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WO2025019679A1 - Positionnement d'un dispositif d'imagerie pour visualiser une partie d'un instrument pendant l'insertion de l'instrument - Google Patents

Positionnement d'un dispositif d'imagerie pour visualiser une partie d'un instrument pendant l'insertion de l'instrument Download PDF

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Publication number
WO2025019679A1
WO2025019679A1 PCT/US2024/038558 US2024038558W WO2025019679A1 WO 2025019679 A1 WO2025019679 A1 WO 2025019679A1 US 2024038558 W US2024038558 W US 2024038558W WO 2025019679 A1 WO2025019679 A1 WO 2025019679A1
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WO
WIPO (PCT)
Prior art keywords
instrument
configuration
control system
view
computer
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/US2024/038558
Other languages
English (en)
Inventor
Pavel Chtcheprov
Paul G. GRIFFITHS
Sophia R. HANNAFORD
Xingchi HE
Goran A. LYNCH
Paul W. Mohr
Daniel W. NISSENBAUM
Trevor PIER
Jason A. PILE
Prasad V. Upadrasta
Zhuoqun XU
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Intuitive Surgical Operations Inc
Original Assignee
Intuitive Surgical Operations Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Intuitive Surgical Operations Inc filed Critical Intuitive Surgical Operations Inc
Publication of WO2025019679A1 publication Critical patent/WO2025019679A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Leader-follower robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/32—Surgical robots operating autonomously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/302—Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

Definitions

  • the present disclosure relates generally to computer-assisted systems and more particularly to positioning an imaging device to view a portion of an instrument during insertion of the instrument.
  • Some computer-assisted systems include one or more instruments that are articulated in order to perform various procedures.
  • the computer-assisted system can be automated, semi-automated, teleoperated, etc.
  • a human operator manipulates one or more leader input controls to command motion of one or more follower instruments located in a workspace.
  • the teleoperated system is configured to support an instrument that includes an imaging device, such as an endoscope or a camera, that enables the operator to observe the workspace.
  • the field of view of the imaging device is directed to enable the operator to see the instrument s) as the operator commands motion of the instrum ent(s).
  • the computer-assisted system includes multiple repositionable structures, such as manipulator arms, where one or more instruments or other devices are mounted to each of the repositionable structures.
  • a first instrument comprising an imaging device is mounted to a first repositionable structure and is directed towards a worksite
  • a second instrument such as a catheter, electrocautery device, cutting device, grasping device, stapler, etc.
  • the second instrument is moved within a workspace to perform a task at the worksite, such as to manipulate specific tissue within the interior anatomy of a patient in a medical example, an operator often observes the movement of the second instrument in one or more images captured by the imaging device.
  • Example medical imaging devices include endoscopes, ultrasound probes, hyperspectral sensors, etc.
  • the distal portion of the second instrument comprises the end effector.
  • Being able to observe the distal portion as the second instrument is introduced into the workspace helps the operator to understand the location of the distal portion in the workspace and relative to the worksite, and potentially avoid collisions between the distal portion and objects in the workspace (in a medical example, other instruments, patient tissue, etc.), etc. This can help increase the efficiency and effectiveness of operation, reduce operating time for a procedure, reduce likelihood of undesirable motions, etc.
  • improved techniques for viewing instruments as they are introduced into the workspace are desirable.
  • a computer-assisted system includes a computer-assisted system includes a first repositionable structure configured to support a first instrument, the first instrument comprising an imaging device with a field of view, wherein the first repositionable structure supporting the first instrument comprises a first plurality of links coupled by a first plurality of joints.
  • the computer-assisted system further includes a second repositionable structure configured to support a second instrument.
  • the computer-assisted system further includes a control system comprising one or more processors, the control system communicatively coupled to the first repositionable structure and the second repositionable structure.
  • the control system is configured to, while the first repositionable structure is supporting the first instrument: in response to detecting an indication to track an insertion of the second instrument into a workspace, determine a configuration of the first plurality of joints that poses the field of view to include an intermediate position for a distal portion of the second instrument as the second instrument is inserted into the workspace, and in response to determining the configuration, command the first plurality of joints toward the configuration.
  • a method comprises, while a first repositionable structure is supporting a first instrument: in response to detecting an indication to track an insertion of the second instrument into a workspace, determining, by a control system, a configuration of a first plurality of joints that poses the field of view to include an intermediate position for a distal portion of a second instrument as a second instrument is inserted into the workspace, and, in response to determining the configuration, commanding, by the control system, the first plurality of joints toward the configuration.
  • one or more non-transitory machine-readable media include a plurality of machine-readable instructions which when executed by a control system are adapted to cause the control system to perform any of the methods described herein.
  • Figure 1 is a diagram of a computer-assisted system in accordance with one or more embodiments.
  • Figure 2 is a flow diagram of method steps for manipulating an imaging device when inserting an instrument in a computer-assisted system in accordance with one or more embodiments.
  • Figures 3 A-3F illustrate facilitating viewing of an instrument by an imaging device.
  • spatially relative terms such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like-may be used to describe the relation of one element or feature to another element or feature as illustrated in the figures.
  • These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of the elements or their operation in addition to the position and orientation shown in the figures. For example, if the content of one of the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features.
  • a device may be otherwise oriented and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes include various special element positions and orientations.
  • the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context indicates otherwise.
  • the terms “comprises”, “comprising”, “includes”, and the like specify the presence of stated features, steps, operations, elements, and/or components but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups. Components described as coupled may be electrically or mechanically directly coupled, or they may be indirectly coupled via one or more intermediate components.
  • position refers to the location of an element or a portion of an element (e.g., three degrees of translational freedom in a three-dimensional space, such as along Cartesian x- , y-, and z-coordinates).
  • orientation refers to the rotational placement of an element or a portion of an element (e.g., three degrees of rotational freedom in three-dimensional space, such as about roll, pitch, and yaw axes, represented in angle-axis, rotation matrix, quaternion representation, and/or the like).
  • proximal refers to a direction toward a base of the kinematic series
  • distal refers to a direction away from the base along the kinematic series
  • a pose refers to the multi-degree of freedom (DOF) spatial position and orientation of a coordinate system of interest attached to a rigid body.
  • DOF multi-degree of freedom
  • a pose includes a pose variable for each of the DOFs in the pose.
  • a full 6-DOF pose for a rigid body in three-dimensional space would include 6 pose variables corresponding to the 3 positional DOFs (e.g consecutive x, y, and z) and the 3 orientational DOFs (e.g., roll, pitch, and yaw).
  • a 3-DOF position only pose would include only pose variables for the 3 positional DOFs.
  • a 3-DOF orientation only pose would include only pose variables for the 3 rotational DOFs.
  • a velocity of the pose captures the change in pose over time (e.g., a first derivative of the pose).
  • the velocity would include 3 translational velocities and 3 rotational velocities. Poses with other numbers of DOFs would have a corresponding number of velocities translational and/or rotational velocities.
  • aspects of this disclosure are described in reference to computer-assisted systems, which can include devices that are teleoperated, externally manipulated, autonomous, semiautonomous, and/or the like. Further, aspects of this disclosure are described in terms of an implementation using a teleoperated surgical system, such as the da Vinci® Surgical System commercialized by Intuitive Surgical, Inc. of Sunnyvale, California. Knowledgeable persons will understand, however, that inventive aspects disclosed herein may be embodied and implemented in various ways, including teleoperated and non-teleoperated, and medical and non-medical embodiments and implementations. Implementations on da Vinci® Surgical Systems are merely exemplary and are not to be considered as limiting the scope of the inventive aspects disclosed herein.
  • the instruments, systems, and methods described herein may be used for humans, animals, portions of human or animal anatomy, industrial systems, general robotic, or teleoperated systems.
  • the instruments, systems, and methods described herein may be used for non-medical purposes including industrial uses, general robotic uses, sensing or manipulating non-tissue work pieces, cosmetic improvements, imaging of human or animal anatomy, gathering data from human or animal anatomy, setting up or taking down systems, training medical or non-medical personnel, and/or the like.
  • Additional example applications include use for procedures on tissue removed from human or animal anatomies (with or without return to a human or animal anatomy) and for procedures on human or animal cadavers.
  • these techniques can also be used for medical treatment or diagnosis procedures that include, or do not include, surgical aspects.
  • FIG. 1 is a simplified diagram of an example computer-assisted system 100, according to various embodiments.
  • the computer-assisted system 100 is a teleoperated system.
  • computer-assisted system 100 can be a teleoperated medical system such as a surgical system.
  • computer-assisted system 100 includes a follower device 104 that can be teleoperated by being controlled by one or more leader devices (also called “leader input devices” when designed to accept external input), described in greater detail below.
