阅读说明：本技术 用于使用光纤形状传感器减小测量误差的系统和方法 (System and method for reducing measurement error using fiber optic shape sensor ) 是由 R·L·施勒辛格 T·D·苏珀尔 A·B·科威思科 S·J·布鲁门克兰兹 V·多文戴姆 C 于 2015-10-16 设计创作，主要内容包括：本发明涉及用于使用光纤形状传感器减小测量误差的系统和方法。一种装置,其包括具有细长轴的仪器。该装置还包括第一形状传感器,其包括在距中性轴线第一径向距离处在细长轴内延伸的细长光纤。该装置还包括抗扭转特征,抗扭转特征经配置减少细长光纤相对于细长轴的扭转,同时允许细长光纤在细长轴内的轴向平移。(The invention relates to a system and a method for reducing measurement errors using a fiber optic shape sensor. An apparatus includes an instrument having an elongated shaft. The apparatus also includes a first shape sensor including an elongated optical fiber extending within the elongated shaft at a first radial distance from the neutral axis. The apparatus also includes a twist resistant feature configured to reduce twisting of the elongated optical fiber relative to the elongated shaft while allowing axial translation of the elongated optical fiber within the elongated shaft.)

1. An apparatus, comprising:

an instrument comprising an elongate shaft;

a shape sensor comprising an elongated optical fiber extending within the elongated shaft at a first radial distance from a neutral axis;

a reference sensor disposed within the elongated shaft, wherein the shape sensor is fixed in a known first position relative to the reference sensor; and

a twist resistant feature disposed within the elongated shaft, wherein the twist resistant feature is coupled to the shape sensor to reduce twisting of the elongated optical fiber relative to the elongated shaft while allowing axial translation of the elongated optical fiber within the elongated shaft, wherein the shape sensor is coupled to the twist resistant feature at a known second position relative to the reference sensor.

2. The device of claim 1, wherein a first shape sensor is secured to at least one of the reference sensor and the elongated shaft via a bonding agent.

3. The apparatus of claim 1, wherein:

the reference sensor is at a first axial position along the elongated shaft;

the elongated optical fiber is secured to the elongated shaft at the first axial position; and is

The twist resistant feature is coupled to the elongated optical fiber at a second axial location that is distal to the first axial location along the elongated shaft.

4. The apparatus of claim 1, wherein:

the reference sensor is at a first axial position along the elongated shaft;

the twist resistant feature is coupled to the elongated optical fiber at the first axial position; and is

The elongated optical fiber is secured to the elongated shaft at a second axial location that is distal to the first axial location along the elongated shaft.

5. The apparatus of claim 1, wherein:

the reference sensor is fixed to the elongated shaft at a first axial position along the elongated shaft;

the elongated optical fiber is fixed to the reference sensor at the first axial position; and is

The twist resistant feature is coupled to the elongated optical fiber at a second axial location that is distal to the first axial location along the elongated shaft.

6. The apparatus of claim 1, wherein the reference sensor comprises an electromagnetic sensor.

7. The apparatus of claim 1, wherein:

the reference sensor is at an axial position along the elongated shaft;

the elongated optical fiber is fixed to the reference sensor at the axial location;

the twist resistant feature is coupled to the elongated optical fiber at the axial location; and is

The axial position translates to allow the elongated optical fiber and the reference sensor to translate axially along a longitudinal axis of the elongated shaft.

8. An apparatus, comprising:

an instrument comprising an elongate shaft;

a tracking system; and

a first shape sensor comprising an elongated optical fiber extending within the elongated shaft, wherein the elongated optical fiber comprises a marker, wherein the tracking system is configured to detect the marker within the elongated shaft, and wherein a shape of the first shape sensor is determined between the marker and a distal end of the first shape sensor.

9. The device of claim 8, wherein the marker comprises at least one of a bend, a loop, or another shape in the elongated optical fiber.

10. The device of claim 8, wherein the marker is coupled to a reference sensor within the elongate shaft.

11. The apparatus of claim 10, wherein the reference sensor comprises an electromagnetic sensor.

12. The apparatus of claim 8, wherein the indicia is a mechanical fiducial.

13. The device of claim 8, wherein a first length of the elongated optical fiber extending between the marker and the distal end of the elongated shaft is positioned within the lumen of the elongated shaft, and wherein the first length of the elongated optical fiber is unconstrained between the marker and the distal end of the elongated shaft.

