which the outer body is advanced or retracted while the inner body remains stationary;

receive, via the set of user input devices, a toggle drive mode command to toggle the drive mode of the medical instrument;

determine, in response to receiving the toggle drive mode command, that the distance between the distal end of the inner body and the distal end of the outer body is equal to the predetermined distance; and

in response to the toggle drive mode command and determining that the distance between the distal end of the inner body and the distal end of the outer body is equal to the predetermined distance, toggle the drive mode of the medical instrument between the inner body drive mode and the paired drive mode.

12. The robotic surgical system of claim 1, wherein:

the set of one or more instrument manipulators comprises at least three instrument manipulators,

the medical instrument further comprises a robotically controlled surgical instrument configured to be driven through a lumen in the inner body,

the outer body, the inner body, and the robotically controller surgical instrument are respectively coupled to the three instrument manipulators.

13. A robotic surgical system, comprising:

a medical instrument comprising an outer body and an inner body configured to be driven through a lumen in the outer body;

a set of one or more instrument manipulators configured to control movement of the outer and inner bodies;

a set of one or more user input devices;

a set of one or more processors; and

at least one computer-readable memory in communication with the set of processors and having stored thereon computer-executable instructions to cause the set of processors to;

receive, via the set of user input devices, an articulation command to articulate the medical instrument;

treat one of the outer and inner bodies as a primary body and the other one of the outer and inner bodies as a secondary body;

determine the distance between a distal end of the inner body and a distal end of the outer body;

determine a co-articulation factor based on the determined distance;

articulate, via the set of instrument manipulators, the primary body based on the articulation command; and

articulate, via the set of instrument manipulators, the secondary body based on the articulation command and the co-articulation factor.

14. The robotic surgical system of claim 13, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices, a drive mode command for driving the medical instrument in one of a plurality of drive modes,

treat the primary and secondary bodies based on the drive mode command.

15. The robotic surgical system of claim 13, wherein the co-articulation factor comprises a co-articulation ratio that relates an amount of a property of articulation applied to the primary body to an amount of the property of articulation applied to the secondary body.

16. The robotic surgical system of claim 15, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that the determined distance falls outside of a predetermined range of distances; and

in response to determining that the determined distance falls outside of the predetermined range of distances, disable the co-articulation ratio.

17. The robotic surgical system of claim 13, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that the determined distance falls within the predetermined range of distances; and

in response to determining that the determined distance falls within the predetermined range of distances, determine the co-articulation ratio based on a predetermined function that relates the determined distance to the co-articulation ratio,

wherein the co-articulation ratio determined based on the predetermined function decreases as the determined distance increases.

18. The robotic surgical system of claim 17, wherein the predetermined function comprises a first function used in response to the primary body being the inner body and a second function used in response to the primary body being the outer body.

19. The robotic surgical system of claim 13, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices, a relaxation command to relax the medical instrument;

relax, via the set of instrument manipulators, the primary body based on the relaxation command; and

relax, via the set of instrument manipulators, the second body based on the relaxation command and the co-articulation factor.

20. The robotic surgical system of claim 19, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that the primary body has relaxed; and

in response to determining that the primary body has relaxed, relax, via the set of instrument manipulators, the second body based on the relaxation command independent of the co-articulation factor.

21. The robotic surgical system of claim 13, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices, a disable co-articulation command; and

in response to receiving the disable co-articulation command, articulate, via the set of instrument manipulators, the primary body based on the articulation command without articulating the secondary body.

22. The robotic surgical system of claim 13, wherein each of the outer and inner bodies comprises:

i) a set of one or more tendons configured to apply tension for articulation of the corresponding outer or inner body, and ii) a set of one or more tension monitors configured to monitor tension in a corresponding one or more of the tendons, the memory further storing computer-executable instructions to cause the set of processors to;

measure the tension in one of the tendons of at least one of the outer and inner bodies based on output received from the corresponding tension monitors;

compare the measured tension to one or more thresholds; and

modify the articulation applied to the at least one of the outer and inner bodies in response to the measured tension being greater than at least one of the thresholds.

23. The robotic surgical system of claim 13, wherein the one or more thresholds comprise first to fourth thresholds, the memory further storing computer-executable instructions to cause the set of processors to:

slow a speed of articulation in response to the measured tension being greater than the first threshold;

limit articulation to a maximum articulation value in response to the measured tension being greater than the second threshold;

automatically relax the at least one of the outer and inner bodies in response to the measured tension being greater than the third threshold; and

generate a fault condition in response to the measured tension being greater than the fourth threshold.

24. The robotic surgical system of claim 13, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices, a retraction command to retract the medical instrument;

in response to receiving the retraction command, retracting via the set of instrument manipulators, the medical instrument;

determine that a distance the medical instrument has retracted is greater than a threshold distance; and

in response to determining that the distance the medical instrument has retracted is greater than a threshold distance, automatically relax the medical instrument.

25. A robotic surgical system, comprising:

a medical instrument comprising an outer body and an inner body configured to be driven through a lumen in the outer body;

a set of one or more instrument manipulators configured to control movement of the outer and inner bodies;

a set of one or more feedback devices;

a set of one or more processors;

at least one computer-readable memory in communication with the set of processors and having stored thereon a model of a mapped portion of the luminal network, a position of a target with respect to the model, and a path along the model from an access point to the target, the memory further storing computer-executable instructions to cause the set of processor to;

identify a portion of the luminal network along the path having a shape matching a park assistance signature; and

cause, on at least a portion of the set of feedback devices, a parking indication at a position corresponding to the identified portion with respect to the model, the parking indication representing a place to park the distal end of the outer body.

26. The robotic surgical system of claim 25, wherein the set of one or more feedback devices comprises a set of one or more displays, the memory further storing computer-executable instructions to cause the set of processors to:

cause, on at least a portion of the set of displays, a rendering of the model and the parking indication at a position corresponding to the identified portion, the parking indication representing a place to park the distal end of the outer body.

27. The robotic surgical system of claim 26, wherein the memory further stores computer-executable instructions to cause the set of processors to:

determine that a distance from the identified portion to the target is less than a threshold insertion distance for the inner body; and

in response to determining that the distance from the identified portion to the target is less than the threshold insertion distance for the inner body, cause the rendering of the parking indication.

28. The robotic surgical system of claim 26, further comprising a set of one or more user input devices, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input device, an outer body park instruction to park the outer body at a current location;

determine that a distance from the current location to the target is more than a threshold insertion distance for the inner body; and

in response to determining that the distance from the current location to the target is more than a threshold insertion distance for the inner body, cause, on at least a portion of the set of displays, a rendering of an indication that the target is not reachable by the inner body with the outer body parked at the current location.

29. The robotic surgical system of claim 26, wherein the park assistance signature is determined based on previously performed medical procedures, each comprising a path having a shape matching the park assistance signature.

30. The robotic surgical system of claim 26, further comprising a set of one or more user input devices, wherein the memory further stores computer-executable instructions to cause the set of processors to:

receive, via the set of user input devices, a selection identifying the portion of the luminal network as the parking indication.