  • Leader input devices also called “leader input devices” when designed to accept external input
  • Systems that include a leader device and a follower device are referred to as leader-follower systems, and also sometimes referred to as master-slave systems.
  • an input system that includes a workstation 102 (e.g., a console), and in various embodiments the input system can be in any appropriate form and may or may not include a workstation 102.
  • workstation 102 e.g., a console
  • workstation 102 includes one or more leader input devices 106 that are designed to be contacted and manipulated by an operator 108.
  • workstation 102 can comprise one or more leader input devices 106 for use by the hands, the head, or some other body part(s) of operator 108.
  • Leader input devices 106 in this example are supported by workstation 102 and can be mechanically grounded.
  • an ergonomic support 110 e.g., forearm rest
  • operator 108 can perform tasks at a worksite near follower device 104 during a procedure by commanding follower device 104 using leader input devices 106.
  • a display unit 112 is also included in workstation 102.
  • Display unit 112 can display images for viewing by operator 108.
  • Display unit 112 can be moved in various degrees of freedom to accommodate the viewing position of operator 108 and/or to provide control functions as another leader input device.
  • displayed images can depict a worksite at which operator 108 is performing various tasks by manipulating leader input devices 106 and/or display unit 112.
  • images displayed by display unit 112 can be received by workstation 102 from one or more imaging devices arranged at a worksite.
  • the images displayed by display unit 112 can be generated by display unit 112 (or by a different connected device or system), such as for virtual representations of tools, the worksite, or for user interface components.
  • operator 108 When using workstation 102, operator 108 can sit in a chair or other support in front of workstation 102, position his or her eyes in front of display unit 112, manipulate leader input devices 106, and rest his or her forearms on ergonomic support 110 as desired. In some embodiments, operator 108 can stand at the workstation or assume other poses, and display unit 112 and leader input devices 106 can be adjusted in position (height, depth, etc.) to accommodate operator 108.
  • the one or more leader input devices 106 can be ungrounded (ungrounded leader input devices being not kinematically grounded, such as leader input devices held by the hands of operator 108 without additional physical support). Such ungrounded leader input devices can be used in conjunction with display unit 112.
  • operator 108 can use a display unit 112 positioned near the worksite, such that operator 108 manually operates instruments at the worksite, such as a medical instrument in a medical example, while viewing images displayed by display unit 112.
  • Computer-assisted system 100 also includes follower device 104, which can be commanded by workstation 102.
  • follower device 104 can be located near an operating table (e.g., a table, bed, or other support) on which a patient can be positioned.
  • the worksite is provided on an operating table, e.g., on or in a patient, simulated patient, or model, etc. (not shown).
  • the follower device 104 shown includes a plurality of repositionable structures 120, which are sometime referred to as manipulator arms. Each of the repositionable structures 120 is configured to couple to an instrument assembly 122.
  • An instrument assembly 122 can include, for example, an instrument 126.
  • examples of instruments 126 include, without limitation, a sealing instrument, a cutting instrument, a sealing-and-cutting instrument, a suturing instrument (e.g., a suturing needle), a needle instrument (e.g., a biopsy needle), or a gripping or grasping instrument (e.g., clamps, jaws), and/or the like.
  • each instrument assembly 122 is mounted to a distal portion of a respective repositionable structure 120.
  • the distal portion of each repositionable structure 120 further includes a cannula mount 124 which is configured to have a cannula (not shown) mounted thereto.
  • a shaft of an instrument 126 passes through the cannula and into a worksite, such as a surgery site during a surgical procedure.
  • a force transmission mechanism 130 of the instrument assembly 122 can be connected to an actuation interface assembly 128 of the repositionable structure 120 that includes drive and/or other mechanisms controllable from workstation 102 to transmit forces to the force transmission mechanism 130 to actuate the instrument 126.
  • one or more of instruments 126 can include an imaging device for capturing images.
  • the imaging device can include any combination of an endoscope, an optical camera, a hyperspectral camera, ultrasonic sensors, a monoscopic imager, a stereoscopic imager, and/or the like.
  • the imaging device can capture images in any frequency spectrum, including visible light, infrared light, ultraviolet light, and/or the like.
  • the imaging device can include an illumination source to light the region being imaged.
  • the imaging device can be mounted on a straight (e.g., 0 degree) shaft, an angled (e.g., 20 degree, 30 degree, 35 degree, etc.) shaft, and/or the like.
  • one or more of instruments 126 can be an endoscope assembly that includes an imaging device, which can provide captured images of a portion of the worksite to be displayed via display unit 112.
  • a control system 140 is provided external to workstation 102 and communicates with workstation 102.
  • control system 140 can be provided in workstation 102 or in follower device 104.
  • sensed spatial information including sensed position and/or orientation information is provided to control system 140 based on the movement of leader input devices 106.
  • Control system 140 can determine or provide control signals to follower device 104 to control the movement of repositionable structures 120, instrument assemblies 122, and/or instruments 126 based on the received information and operator input.
  • control system 140 supports one or more wired communication protocols, (e.g., Ethernet, USB, and/or the like) and/or one or more wireless communication protocols (e.g., Bluetooth, IrDA, HomeRF, IEEE 1102.11, DECT, Wireless Telemetry, and/or the like).
  • wired communication protocols e.g., Ethernet, USB, and/or the like
  • wireless communication protocols e.g., Bluetooth, IrDA, HomeRF, IEEE 1102.11, DECT, Wireless Telemetry, and/or the like.
  • Control system 140 can be implemented on one or more computing systems.
  • One or more computing systems can be used to control follower device 104.
  • one or more computing systems can be used to control components of workstation 102, such as movement of a display unit 112.
  • control system 140 includes a processor system 150 and a memory 160 storing a control module 170.
  • control system 140 can include one or more processors, non-persistent storage (e.g., volatile memory, such as random access memory (RAM), cache memory), persistent storage (e.g., a hard disk, an optical drive such as a compact disk (CD) drive or digital versatile disk (DVD) drive, a flash memory, a floppy disk, a flexible disk, a magnetic tape, any other magnetic medium, any other optical medium, programmable read-only memory (PROM), an erasable programmable read-only memory (EPROM), a FLASH-EPROM, any other memory chip or cartridge, punch cards, paper tape, any other physical medium with patterns of holes, etc.), a communication interface (e.g., Bluetooth interface, infrared interface, network interface, optical interface, etc.), and numerous other elements and functionalities.
  • non-persistent storage e.g., volatile memory, such as random access memory (RAM), cache memory
  • non-persistent storage and persistent storage are examples of non-transitory, tangible machine readable media that can include executable code that, when run by one or more processors (e.g., processor system 150), can cause the one or more processors to perform one or more of the techniques disclosed herein, including the process of method 200 described below.
  • processor system 150 e.g., processor system 150
  • functionality of control system 140 can be implemented in any technically feasible software and/or hardware in some embodiments.
  • Various embodiments disclose techniques for use with a computer-assisted system 100 configured to support an instrument 126 including an imaging device.
  • the instrument including the imaging device is also referred to as “the imaging instrument.”
  • the imaging instrument is configured to be mounted to a first repositionable structure 120.
  • the control system 140 included in the computer-assisted system 100 drives the first repositionable structure 120 and/or the imaging instrument to automatically position and/or orient (“pose”) the field of view (FOV) of the imaging device to provide images of another instrument 126 during at least part of an insertion of another instrument 126.
  • This technique can support the installation, deployment, and insertion of another instrument 126 into a workspace and/or toward a worksite in the workspace.
  • an instrument 126 including an imaging device (the “imaging instrument”) is already inserted into the patient. Then, another instrument 126 (the “inserted instrument”) is to be deployed to a workspace in the interior anatomy of the patient through a cannula.
  • the cannula is inserted through an opening leading to the interior anatomy, such as through an incision or natural orifice of the patient.
  • the inserted instrument 126 can be any appropriate instrument, and can even include a second imaging device.
  • computer-assisted system 100 can help reposition and/or reorient the imaging device to put the imaging device in a pose where the imaging device can capture images of a position associated with the insertion of the inserted instrument 126.
  • a position include the end of the cannula, a predicted position of a distal portion of the instrument as the instrument is inserted, etc.
  • Example distal portions of the inserted instrument 126 include the tip of an end effector, a clevis (for a jaws instrument), a wrist (for a wristed instrument), a predetermined section on a distal part of a shaft of the instrument, etc.
  • the imaging device pose needs to be changed to be able to locate such a position associated with the insertion of the inserted instrument 126 within a field of view (“FOV”) of the imaging device.
  • FOV field of view
  • the inserted instrument 126 is inserted through an opening into the workspace to perform a task at the worksite, and the opening correlates with a position to be captured by the FOV in this technique.