14. The device of claim 8, wherein at least a portion of the elongated optical fiber is helically wound within a wall of the elongated shaft or along a distal steerable portion of the elongated shaft.

15. The device of claim 14, wherein the elongated optical fiber comprises an auxiliary tube bundle loop proximal to a proximal end of the elongated shaft, and wherein the auxiliary tube bundle loop is configured to facilitate axial movement of the elongated optical fiber relative to the elongated shaft.

16. A method of operating a shape sensing device, comprising:

receiving shape data from a shape sensor, the shape sensor comprising an elongated optical fiber extending within the elongated shaft and coupled along at least a portion of the elongated optical fiber to a twist resistant feature configured to limit twisting of the elongated optical fiber relative to the elongated shaft;

receiving position data from a reference sensor disposed at a first axial position along the elongated shaft; and

an instrument bend measurement is generated based on the received shape data and the position data.

17. The method of claim 16, wherein generating the instrument bend measurement comprises adjusting the shape data based on the position data and a predetermined algorithm for evaluating a twist of the elongated optical fiber, wherein the predetermined algorithm comprises a mathematical model, and wherein the mathematical model comprises at least one of:

assuming that the twist of the elongated optical fiber relative to the elongated shaft is linearly proportional along the axial distance from the distal end of the elongated shaft;

a polynomial fit of the twist of the elongated optical fiber relative to the elongated shaft; or

An exponential fit of a twist of the elongated optical fiber relative to the elongated shaft.

18. The method of claim 16, wherein receiving position data from the reference sensor comprises receiving position data from an electromagnetic sensor.

19. The method of claim 16, further comprising tracking a position of a mechanical fiducial using a mechanical fiducial tracking system, wherein the mechanical fiducial is coupled to the elongated optical fiber proximal to a proximal end of the elongated optical fiber.

20. The method of claim 16, further comprising tracking a marker using a marker tracking system, wherein the marker is coupled to the elongated optical fiber, and wherein the marker is at least one of a bend, a loop, or another marker detectable by the marker tracking system.

Technical Field

The present disclosure relates to systems and methods for reducing measurement errors in shape sensing optical fibers, and more particularly to systems and methods for reducing measurement errors using shape sensing optical fibers in medical instruments.

Background

Minimally invasive medical techniques aim to reduce the amount of tissue damaged during diagnostic or surgical treatment, thereby reducing patient recovery time, discomfort and harmful side effects. Such minimally invasive techniques may be performed through natural orifices in the patient anatomy or through one or more surgical incisions. Through these natural orifices or incisions, the clinician may insert medical instruments to reach the target tissue site. To reach the target tissue location, minimally invasive medical instruments may navigate natural or surgically created passageways in anatomical systems such as the lungs, colon, intestines, kidneys, heart, circulatory system, and the like. Navigation assistance systems help clinicians deliver medical instruments and avoid injuring anatomical structures. These systems can incorporate the use of shape sensors to more accurately describe the shape, position, orientation, and pose of the medical instrument in real space or relative to pre-operative or concurrent images. The accuracy and precision of these shape sensors can be affected by many factors, including the torsion of the sensor, temperature variations, the position of the shape sensor within the instrument, and the axial load on the sensor.

There is a need for improved systems and methods to improve the accuracy and precision of navigation assistance systems, including minimizing the impact of factors that compromise the accuracy of shape sensors. The apparatus, systems, and methods disclosed herein overcome one or more of the disadvantages of the prior art.

Disclosure of Invention

Embodiments of the present invention are summarized by the following.

In one embodiment, the device includes an instrument having an elongated shaft. The apparatus also includes a first shape sensor including an elongated optical fiber extending within the elongated shaft at a first radial distance from the neutral axis. The apparatus also includes a twist resistant feature configured to reduce twisting of the elongated optical fiber relative to the elongated shaft while allowing axial translation of the elongated optical fiber within the elongated shaft.

