Invented by Steven E. Yampolsky, Enrique Romo, Auris Health Inc
The Auris Health Inc invention works as followsCertain aspects are related to optical strain sensors in medical instruments. In one aspect, the medical instrument comprises an elongated sleeve and at least one pulling wire that extends from the proximal to distal ends of the shaft. The at least pull wire is configured for actuation of a medical instrument with at least a degree of freedom. The at least pull wire contains an optical fiber that is configured to indicate strain along the at most one pull cable.
Background for Systems and Methods for Optical Strain Sensing in Medical Instruments
Robotic systems can include robotic arm configured to manipulate medical instruments through the anatomy of a patient. These medical instruments can be moved by pulling wires that run along their length. Some medical instruments can also have optical fibers along their length that are used to detect the strain on the instrument.
The systems, methods, and devices disclosed in this disclosure have multiple innovative aspects. No single aspect is responsible for all the desirable characteristics.
The medical instrument is described as having: An elongated sleeve; and, at least, one pull-wire extending from the proximal to distal ends of the shaft. This at least pull-wire is configured to actuate the medical device in at least a degree of freedom.
The invention also includes a medical robot system that comprises: a medical device designed to be inserted in a particular region of a human body; at least a pull-wire extending from the proximal to distal ends of the shaft; the pull-wire configured to actuate the medical tool with at least a degree of freedom; wherein the optical fiber is configured to indicate strain along the shaft; a sensor configured for generating strain data indicative at the position at which at least a fiber Bragg grating grating grating grating grating grating grating grating grating grating grat
The method is described as follows: “In a further aspect, a method for determining strain within a medical device, which comprises: transmitting light from a sensor along at least a pull wire, where the medical device includes: an elongated sleeve, with the at a least one wire extending between the proximal and distal ends of the shaft. This at least pull cable is configured to actuate the medical tool in at least a degree of freedom, the at a
The present disclosure can be integrated into a medical system that is robotically enabled and capable of performing various medical procedures. These include minimally-invasive procedures such as laparoscopy as well as non-invasive procedures such as endoscopy. The system can perform bronchoscopy as well as ureteroscopy and gastroscopy.
The system can provide additional benefits to the physician, including enhanced imaging and guidance. The system can also allow the physician to perform the procedure in an ergonomic position, without awkward arm movements and positions. The system may also allow the physician to perform the procedure in a more comfortable way, such as by controlling one or several instruments with a single user.
The following descriptions will include illustrations of various embodiments. The disclosed concepts can be implemented in many different ways, and the disclosed implementations offer a variety of advantages. The headings in this document are provided for your convenience and to help you locate the various sections. These headings do not limit the scope or the description of concepts. These concepts can be used throughout the specification.
Cart “A Robotic System?
The robotically enabled medical system can be configured in different ways, depending on the procedure. FIG. FIG. 1 shows an embodiment of a robotically-enabled cart-based system 10 for a diagnostic or therapeutic bronchoscopy. During a Bronchoscopic procedure, the system 10 can comprise a cart 11, which has one or more robotic arms 12, to deliver medical instruments, such as steerable endoscopes 13, or a procedure-specific bronchscope for bronchoscopy to a natural access point, i.e. the mouth of a patient on a table, in the present example, to deliver diagnostic or therapeutic tools. The cart 11 can be placed near the upper torso of the patient to allow access to the access points. The robotic arms 12 can also be used to move the bronchoscope to the access point. FIG. The arrangement in FIG. FIG. “Fig. 2 shows a more detailed example of the cart.
With continued reference to FIG. 1 , once the cart 11 is properly positioned, the robotic arms 12 may insert the steerable endoscope 13 into the patient robotically, manually, or a combination thereof. As shown, the steerable endoscope 13 may comprise at least two telescoping parts, such as an inner leader portion and an outer sheath portion, each portion coupled to a separate instrument driver from the set of instrument drivers 28, each instrument driver coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers 28, which facilitates coaxially aligning the leader portion with the sheath portion, creates a ?virtual rail? 29 that may be repositioned in space by manipulating the one or more robotic arms 12 into different angles and/or positions. The virtual rails described herein are depicted in the Figures using dashed lines, and accordingly the dashed lines do not depict any physical structure of the system. Translation of the instrument drivers 28 along the virtual rail 29 telescopes the inner leader portion relative to the outer sheath portion or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 29 may be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and position of the virtual rail 29 as shown represents a compromise between providing physician access to the endoscope 13 while minimizing friction that results from bending the endoscope 13 into the patient’s mouth.