  • the pose of the imaging device that directs the FOV to include the opening is often different from the pose of the imaging device that directs the FOV to include the worksite. For particular workspaces, worksites, procedures, instrument types and numbers of instruments, and the like, these poses can be very different. The benefits of the computer-assisted system 100 facilitating the process is then quite apparent.
  • the control system 140 receives an indication that a second instrument 126 that is mounted to a second repositionable structure 120 is ready to be inserted into the workspace.
  • this second instrument 126 can be inserted through an opening, such as through a lumen in a port or cannula, or a natural orifice in a patient.
  • the control system 140 determines a configuration of the joints of the first repositionable structure 120 and/or a first instrument 126 that includes an imaging device (the “imaging instrument”) that poses the field of view of the imaging device to include an intermediate position.
  • imaging instrument the imaging device
  • intermediate position is a position that a distal portion of the second instrument 126 would reach as the second instrument 126 is inserted into the workspace.
  • the intermediate position is fixed relative a specified linkjoint, or feature of the repositionable structure, and the control system 140 determines the intermediate position based on kinematic data of the repositionable structure. In some instances, the intermediate position is not fixed to the repositionable structure, and the control system 140 determines the intermediate position by predicting one or more positions of the distal portion during insertion.
  • the second repositionable structure 120 can be designed such that a typical insertion of a second instrument 126 supported by the second repositionable structure 120 would cause a distal portion of the second instrument 126 to traverse through a remote center of motion (RCM) of the second repositionable structure 120.
  • RCM remote center of motion
  • the control system 140 determines a configuration of the joint(s) of the first repositionable structure 120 and/or the imaging instrument that poses the field of view of the imaging device to include the remote center of motion of the second repositionable structure 120.
  • the instrument 126 can be inserted through an opening to reach the workspace.
  • the system can be configured to determine a configuration of the joint(s) of the first repositionable structure 120 and/or the imaging instrument that poses the field of view to include the position of the opening. In determining this configuration, the control system 140 may also determine a physical or digital zoom level of the imaging device. [0040] As shown by these examples, the intermediate position can be determined through preset data, determined dynamically, can be determined through a combination of preset and dynamic data, or the like.
  • the intermediate position can be a position disassociated with any particular physical feature or object in a workspace, such as a distance offset from a part of the repositionable structure from an end of a distal link or mounting feature of a repositionable structure), along a direction defined by the repositionable structure (e.giller an insertion axis, a translational axis of a prismatic link of the repositionable structure, and/or the like), etc.
  • the intermediate position can be associated with tangible features or objects such as a tip of a cannula or an opening allowing access to the workspace.
  • the intermediate position can be based on a stored location of an opening or based on image analysis, kinematics, etc.
  • information about the intermediate position can be entered manually into the system.
  • the intermediate position can be coincident with a tip of a cannula mounted to the second repositionable structure 120 during operation.
  • the system can determine the intermediate position by using kinematic data and one or more kinematic models of the second repositionable structure 120, and a geometric model of the cannula, to determine the position of the tip of the cannula.
  • the models can be complex or simple, depending on the physical structure.
  • the model of the cannula can comprise just offset distances from a mounting location of the cannula to the second repositionable structure 120.
  • the system can use one or more kinematic models of the first repositionable structure 120 and/or the imaging instrument. For example, the system can use such model(s) to determine a configuration of the joints of the first repositionable structure 120 and/or the imaging instrument, such that the configuration would pose the FOV in a manner to include the space at and around the intermediate position. In such a pose, the imaging device can then capture images including the intermediate position, and of the space around the intermediate position.
  • the control system 140 then commands the first repositionable structure 120 and/or the imaging instrument to a configuration which poses the FOV of the imaging device to include the space at and around the intermediate position.
  • the control system 140 can cause the configuration of the first repositionable structure 120 and the imaging instrument to be held at least until the second instrument 126 is detected to have reached or passed the intermediate position.
  • the second instrument 126 supported by the second repositionable structure which is an example of an “inserted instrument 126” described above, is also referred to as “tracked instrument” in the following discussion.
  • the control system 140 determines the location of a distal portion of the tracked instrument 126 as the tracked instrument 126 is inserted.
  • the control system 140 can use any applicable manner of location determination, such as by visual tool tracking, by using the one or more kinematic models, etc.
  • the imaging device is in a pose that can provide images of the space around the intermediate position.
  • the intermediate position is set such that images of the space around the intermediate position include part or all of the opening, the distal portion of the cannula, and/or the distal portion of the tracked instrument 126 as the distal portion emerges from the tracked instrument 126 exits the opening or cannula, and/or the like (along with the surrounding workspace).
  • the control system 140 keeps the first repositionable structure 120 and the imaging instrument in the same configuration. In some embodiments, after the distal portion of the tracked instrument 126 is inserted past the intermediate position (or a tolerance past the intermediate position), the control system 140 uses the one or more kinematic models to determine and command additional configurations of the first repositionable structure 120 and/or the imaging instrument that reposition and/or reorient the FOV of the imaging device so that the imaging device can continue to capture images including the distal portion of the tracked instrument 126 as the distal portion of the tracked instrument 126 is inserted.
  • the imaging device can continue to capture images of the distal portion of the tracked instrument 126 as further insertion of the tracked instrument 126 occurs. In some instances, this further tracking only occurs for insertion and not retraction. In some instances, this further tracking occurs for both insertion and retraction. In some instances, the system determines and commands new configurations such that the FOV of the imaging device is reoriented and/or repositioned to keep the distal portion of the tracked instrument 126 within a central region of the FOV. This updating of configurations can be periodic on a regular time sequence, event driven (e.g., triggered by an amount of movement of the tracked instrument 126 in particular directions or overall), and the like.
  • this workflow is performed only at operator command, or only for particular instruments 126 or repositionable structures 120. In some embodiments, this workflow is repeated for each instrument 126 that is not the imaging instrument, as such instrument 126 is newly inserted into the workspace or re-inserted into the workspace.
  • Each of the one or more processors of processor system 150 can be an integrated circuit for processing instructions.
  • the one or more processors can be one or more cores or micro-cores of a processor, a central processing unit (CPU), a microprocessor, a field-programmable gate array (FPGA), an application-specific integrated circuit (ASIC), a digital signal processor (DSP), a graphics processing unit (GPU), a tensor processing unit (TPU), and/or the like.
  • Control system 140 can also include one or more input devices, such as a touchscreen, keyboard, mouse, microphone, touchpad, electronic pen, or any other type of input device.
  • a communication interface of control system 140 can include an integrated circuit for connecting the computing system to a network (not shown) (e.g perhaps a local area network (LAN), a wide area network (WAN) such as the Internet, mobile network, or any other type of network) and/or to another device, such as another computing system.
  • control system 140 can include one or more output devices, such as a display device (e.g., a liquid crystal display (LCD), a plasma display, touchscreen, organic LED display (OLED), projector, or other display device), a printer, a speaker, external storage, or any other output device.
  • a display device e.g., a liquid crystal display (LCD), a plasma display, touchscreen, organic LED display (OLED), projector, or other display device
  • printer e.g., a printer, a speaker, external storage, or any other output device.
  • speaker e.g., a speaker, external storage, or any other output device.
  • control system 140 can be connected to or be a part of a network.
  • the network can include multiple nodes.
  • Control system 140 can be implemented on one node or on a group of nodes.
  • control system 140 can be implemented on a node of a distributed system that is connected to other nodes.
  • control system 140 can be implemented on a distributed computing system having multiple nodes, where different functions and/or components of control system 140 can be located on a different node within the distributed computing system.
  • one or more elements of the aforementioned control system 140 can be located at a remote location and connected to the other elements over a network.
  • Some embodiments can include one or more components of a teleoperated medical system such as a da Vinci® Surgical System, commercialized by Intuitive Surgical, Inc. of Sunnyvale, California, U.S.A.
  • a teleoperated medical system such as a da Vinci® Surgical System, commercialized by Intuitive Surgical, Inc. of Sunnyvale, California, U.S.A.
  • da Vinci® Surgical Systems are merely examples and are not to be considered as limiting the scope of the features disclosed herein.
  • different types of teleoperated systems having follower devices at worksites, as well as non-teleoperated systems can make use of features described herein.
  • Figure 2 is a flow diagram of method steps for manipulating an imaging device when inserting an instrument in a computer-assisted system 100 in accordance with one or more embodiments.
  • the method steps are described in conjunction with the computer-assisted system 100 of Figure 1 and the examples of Figures 3A-3F and 4A-4G, persons of ordinary skill in the art will understand that any system configured to perform the method steps, in any order, is within the scope of the present disclosure.
  • One or more of the processes 202-216 of method 200 can be implemented, at least in part, in the form of executable code stored on non-transient, tangible, machine-readable media.