In another embodiment, a method of operating a shape sensing device includes providing an instrument including a shape sensor disposed along an elongated shaft and receiving shape data from the shape sensor. The shape sensor includes an elongated optical fiber extending within the elongated shaft and is coupled to a twist resistant feature along at least a portion of the elongated optical fiber. The twist resistant feature is configured to limit twisting of the optical fiber relative to the elongated shaft. The method also includes generating instrument bend measurements based on the received shape data.

In another embodiment, an apparatus includes an instrument having an elongated shaft and a first shape sensor including an elongated optical fiber extending within the elongated shaft at a first radial distance from a neutral axis. The apparatus also includes a torsional mitigation feature configured to reduce axial strain in at least a portion of the first shape sensor.

Drawings

Aspects of the disclosure are best understood from the following detailed description when read with the accompanying drawing figures. It is emphasized that, in accordance with the standard practice in the industry, various features are not drawn to scale. In fact, the dimensions of the various features may be arbitrarily increased or reduced for clarity of discussion. Further, the present disclosure may repeat reference numerals and/or letters in the various examples. This repetition is for the purpose of simplicity and clarity and does not in itself dictate a relationship between the various embodiments and/or configurations discussed

Fig. 1 illustrates an exemplary telemedicine system according to one embodiment of the present disclosure.

Fig. 2 illustrates a medical instrument system utilizing aspects of a telemedicine system according to one embodiment of the present disclosure.

Fig. 3 and 4 are cross-sectional views of a medical instrument including a fiber optic shape sensor according to one embodiment of the present disclosure.

Fig. 5 illustrates a cross-sectional view of an example medical instrument including a fiber lumen including a fiber optic shape sensor and an example twist resistant feature, according to an embodiment of the present disclosure.

Fig. 6A and 6B illustrate an optical fiber shape sensor and an example twist resistant feature according to embodiments of the present disclosure. Fig. 6A is a perspective view and fig. 6B is a cross-sectional view.

Fig. 7A-7C illustrate an optical fiber shape sensor and an example twist resistant feature according to various embodiments of the present disclosure. Fig. 7A is a perspective view and fig. 7B and 7C are cross-sectional views.

Fig. 8A is a perspective view of a fiber optic shape sensor and an exemplary keying feature (keyingfeature) according to an embodiment of the present disclosure.

FIG. 8B is a cross-sectional view of the optical fiber shape sensor and exemplary keying feature shown in FIG. 8A.

Fig. 8C is a cross-sectional view of an example medical instrument including a fiber optic shape sensor and example keying features and reference sensors positioned within an example fiber lumen, according to an embodiment of the present disclosure.

Fig. 9A is a perspective view of a fiber optic shape sensor and an exemplary keying feature according to an embodiment of the present disclosure.

Fig. 9B is a perspective view of a fiber optic shape sensor and an exemplary keying feature according to an embodiment of the present disclosure.

Fig. 10 is a cross-sectional view of an example medical instrument including a fiber optic shape sensor and an example fiber lumen, according to an embodiment of the present disclosure.

11A-11D are cross-sectional views of different example medical instruments that each include a fiber shape sensor, a twist resistant feature, and a reference sensor, according to various embodiments of the present disclosure.

Fig. 12A and 12B are cross-sectional views of different example medical instruments that each include a fiber optic shape sensor and a twist resistant feature, according to various embodiments of the present disclosure.

FIG. 13 illustrates a medical instrument system having a helically wound fiber optic shape sensor according to one embodiment of the present disclosure.

Fig. 14 illustrates a medical instrument system with a distally secured fiber optic shape sensor according to one embodiment of the present disclosure.

Detailed Description

For the purposes of promoting an understanding of the principles of the disclosure, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the disclosure is thereby intended. In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the disclosed embodiments. It will be apparent, however, to one skilled in the art that embodiments of the present disclosure may be practiced without these specific details. In other instances, well-known methods, procedures, components, and circuits have not been described in detail as not to unnecessarily obscure aspects of the embodiments of the present disclosure.

Any alterations and further modifications in the described devices, apparatus, methods, and any further applications of the principles of the disclosure as described herein are contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or processes described with respect to one embodiment may be combined with the features, components, and/or processes described with respect to other embodiments of the present disclosure. Further, the dimensions provided herein are for specific examples, and it is contemplated that the concepts of the present disclosure may be implemented with different sizes, dimensions, and/or ratios. To avoid unnecessary repetition of the description, one or more components or actions described in accordance with one illustrative embodiment can be used or omitted as applicable to other illustrative embodiments. For the sake of brevity, a large number of iterations of these combinations will not be described separately. For purposes of simplicity, the same reference numbers will be used throughout the drawings to refer to the same or like parts.