The robotic system can direct the endoscope down the patient’s trachea or lungs using precise commands until it reaches the desired destination. To improve navigation and/or to reach the target, the endoscope can be manipulated by telescopically extending the inner leader from the outer sleeve portion in order to achieve enhanced articulation. Separate instrument drivers 28 allow the sheath and leader portions to be driven independently of each other.
For instance, the endoscope can be used to deliver a needle for biopsy to a target such as a nodule or lesion within the lung of a patient. The needle can be inserted into a working channel running the length of the instrument to collect tissue samples for analysis by a pathologist. The pathology report may dictate the placement of additional tools in the working channel to perform additional biopsies. The endoscope can deliver endoscopic tools to resect potentially cancerous tissue after identifying the nodule as malignant. In certain cases, diagnostic and therapeutic treatment can be performed in separate procedures. In these circumstances, an endoscope 13 can also be used to deliver fiducials to “mark” In those circumstances, the endoscope 13 may also be used to deliver a fiducial to?mark? Other times, diagnostic and therapeutic treatment may be administered during the same procedure.
The system 10 can also include a mobile tower 30 that is connected to the cart via cables. The tower 30 provides support for the cart’s controls, fluidics and optics, sensors or power. By placing such functionality within the tower 30, a cart 11 with a smaller size can be created that is more easily repositioned and/or adjusted by operatives and their staff. The division of the functionality between the table/cart and the tower 30 also reduces the clutter in the operating room and improves clinical workflow. The cart 11 can be placed close to the patient while the support tower 30 can be stored in a distant location.
In order to support the robotic systems described in the previous section, the tower 30 can include components of a computer-based system that store computer program instructions. For example, these computer program instructions may be stored on a nontransitory computer readable storage medium, such as a solid state drive or persistent magnetic storage device. Whether the instructions are executed in the tower 30, or on the cart 11, they can control the whole system, or subsystems thereof. When executed by the processor of the computer, for example, the instructions can cause the components of a robotics system actuate relevant carriages and arms mounts, actuate robotics arms and control medical instruments. In response to the control signal received, the motors of the joints in the robotics arm may place the arms in a specific posture.
The tower 30 can also include a flow meter, valve controls, or fluid access to allow controlled irrigation and aspiration of the system which may be deployed via the endoscope 13″. The tower 30’s computer system can also control these components. Some embodiments may deliver irrigation and aspiration capability directly to the endoscope 13. This can be done through separate cables.
The tower 30 could include a surge and voltage protector that provides filtered and protected power to the cart 11. This would allow the cart to be smaller and more mobile by avoiding the need for a power converter and other auxiliary components.
The tower 30 can also contain support equipment for sensors that are deployed throughout the robotics system 10. The tower 30 could, for example, include opto-electronics to detect, receive, and process data from optical sensors or camera throughout the robotic system 10 These opto-electronics devices can be used in conjunction with the control system to create real-time images that are displayed in any of the consoles throughout the robotic system 10, including the tower 30. The tower 30 can also include a subsystem that receives and processes signals from electromagnetic (EM), sensors. The tower 30 can also be used to position and house an EM field generation for detection by EM sensor in or on the instrument.
The tower 30 can also include a console 31, in addition to the other consoles in the rest system, such as the console on the top of the cart. Console 31 can include a user-interface and a display, such as touchscreen, for the operator. Consoles of system 10 provide pre-operative information and real-time data of the procedure. For example, navigational and location information for the endoscope 13 are provided. The console 31 may be used to provide data specific to the procedure by a second operator such as a nursing assistant, if the console is not available only to the physician. In some embodiments, console 30 may be housed in an external body separate from tower 30.
The tower 30 can be connected to the cart 11, and endoscope 13, through one or multiple cables or connections. In certain embodiments, support functionality provided by the tower 30 can be delivered through a single cord to the cart 11. This simplifies and declutters the operating room. In some embodiments, certain functionality can be connected and cabling separately. “For example, a cart may receive power through a single cable, but support for controls and navigation, fluidics or optics may come through a different cable.
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