  • method 200 can be performed by a control system, such as the control system 140.
  • method 200 can be applied to one or more repositionable structures, such as repositionable structures 120, of a computer-assisted system 100 to direct a field of view of an imaging device to include an intermediate position for a distal portion of an instrument as the instrument is inserted into a workspace.
  • the computer-assisted system 100 continues to maintain the field of view to include an intermediate position for the distal portion until detecting an indication to stop tracking the insertion of the instrument.
  • the control system 140 in response to detecting an indication to stop tracking the insertion of the second instrument 126, commands a display device, such as display unit 112, to display a synthesized view of the distal portion of the second instrument 126 relative to the workspace.
  • the synthesized view can depict the second instrument 126 in poses and positions determined from a model of the second instrument 126.
  • the synthesized view is based on a geometric model of the second instrument 126, modified with kinematic information from the instrument 126 or the repositionable structure 120, or image data from images of the second instrument 126 previously acquired by the imaging device.
  • Figures 3A-3F illustrate facilitating viewing an instrument by an imaging device.
  • Figures 4A-4G illustrate facilitating viewing an instrument by an imaging device as the instrument is inserted toward a worksite.
  • the examples of Figures 3A-3F and 4A-4G are not restrictive, and that other repositionable structures, instruments, behaviors, and/or the like depicted in Figures 3 A-3F and 4A-4G may be different for other computer-assisted systems, different repositionable structures, different imaging devices, different instruments, different DOFs, different procedures, and/or the like.
  • method 200 illustrates processes 202-216, implementations of method 200 may have fewer, more, or different processes than illustrated.
  • various embodiments may lack one or more of processes 202 to 216.
  • various embodiments may lack one, some, or all of process 204, 208, 210, 212, or 216.
  • an embodiment may include processes 202, 206, and 210, and may or may not include the other processes shown in Figure 2; an embodiment may include processes 202, 206, 208, 210, 216, and may or may not include the other processes shown in Figure 2; an embodiment may include processes 202, 206, 212, 214, and may or may not include the other processes shown in Figure 2.
  • some embodiments may have alternatives to one or more of processes 202 to 216.
  • some embodiments may have additional processes not illustrated in Figure 2, such as any of the other processes discussed herein.
  • an embodiment that includes process 204 may also include a process (not shown in Figure 2), to move the first repositionable structure to the first configuration when exiting from tracking the insertion of a tracked instrument.
  • the cannulas 320(0), 322(0), 324(0), and 326(0) are analogous to the cannulas that can be mounted to cannula mounts 124 of Figure 1.
  • a first instrument 330(0) including an imaging device (also called an “imaging instrument”) is mounted onto the first repositionable structure 310(0).
  • a display device 350(0) is used to present images captured by the imaging device of the imaging instrument 330(0) in a field of view of the imaging device.
  • Figure 3A further shows an operator 370(0) positioning a second instrument 340(0) to be supported and controlled by the second repositionable structure 312(0).
  • Figures 3 A-3F depict four repositionable structures 310(0), 312(0), 314(0), and
  • the repositionable structures do not share such a common kinematic base, and are mounted to two or separate carts, configured to be mounted to walls, tables, ceilings, floors independently of each other, etc.
  • the control system may employ registration techniques, applied with appropriate geometric models and reference frame transformations, to locate the repositionable structures, and components such as cannulas and instruments supported by the repositionable structures, relative to each other.
  • Techniques related to registration and frame transforms include those described in U.S. Pat. 9,259,289, filed January 27, 2012, and titled “Estimation of a position and orientation of a frame used in controlling movement of a tool,” U.S. Pat. 11,534,252, filed November 13, 2018, and titled “Master/slave registration and control for teleoperation,” and U.S. Pat. Publication 2023/0028689, filed January 1, 2021, and titled “System and method for inter-arm registration.”
  • the operator 370 has coupled the second instrument 340(1) onto the second repositionable structure 312(1) of the computer-assisted system 100.
  • the other three repositionable structures 310(1), 314(1), and 316(1) remain in the configurations shown in Figure 3A.
  • the display device 350(1) displays an image captured by the imaging device in the imaging instrument 330(1).
  • the computer-assisted system 100 is now ready to enter instrument insertion tracking mode in order to facilitate insertion for the second instrument 340(1).
  • the control system can employ various techniques to detect the indication to enter the instrument insertion tracking mode.
  • the control system detects the indication to enter the instrument insertion tracking mode by receiving a command from the operator 370.
  • the system receives a direct command to enter the instrument insertion tracking mode from the operator 370 pressing one or more buttons. These one or more buttons can be located on the imaging instrument, the repositionable structure to which the imaging instrument is mounted, the second instrument, and/or the second repositionable structure.
  • the system receives a direct command to enter the instrument insertion tracking mode from the operator 370 selecting an option directly or indirectly linked to the instrument insertion tracking mode from a user interface located locally or remotely to the first or second repositionable structure.
  • the operator 370 can generate the command by uttering a voice command, by making a gesture with a hand or other body part, and/or the like.
  • control system determines a signal received to be an indication to enter the instrument insertion tracking mode only during particular modes or stages of a procedure, such as for a setup mode or setup stage, for changing the instrument mounted to a repositionable structure, etc.
  • the control system detects the indication to enter the instrument insertion tracking mode by detecting the mounting of the to-be-inserted instrument before the operator 108 begins using leader input devices 106 to cause follower device 104 to perform tasks at the worksite.
  • the control system detects the indication to enter the instrument insertion tracking mode by detecting an instrument removal and mounting under conditions where the guided tool change mode is not entered, or is exited before the instrument has been inserted.
  • control system detects the indication to enter the instrument insertion tracking mode by detecting that the computer- assisted system 100 was previously in a guided tool change mode, and subsequently exited the guided tool change mode.
  • control system detects the indication to enter the instrument insertion tracking mode by receiving a signal indicative of an insertion movement of an instrument along an insertion axis of the instrument. In some examples, the control system detects the indication to enter the instrument insertion tracking mode by receiving a signal indicative of a mounting of a subsequent instrument to a repositionable structure.
  • the control system stores a first configuration of a first repositionable structure to which a first instrument including an imaging device is mounted.
  • the control system can subsequently retrieve the stored first configuration in later steps if needed.
  • the control system can record the current joint positions of the joints of the first repositionable structure and/or the imaging instrument.
  • the first configuration is stored as a complete kinematic description of the joints of the first repositionable structure.
  • the first configuration poses the field of view of the imaging device in a pre-tracking pose.
  • the control system determines a second configuration of the first repositionable structure that poses the field of view of the imaging device to include an intermediate position for a distal portion of the second instrument as the second instrument is inserted through an opening and into the workspace.
  • the intermediate position can be determined using any appropriate technique, including any of techniques described in conjunction with Figure 1.
  • the control system can employ any of various techniques to determine such second configuration.
  • the control system determines the second configuration by determining what is visualized in the field of view of the imaging device. In some examples, the control system determines the second configuration so as to encompass some particular feature(s) or object(s) (e.gively at least a portion of the cannula, of the target anatomy, and/or of another feature or object) in the field of view of the imaging device.
  • the target anatomy or other object can include the target tissue, one or more instruments, other region(s) of interest, and/or the like.
  • the particular feature(s) or object(s) change depending on context. For example, in some instances, when a second instrument is inserted, a distal portion of the second instrument determined as the particular feature, and the control system determines the second configuration to encompass the distal portion of the second instrument in the field of view.
  • the particular feature when a subsequent instrument is inserted, or mounted to the computer-assisted system, after the second instrument, the particular feature may or may not change.
  • the particular feature does not change (e.g., still the distal portion of the second instrument), and the control system does not determine an updated configuration of the first repositionable structure, and determines updated configurations to continue to encompass the distal portion of the second instrument within in the FOV.
  • the particular feature does change (e.g., to be the distal portion of the subsequent instrument), and the control system determines updated configurations to encompass the distal portion of the subsequent instrument within in the FOV.
  • the particular feature changes to be a composite or average feature (e.g., to be both the distal portion of the second instrument and the distal portion of the subsequent instrument, or a centroid between the distal portions of the second and subsequent instruments), and the control system determines updated configurations to encompass such particular feature within in the FOV.
  • a composite or average feature e.g., to be both the distal portion of the second instrument and the distal portion of the subsequent instrument, or a centroid between the distal portions of the second and subsequent instruments
  • the control system determines the second configuration based on the pre-tracking pose of the field of view associated with the first configuration stored at process 202. For example, in some instances, the control system is configured to determine the second configuration to be as similar to the pre-tracking field of view as reasonable, while also being able to visualize the intermediate position during insertion of the inserted instrument. This can be done using any appropriate method. For example, this can be done by characterizing different parameters of the field of view in the second configuration as compared to the pre-tracking configuration.
  • Example parameters include: amount of translational and rotational displacement, amount of zoom difference, how much of the field of view in the pre-tracking configuration is overlapped by the field of view in the second configuration, location of the intermediate position in the field of view in the second configuration, zoom level in the second configuration, etc. These parameters can be weighed, prioritized, captured in a cost function that optimized for determining the second configuration, or the like.
  • control system determines the second configuration to maintain a visualization of multiple instruments simultaneously in the workspace, such as an already-present instrument at the worksite while a second instrument is being inserted, second and third instruments being inserted simultaneously, etc. Similar approaches to evaluating the visualization of these multiple instruments can be used.
  • the control system determines the second configuration by determining a position and/or an orientation of the field of view of the imaging device so that the field of view includes the space around the intermediate position.
  • the control system can determine the position and/or orientation of the field of view of the imaging device through a model of the field of view, such as based on a position or orientation of imaging sensor(s) of the imaging device, a proxy fixed relative to the field of view such as an image capture portion (e.g., a lens) of the imaging device or an instrument comprising the imaging device, and/or the like.
  • the position and/or orientation can further use kinematic information of a fixture or manipulator supporting the imaging instrument, and forward kinematic calculations to relate the position and/or orientation to a kinematic base of such fixture or manipulator.
  • the control system can further determine the second configuration by aligning a direction of the field of view such that the direction of the field of view intersects the intermediate position.
  • control system determines the second configuration by using inverse kinematics of the first repositionable structure and/or the imaging instrument. Inverse kinematics can be used to determine joint commands for the first repositionable structure and/or the imaging instrument, such as to position or orient the field of view of the imaging device.
  • control system determines the second configuration so that the imaging device is positioned and/or oriented to provide a wider view of the workspace.
  • control system determines the second configuration to include retracting the imaging instrument.
  • control system determines the second configuration such that a base of the field of view is located at or near an end portion of a cannula, or at or near an opening, through which the imaging instrument is inserted.
  • control system determines the second configuration to position the imaging device at a predetermined distance from the intermediate position (e.g., a distance along a vector pointing from the intermediate position toward a central point in the worksite), in a direction defined based on an insertion axis of the tracked instrument, to include a predetermined pose of one or more links of the first repositionable structure, a combination of one or more of the foregoing, and/or the like.
  • control system can determine the second configuration to include a change of a zoom level of the imaging device to achieve a narrower or wider view of the workspace than the initial configuration. Adjusting the zoom level of the imaging device can help bring the region around the intermediate position into the field of view the imaging device.
  • control system can determine the second configuration to include a change in the zoom level based on the distance between the imaging portion of the imaging device and the intermediate position.
  • the zoom mechanism can include an optical zoom mechanism, a digital zoom mechanism, physical movement of the imaging device, and/or the like.
  • control system can determine the second configuration to include a pan of the imaging device to achieve a different view of the workspace.
  • control system can determine the second configuration to include a panning of the field of view based on the distance between the imaging device and the intermediate position.
  • the pan mechanism can include an optical pan mechanism, a digital pan mechanism, physical movement of the imaging device, a combination of one or more of the foregoing, and/or the like.
  • the control system can determine the second configuration so that the intermediate position is positioned in a central region of the field of view of the imaging device when the second configuration is adopted.
  • the control system can determine positions of the joints of the first repositionable structure to locate the intermediate position in a central region of the field of view.
  • the control system can determine the configuration of the joints of the first repositionable structure based on kinematics, image processing, using kinematic or geometric models of the first repositionable structure and the imaging instrument, accessing pre-stored parameters about the imaging device or the system itself, using real-time data received regarding the environment or the system, and/or the like.
  • the control system does not determine updated configurations to update the pose of the FOV and track the tracked instrument as the tracked instrument moves.
  • the FOV does not translate or rotate as the tracked instrument is inserted past the intermediate position, even as the distal portion of the tracked instrument is inserted past the FOV and can no longer be visualized by the imaging device.
  • the control system has determined the second configuration such that the FOV includes both the intermediate position and the worksite, such that the imaging device can visualize the insertion of the second instrument to the worksite without further changes in FOV pose.
  • a zoom level of the imaging device is changed as the second instrument is inserted, such as to zoom out and maintain the distal portion of the second instrument in the FOV as the second instrument is inserted.
  • the control system determines the second configuration to reduce the likelihood of collision. For example, the control system can determine the second configuration with a greater preference (e.g., by applying weights, priorities, costs) for lower joint speeds, joint positions that result in less displacement of the repositionable structure and/or the imaging instrument, that place the relevant portion(s) of the repositionable structure and the imaging system at least a predetermined distance from personnel, objects, other instruments, other repositionable structures of the computer-assisted system 100, etc. In some instances, the control system determines the second configuration with greater preference for one or more degrees of freedom, such as a roll degree of freedom.
  • a pure roll of the imaging instrument about the shaft axis moves the field of view without substantive change to a volume occupied by the imaging instrument.
  • the control system can determine the second configuration to limit an amount of motion of the field of view of the imaging device, an amount of motion of the imaging instrument, and/or an amount of motion of the first repositionable structure when moving from the first configuration to the second configuration.
  • the control system can limit at least one degree of freedom by allowing the imaging instrument to move only in a set of allowed degrees of freedom while limiting movement of the imaging instrument in other nonallowed degrees of freedom.
  • the control system can limit movement of the imaging instrument by disallowing the imaging instrument from moving in the non-allowed degrees of freedom.
  • the control system can limit movement of the imaging instrument by limiting an amount of motion of the imaging instrument in the non-allowed degrees of freedom.
  • the control system determines the second configuration such that the second configuration relative to the first configuration can be reached using limited motions of the first repositionable structure and/or the imaging instrument.
  • the control system can limit the motion in one or more spatial degrees of freedom, and/or joint degrees of freedom.
  • the control system can determine a second configuration that limits the motion to be along the insertion/retraction axis of the imaging instrument.
  • the insertion/retraction axis can be a longitudinal axis associated with a shaft of the imaging instrument.
  • the control system can determine a second configuration that limits the motion to rotation about the roll axis of the imaging instrument.
  • the roll axis can be a longitudinal axis associated with the shaft of the instrument.
  • the control system determines the intermediate position using forward kinematics applied to kinematic information about the second repositionable structure (such as received through joint encoders, processing of images including the second repositionable structure, etc.). Some embodiments use other techniques instead of, or in addition to, techniques involving kinematics. In some such examples, the control system uses image processing on images captured by the imaging device to segment and identify components in the images, and locate parts of the components relative to the FOV. This image processing can be performed using any suitable technique, and be used by the control system to locate a certain reference position in the FOV of the imaging instrument.
  • reference positions examples include: a position of the opening into the workspace through which the second instrument is (or will be) inserted, a position of a feature of a cannula through which the second instrument is to be inserted (e.g., a marking detectable by the imaging device, a distal end of the cannula), etc.
  • a marking visible to the human eye is made on the cannula, and coincides with a remote center of the second repositionable structure when the cannula is attached to the second repositionable structure.
  • the intermediate position can be defined as this remote center, and the control system can include the intermediate position in the field of view of the imaging device by locating the remote center of motion in the field of view.
  • the control system determines the intermediate position by employing image processing techniques to identify or predict the intermediate position.
  • the control system can store a series of one or more image frames captured by the imaging device over a duration of time.
  • the control system can perform image analysis on each frame included in the stored image frames to determine the intermediate position based on a reference position identified in the FOV of the imaging device. This reference position can coincide with, or be offset from, the intermediate position.
  • the reference position can be based on the position and/or orientation of the distal portion of the instrument being inserted.
  • the control system can determine the change in position and/or orientation of the distal portion to determine the estimated speed and direction of travel of the distal portion.
  • control system can estimate the likely position and/or orientation of the distal portion when the imaging device captures the next image frame.
  • the control system can set the intermediate position as the likely position and/or orientation of the distal portion.
  • the control system commands each of one or more other repositionable structures to move toward an avoidance configuration for reducing the likelihood of collision between the first repositionable structure and one or more other repositionable structures.
  • the control system determines avoidance configurations of the other repositionable structures.
  • the avoidance configurations are kinematic configurations of the other repositionable structures that place the other repositionable structures out of one or more avoidance regions.
  • the other repositionable structures adopting the avoidance configurations help reduce the likelihood of physical interference with the first repositionable structure (and/or the imaging instrument) as the first repositionable structure moves to position or orient the imaging device during insertion tracking. For example, moving the other repositionable structures out of these avoidance regions while allowing the first repositionable structure to enter and move within the avoidance regions reduces potential physical interference as the first repositionable structure moves toward the second configuration to visualize the intermediate position, and/or to further configurations to position or orient the imaging device to track the second instrument as it is inserted.
  • the avoidance regions change with a change in the configuration of the first repositionable structure, in the configuration of the second repositionable structure, with an amount of insertion of the second instrument, or other contextual parameters associated with the computer-assisted system, instruments or cannulas or other components supported by the computer-assisted system, the type or stage or procedure being performed, changes in the worksite or workspace, etc.
  • the control system also stores pre-avoidance configurations of the other repositionable structure(s). Pre-avoidance configurations are the configurations of the other repositionable structures before moving those repositionable structures to their respective avoidance configurations.
  • the control system can determine that a currently commanded configuration of the first repositionable structure would cause a collision between the first repositionable structure and another repositionable structure, or between the imaging instrument and another instrument.
  • the control system determines and commands an avoidance configuration of another repositionable structure (and/or another instrument) that would reduce or avoid the collision.
  • the control system can command another repositionable structure (and/or another instrument) to move toward the avoidance configuration.
  • the control system performs additional steps before moving this repositionable structure supporting the existing instrument.
  • the control system saves the insertion position for the existing instrument and corresponding repositionable structure.
  • the control system retracts the existing instrument into the cannula before moving the corresponding repositionable structure to the avoidance configuration.
  • These additional steps can help reduce the likelihood that the existing instrument will interact in an unintended with the workspace when the corresponding repositionable structure moves away from the motion path of the first repositionable structure.
  • these additional can include moving the existing instrument to the pre-tracking insertion position, such as at or after process 216, after tracking is terminated.
  • Figure 3C shows the repositionable structures 314(2) and 316(2) after the repositionable structures 314(2) and 316(2) have been moved to respective avoidance configurations. As shown, the repositionable structures 314(2) and 316(2) have been angled away from the repositionable structures 310(2) and 312(2), respectively, so as to reduce the likelihood of collisions with the repositionable structures 310(2) and 312(2).
  • the control system commands the first repositionable structure to move from the first configuration toward the second configuration.
  • the control system determines a trajectory of the first repositionable structure and/or the imaging instrument that moves the first repositionable structure from the first configuration to the second configuration and that poses the field of view of the imaging device to include the intermediate position. In so doing, the control system causes the first repositionable structure to move so as to move the FOV of the imaging device to include the intermediate position.
  • Figure 3C shows the second repositionable structure 312(2) in the second configuration so that the FOV of the imaging device of imaging instrument 330(2) is positioned to allow the imaging device to capture images of the intermediate position for the second instrument 340(2).
  • the second repositionable structure 312(2) of the computer-assisted system 100 has moved from the configuration shown in Figure 3B to a different configuration.
  • the distal portion of the second instrument 340(2) has correspondingly moved within the workspace 360(2).
  • the intermediate position is unchanged as the distal portion is further inserted.
  • the control system updates the intermediate position, as discussed further below).
  • distal portion 352(2) of the second instrument 340(2) is in the field of view of the imaging device of imaging instrument 330(2), as shown by the image displayed by display device 350(2).
  • Figure 4A shows a cross-sectional view of a workspace 460(0) and a worksite 462(0) within the workspace 460(0).
  • a first cannula 420(0) is supported by a first repositionable structure 410(0).
  • an imaging device 432(0) is attached to a first instrument 430(0) (also, an “imaging instrument”).
  • an imaging device 432(0) is included in, and is part of, the first instrument 430(0).
  • the imaging device 432(0) and a distal portion of the shaft of the first instrument 430(0) are inserted into the workspace 460(0) via the first cannula 420(0).
  • the FOV of the imaging device 432(0) is directed so that the imaging device 432(0) is able to capture images of the worksite 462(0).
  • a second cannula 422(0) is supported by a second repositionable structure 412(0).
  • each of the first and second cannulas 420(0), 422(0) has a black band that, when mounted to the first and second repositionable structures 410(0), 412(0), coincides with a remote center of the first and second repositionable structures 410(0), 412(0).
  • the second repositionable structure 412(0) is ready to receive an instrument.
  • Figure 4A shows only part of the first and second repositionable structures 410(0), 412(0).
  • FIG. 4B illustrates mounting of a second instrument 440(1) to the second repositionable structure 412(1).
  • the second instrument 440(1) includes an end effector 442(1) in the form of a gripping device.
  • the end effector 442(1) and a distal portion of the shaft of the second instrument 440(1) are inserted into the workspace 460(1) via the second cannula 422(1).
  • the instrument insertion tracking mode is not yet enabled, and the imaging device 432(1) and the first instrument 430(1) are physically configured such that the field of view of the imaging device 432(1) remains directed in the same way as in Figure 4A.
  • the first instrument 430(1) includes a shaft and an imaging device 432(1), where the imaging device may or may not articulate in relation to the shaft. Therefore, the field of view of the imaging device 432(1) can be changed by re-configuring the first instrument 430(1), which may include re-configuring the shaft and/or articulating the imaging device 432(1).
  • Figure 4C illustrates the movement of the imaging device 432(2) after the instrument insertion tracking mode is enabled, and the control system has caused the first repositionable structure to adopt a configuration for enabling the field of view of the imaging device to visualize an intermediate position.
  • the intermediate position is located at the distal portion (e.g., a distal end) of the cannula 422(2), and is offset from the marking on the cannula 422(2).
  • the first repositionable structure 410(2), the first instrument 430(2), and the imaging device 432(2) are moved to direct the FOV of the imaging device 432(2) so that the FOV includes the distal portion of the second cannula 422(2).
  • the end effector 442(2) and distal portion of the second instrument 440(2) are still inserted into the second cannula 422(2) but have not yet entered the workspace 460(2).
  • the second instrument 440(2) is also called the “inserted instrument” and the “tracked instrument.”
  • the control system has caused the first instrument 430(2) to articulate the imaging device relative to a shaft of the first instrument 430(2) in posing the FOV.
  • the imaging instrument is articulated from a previous configuration.
  • the control system does not cause the imaging instrument to articulate the imaging device relative to a shaft of the imaging instrument; this may be because the control system has determined configurations that do not include articulating the imaging device relative to the shaft, or because the imaging instrument lacks joint(s) that enable the field of view to move relative to the shaft.
  • the technique described in Figures 2-4 can be applied with imaging instruments with or without the ability to articulate the imaging device relative to the shaft.
  • the configurations determined by the controller for the first repositionable structure differ depending on the amount and direction that the imaging instrument can articulate the imaging device.
  • the examples shown in Figures 4A-4G generally illustrate tracking of the end effector of the tracked instrument.
  • the tracking may be of a different part of the tracked instrument, such as an instrument joint proximal to an end effector, or some other distal portion of the instrument that is not the end effector.
  • Figure 4D illustrates no further tracking by the FOV of the imaging device 432(3) as the end effector 442(3) (and the distal portion of the second instrument 440(3)) have been inserted past the distal end of the second cannula 422(3) and into the workspace 460(3).
  • the end effector 442(3) has inserted past the distal end of the second cannula 422(3), towards the worksite 462(3).
  • the first repositionable structure 410(3), the first instrument 430(3), and the imaging device 432(3) have not moved from the configurations shown in Figure 4C.
  • the FOV of the imaging device 432(3) still includes the end effector 442(3) and the distal portion of the second instrument 440(3).
  • control system causes further tracking by the FOV of the imaging device 432(3) as the end effector 442(3) is further inserted, and the first repositionable structure 410(3), the first instrument 430(3), and the imaging device 432(3) to change from the configurations shown in Figure 4C.
  • the further tracking may be to keep the end effector 442(3) in a central region of the FOV of the imaging device 432(3).
  • the control system also generates haptic feedback by changing the resistance on the tracked instrument as the instrument is inserted further into the workspace.
  • the resistance can be based on an amount of insertion of the tracked instrument. For example, greater resistance for larger amounts of insertion can lead to slower insertion.
  • the control system commands actuators of the second instrument or the second repositionable structure to provide resistance as a function of insertion depth, with higher resistance correlating to greater insertion depth). In some instances, adjusting resistance can reduce insertion speeds on deeper instruments, and can serve to improve synchronized visualization of multiple instruments.
  • control system can determine the second configuration by employing various techniques to determine shorter motion paths for the first repositionable structure, the imaging device, and/or the imaging instrument. In some instances, shorter motion paths provide lower energy expenditure, faster response, more efficient movement, and/or better user experience.
  • the control system can determine the shortest path of the imaging device, or imaging instrument, in the workspace. Additionally or alternatively, the control system can determine as the shortest path the smallest amount of movement of one or more joints of the repositionable structure and/or one or more joints of the imaging instrument within their respective joint spaces.
  • control system can determine the second configuration while preferring (e.gively by applying weights, priorities, optimizing cost functions, limiting degrees of freedom or amounts of motion, etc.) motion paths that include joint rotation over motion paths that include joint translation.
  • the control system can use weighted objectives to reduce the change in the spatial volume occupied by the imaging instrument as the imaging device is moved to adjust the FOV. This can help reduce the potential interference to motion of the imaging instrument due to other objects, materials, anatomy, and/or the like in the workspace.
  • the control system can prefer rolling the imaging instrument about a shaft of the imaging instrument. In many embodiments, rolling the imaging instrument about a shaft of the imaging instrument causes little or no change to the volume occupied by the imaging instrument.
  • the control system can determine motion paths that combine multiple motion components (e.g., translate and rotate contemporaneously). In some examples, the control system can determine motion paths that use separate sequences of moves. In a particular example, when commanding the joints of the first repositionable structure and/or the imaging instrument towards the second configuration, the control system commands the joints to translate and/or rotate the field of view sequentially. As one example, the control system can determine motion paths that isolate Cartesian movements of the field of view (such as by separating translation movements from rotation movements), by moving each individual joint in sequence, and/or the like. In some examples, the control system can determine motion paths that do not use separate sequences of moves, and instead comprise combined, simultaneous motion paths of all of the degrees of freedom to be moved.
  • control system can determine motion paths that reduce energy consumption, such as by determining motion paths that minimize joint motion, motion paths that consider the mass and moment of inertia of the repositionable structures and instruments, and/or the like. In some examples, the control system can determine motion paths improve user experience, such as selecting motion paths with cinematic camera motion.
  • the computer-assisted system 100 further includes a human interface system configured to provide feedback detectable by a human.
  • the control system can determine that the joints of the first repositionable structure and/or the joints of the imaging instrument cannot achieve the second configuration.
  • the control system can cause the human interface system to provide a human-detectable indication.
  • the human-detectable indication can be one or more visual indications, audio indications, haptic indications, and/or the like.
  • the control system commands the first repositionable structure to track the distal portion of the second instrument as the second instrument is further inserted into the workspace.
  • the control system determines a current position of the distal portion after the distal portion is inserted past the intermediate position.
  • the control system determines an updated configuration of the first plurality of joints that poses the field of view based on the current position.
  • the control system commands the first repositionable structure to move the first plurality of joints toward the updated configuration.
  • the control system determines an updated intermediate position based on the current position.
  • the control system determines the updated configuration to pose the field of view to include the updated intermediate position.
  • the control system commands the first repositionable structure and/or the imaging instrument to redirect the field of view, and keep the distal portion of the tracked instrument within at least a portion of the field of view.
  • the control system causes motion of the first repositionable structure and/or the imaging instrument to keep a direction of the field of view pointed toward the distal portion or other portion of the tracked instrument.
  • the repositionable structures 314(3) and 316(3) of the computer-assisted system 100 remain in their respective avoidance configurations as the operator 370(3) moves the instrument 340(3) mounted to the second repositionable structure 312(3) and cause the instrument 340(3) to be inserted into the workspace.
  • the first repositionable structure 310(3) continues to move so as to maintain the distal portion of the second instrument 340(3) within the field of view of the imaging device included in imaging instrument 330(3).
  • the imaging device can provide real-time images including the distal portion 352(3) of the second instrument 340(3) as the second instrument 340(3) is further inserted into the workspace, as shown by the image displayed by display device 350(3).
  • Figure 4E shows a first repositionable structure 410(4) supporting a first cannula 420(4) and a first instrument 430(4) with an imaging device 432(4) as well as a second repositionable structure 412(4) supporting a second cannula 422(4) and a second instrument 440(4) with an end effector 442(4).
  • the end effector 442(4) and a distal portion of the second instrument 440(4) have been inserted past the distal end of the second cannula 422(4) and towards the worksite 462(4).
  • the imaging device 432(4) and the first instrument 430(4) are inserted into the workspace 460(4).
  • the first repositionable structure 410(4), the first instrument 430(4), and the imaging device 432(4) have moved from previous configurations to the configurations shown in Figure 4E, such that the FOV of the imaging device 432(4) is able to capture images of the end effector 442(4) and the distal portion of the second instrument 440(4).
  • An example of previous configurations are configurations similar to that shown in Figure 4D for first repositionable structure 410(3), first instrument 430(3), and imaging device 432(3).
  • the control system causes the first repositionable structure 410(4), the first instrument 430(4), and the imaging device 432(4) to move to further configurations in order to pose the FOV such that the end effector 442(4) is maintained in the FOV.
  • Figure 4F shows the end effector 442(5) as the end effector 442(5) is further inserted beyond the distal end of the second cannula 422(5) and has reached the worksite 462(5).
  • the control system has caused the first instrument 430(5) to articulate the imaging device 432(5) to track the end effector 442(5) such that the FOV of the imaging device 432(5) is directed to be able to capture images of the end effector 442(5).
  • the FOV is also directed such that the FOV includes the distal portion of the second instrument 440(5) and the worksite 462(5).
  • the control system has determined that the first repositionable structure can maintain the configuration from Figure 4E in tracking.
  • the control system performs steps to determine the position of the distal portion of the tracked instrument as the instrument is further inserted past the intermediate position.
  • the control system determines the current position of the distal portion of the tracked instrument relative to the position associated with the imaging device. The control system determines this current position by employing techniques similar to the techniques described in conjunction with process 206.
  • the control system determines the command to the first repositionable structure and/or the imaging instrument by employing techniques similar to the techniques described in conjunction with process 210.
  • the control system employs these techniques to maintain the distal portion of the tracked instrument within the field of view of the imaging device, such as within a central region or a peripheral region of the field of view of the imaging device.
  • the control system maintains the distal portion of the tracked instrument within the field of view of the imaging device by causing adjustment of a zoom level of the imaging device.
  • the control system adjusts the zoom level by maintaining a desirable instrument-to-field-of-view size ratio.
  • the mechanism to adjust the zoom level can include an optical zoom mechanism, a digital zoom mechanism, physical movement of the imaging device, and/or the like.
  • the control system maintains the distal portion of the tracked instrument within the field of view of the imaging device by causing panning of the imaging device.
  • the mechanism to adjust the pan can include an optical pan mechanism, a digital pan mechanism, physical movement of the imaging device, and/or the like.
  • the control system detects an indication to stop tracking the insertion of the tracked instrument to the workspace and/or exit the instrument insertion tracking mode.
  • the control system can employ various techniques to detect the indication to stop tracking the insertion of the tracked instrument to the workspace.
  • control system detects the indication to stop tracking the insertion of the instrument by detecting an indication to track an insertion of an instrument into the workspace, where the new instrument is different from the current instrument being tracked. In such examples, the control system stops tracking the insertion of the first instrument and begins tracking the insertion of the new instrument.
  • the control system detects the indication to stop tracking the insertion of the tracked instrument by receiving a command from the operator 370 to exit the instrument insertion tracking mode.
  • the operator 370 can generate the command by pressing one or more buttons, selecting an option on a user interface, uttering a voice command, by making a hand and/or body gesture, by entering a command via a user interface, and/or the like.
  • the operator 370(4) pushes a button associated with the imaging instrument 330(4) while the FOV of the imaging device visualizes the distal portion 352(4) of the second instrument 340(4).
  • the control system stops tracking the insertion of the second instrument 340(4) into the workspace 360(4).
  • the control system detects the indication to stop tracking the insertion of the instrument by determining that the insertion of the tracked instrument by the operator 370 has stopped, or that the speed of insertion is below a threshold speed. In so doing, the control system can apply a time-out duration for a predetermined period of time. If the insertion of the tracked instrument has stopped and/or the speed of insertion is below the threshold speed for at least the predetermined period of time, then the control system determines that tracking the insertion of the instrument should stop.
  • control system detects the indication to stop tracking the insertion of the second instrument by detecting that a force applied to the first repositionable structure, on the imaging instrument, or another repositionable structure or instrument, has exceeded a threshold level. Stopping tracking in response to such force can reduce the chances of damage to the repositionable instrument, damage to the instrument, unintended motion of the instrument within the workspace, and/or the like.
  • the control system detects the indication to stop tracking the insertion of the tracked instrument by detecting that the operator 370 is moving (or commanding motion of) the tracked instrument in a direction other than along the insertion axis, or in a direction deviating from some other expected insertion direction.
  • the control system can detect the indication to stop tracking the insertion of the instrument by detecting that the operator 370 is retracting the tracked instrument or commanding the tracked instrument to retract, rolling the tracked instrument about an insertion axis of the tracked instrument, moving the tracked instrument laterally relative to the insertion axis, operating an end effector of the tracked instrument (such as opening a jaw device, closing a jaw device, firing a staple, etc.), and/or the like.
  • such non-insertion-axis motion may indicate aberrant input.
  • such non-insertion-axis motion may indicate that insertion has been completed.
  • the control system detects the indication to stop tracking the insertion of the instrument by detecting that the tracked instrument has arrived at the worksite within the workspace.
  • the control system can detect such arrival by determining that a distal portion of the tracked instrument is within a tolerance of a target location, in a worksite space, within a region defined based on already-inserted instruments or previously inserted instruments, and the like.
  • the arrival of the tracked instrument at the worksite indicates that insertion of the tracked instrument is complete, and that the tracked instrument is in position to begin a procedure.
  • the control system detects the indication to stop tracking the insertion of the tracked instrument by detecting that a pose of the field of view of the imaging device is within some tolerance of a target pose.
  • target poses include a pose that visualizes all deployed instruments within the field of view, a pose that visualizes a defined worksite where a procedure is to be performed, a pose that visualizes the field of view prior to tracking insertion of the instrument, and/or the like.
  • the control system detects the indication to stop tracking the insertion of the tracked instrument by detecting a distance change beyond a safety threshold between the tracked instrument and an object in the workspace, such as a portion of anatomy, an object in the workspace environment, another instrument, and/or the like.
  • a safety threshold corresponds to the minimum distance to be maintained by the system to prevent a collision between the instrument and the object.
  • control system detects the indication to stop tracking the insertion of the tracked instrument by determining that a current pose of the field of view of the imaging device is within a tolerance of the pre-tracking pose stored at process 204.
  • the control system commands the one or more other repositionable structures to move toward their respective pre-avoidance configurations (e.gitch the respective pre-avoidance configurations stored during process 208) after the tracking of the second instrument has stopped.
  • the repositionable structures 314(5) and 316(5) of the computer-assisted system 100 have moved to their respective pre-avoidance configurations.
  • the first repositionable structure 310(5) and the imaging instrument 330(5) maintain their configurations, such that the distal portion of the instrument 340(5) is maintained within the field of view of the imaging device.
  • the computer-assisted system 100 is now ready to begin a procedure.
  • the computer-assisted system 100 is now ready to command the first repositionable structure 310(5) and/or imaging instrument 330(5) to begin tracking the insertion into the workspace 360(5) of a new instrument that is mounted, or is soon to be mounted, onto repositionable structure 314(5) or repositionable structure 316(5).
  • the control system restores the instrument to the insertion position stored during process 208.
  • the method 200 then returns to process 202 and repeats processes 202-216 when tracking of additional instrument insertions is indicated.
  • Figure 4G illustrates an additional instrument 444(6) with an additional end effector 446(6) being inserted into the workspace 460(6).
  • the additional end effector 446(6) is in the form of a scalpel, and is entering the workspace 460(6) via a cannula 424(6).
  • the additional instrument 444(6) is supported by an additional repositionable structure 414(6).
  • the first instrument 430(6) is retracted within the workspace 460(6) toward the first cannula 420(6) such that the FOV of the imaging device 432(6) has a wider view of the workspace 460(6).
  • the FOV of the imaging device 432(6) has been changed in pose to include the distal portion of the second instrument 440(6) and the distal portion of the additional instrument 444(6).
  • the FOV is directed so that the imaging device 432(6) is able to capture images of the end effector 442(6), the distal portion of the second instrument 440(6), the worksite 462(6), the additional end effector 446(6), and the distal portion of the additional instrument 444(6).
  • control system restores, at or after process 216, the first repositionable structure to the pre-tracking configuration. This helps to return the field of view of the imaging device to the pre-tracking field of view.
  • the control system can maintain one or more additional or alternative positions in the field of view of the imaging device (additional or alternative in being other than the intermediate position).
  • additional or alternative positions include any relevant location that can be located relative to: the intermediate position, a feature of the tracked instrument, a feature of the repositionable structure supporting the tracked instrument, and/or a position of a part of the tracked instrument.
  • an alternative position can be an opening into the workspace, a distal portion of a cannula, a distal portion of any other instrument introduced into the workspace, a part of the worksite, a target object, and/or the like.
  • an additional or alternative position can be a fixed distance (such as 15 mm, 20 mm, 30 mm, and/or the like) beyond the intermediate position and toward the worksite.
  • an additional or alternative position can be any other relevant location relative to the intermediate position and/or an instrument.
  • the control system omits process 216 and returns to process 206 to track the insertion of the new instrument.
  • the repositionable structures other than the repositionable structure to which the new instrument is mounted, remain in their respective avoidance configurations or are moved to new respective avoidance configurations. This can be done by repeating process 208 to account for the intermediate position for the new instrument. These repositionable structures can remain in these avoidance configurations as the new instrument is mounted to a repositionable structure and inserted into the workspace (or until the instrument insertion tracking has been stopped).
  • the control system is unable to pose the field of view to locate the intermediate position, or alternative position, in a central region of the field of view.
  • the control system determines an expected location in the field of view of the imaging device. This expected location is a location where the intermediate position would be if the imaging device and/or the first repositionable structure are in the desired configuration.
  • the control system determines whether the intermediate position, or alternative position is within a tolerance range of the expected location in the field of view of the imaging device. This can be done while tracking the insertion of a tracked instrument and with the first repositionable structure and/or the imaging instrument in the configuration.
  • the control system does not store previous positions of the distal portions of the instruments. In some embodiments, the control system stores previous positions of the distal portions of the instruments. After an instrument insertion is completed, the control system stores the position of the distal portion of that instrument. After that instrument is retracted into the cannula, the corresponding repositionable structure supporting that instrument is moved toward an avoidance configuration (as described in conjunction with process 208). Then, the control system can cause a virtual depiction of the distal portion of the retracted instrument to be displayed in conjunction with the image captured by the imaging device. This augmented display can aid the operator 370 in guiding the remaining instruments into the workspace.
  • the control system tracks and assists in the insertion of multiple instruments.
  • the control system determines which instrument to track at any given time and determines how to continue insertion assistance from a current instrument to a different instrument. If the operator 370 generates a command to enter tracking for multiple instruments, then the control system selects an instrument for insertion tracking.
  • the control system can select the instrument that was installed earliest (similar to a “first-in- first-ouf ’ approach), the instrument that was most recently installed (similar to a “last-in-first- ouf ’ approach), the instrument that was installed immediately after the imaging instrument was installed or inserted, and/or the like.
  • the control system selects a next instrument for insertion tracking. If the control system initially selects the instrument that was installed earliest for insertion tracking, then the control system can subsequently select the instrument that was next installed for insertion tracking, and so on. Similarly, the control system initially selects the instrument that was most recently installed for insertion tracking, then the control system can subsequently select the next most recently installed for insertion tracking, followed by the third to last instrument, and so on.
  • control system maintains the intermediate position within the field of view of the imaging device by causing the imaging instrument to articulate.
  • control system generates commands for redirecting the field of view by commanding changes to the configuration of joints of the imaging instrument.
  • control system generates commands for redirecting the field of view by preferring changes to the configuration of joints of the imaging instrument over changes to the configuration of joints of the first repositionable structure.
  • control units such as the control system 140 of Figure 1 can include non-transient, tangible, machine-readable media that include executable code that when executed by a processor system (e.g., the processor system 150 of Figure 1) can cause the processor system to perform the processes of method 200.
  • a processor system e.g., the processor system 150 of Figure 1
  • Some common forms of machine-readable media that can include the processes of method 200 are, for example, floppy disk, flexible disk, hard disk, magnetic tape, any other magnetic medium, CD-ROM, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, RAM, PROM, EPROM, FLASH-EPROM, any other memory chip or cartridge, and/or any other medium from which a processor or computer is adapted to read.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Robotics (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manipulator (AREA)

Abstract

La présente invention concerne un système assisté par ordinateur qui comprend une première structure repositionnable conçue pour supporter un premier instrument comprenant un dispositif d'imagerie avec un champ de vision, une seconde structure repositionnable conçue pour supporter un second instrument ; et un système de commande. La première structure repositionnable est une première pluralité de liaisons couplées par une première pluralité d'articulations. Le système de commande est conçu, tandis que la première structure repositionnable supporte le premier instrument, en réponse à la détection d'une indication pour suivre une insertion du second instrument dans un espace de travail, pour déterminer une configuration de la première pluralité d'articulations qui pose le champ de vue pour inclure une position intermédiaire pour une partie distale du second instrument lorsque le second instrument est inséré dans l'espace de travail, et, en réponse à la détermination de la configuration, commander la première pluralité d'articulations jusque dans la configuration.
PCT/US2024/038558 2023-07-19 2024-07-18 Positionnement d'un dispositif d'imagerie pour visualiser une partie d'un instrument pendant l'insertion de l'instrument Pending WO2025019679A1 (fr)

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