The following examples will describe various instruments and parts of the instruments according to their states in three-dimensional space. As used herein, the term "position" refers to the positioning of an object or a portion of an object in three-dimensional space (e.g., three translational degrees of freedom along cartesian X, Y, Z coordinates). As used herein, the term "orientation" refers to the rotational arrangement (three rotational degrees of freedom-e.g., roll, pitch, and yaw) of an object or a portion of an object. As used herein, the term "pose" refers to a position of an object or a portion of an object in at least one translational degree of freedom and an orientation of an object or a portion of an object in at least one rotational degree of freedom (up to six degrees of freedom in total). As used herein, the term "shape" refers to a set of poses, positions, or orientations measured along an elongated object.

It should be understood that the terms "proximal" and "distal" are used herein with reference to a clinician manipulating an end of an instrument extending from the clinician to a surgical site. The term "proximal" refers to the portion of the instrument that is closer to the clinician, and the term "distal" refers to the portion of the instrument that is further away from the clinician and closer to the surgical site. For the sake of brevity, spatial terms such as "horizontal," "vertical," "above," and "below" may be used herein with reference to the drawings. However, medical instruments are used in many orientations and positions, and the terms are not intended to be limiting and absolute.

The present disclosure relates generally to using a shape sensor system to monitor, estimate, and/or predict the shape and/or position of a medical instrument for use in various medical procedures, including but not limited to diagnostic, surgical, and/or therapeutic procedures. In particular, in some embodiments, the shape sensor systems disclosed herein rely on the ability to obtain and interpret optical data from optical shape sensor fibers coupled to a flexible body of a medical instrument. In particular, some embodiments of the present disclosure relate to shape and/or position tracking by minimizing the effect of torsion on the optical fiber when the operator is using the medical instrument during a minimally invasive procedure. In some embodiments, the shape sensing system may be coupled to a telemedicine system. Embodiments disclosed herein may improve the position and shape assessment capabilities of a shape sensing system coupled to a telemedicine system by reducing errors and inaccuracies introduced by the twisting of the optical fiber during manipulation of the medical instrument. In particular, some embodiments described herein utilize, by way of non-limiting example, mechanical elements such as spline wedges and adhesives to constrain movement of the optical fiber with respect to the body of the medical instrument. For example, in some embodiments, the optical fiber is coupled to various points and/or other sensors (e.g., EM position sensors) within the medical instrument to minimize the effects of torsion on the optical fiber.

Those skilled in the art will recognize that the shape sensing systems disclosed herein may be used in similar (e.g., non-teleoperated) applications that benefit from more accurate shape and/or position sensing. By utilizing the shape sensing systems and methods disclosed herein, a user may experience more intuitive and more efficient interaction with medical instruments and other components coupled to a telemedicine system.

According to various embodiments, a teleoperational system may be used to perform minimally invasive medical procedures to guide instrument delivery and operation. Referring to fig. 1 of the drawings, a teleoperational medical system for use in medical procedures, including, for example, diagnostic, therapeutic, or surgical procedures, is generally indicated by reference numeral 10. As will be described, the teleoperational medical system of the present disclosure is under the control of teleoperation by the surgeon. In an alternative embodiment, the teleoperational medical system may be programmed to executeUnder partial control of the computer of the line process or sub-process. In still other alternative embodiments, a fully automated medical system under the full control of a computer programmed to perform a procedure or sub-procedure may be used to perform the procedure or sub-procedure. As shown in FIG. 1, a teleoperational medical system 10 generally includes a teleoperational assembly 12 that is adjacent to or mounted to an operating table O on which a patient P is positioned. The teleoperational assembly 12 may be referred to as a Patient Side Manipulator (PSM). The medical instrument system 14 is operably coupled to the teleoperational assembly 12. Operator input system 16 allows a surgeon or other type of clinician S to view images of or representing a surgical site and to control operation of medical instrument system 14. Operator input system 16 may be referred to as a master or surgeon's console. One example of a teleoperated Surgical system that can be used to implement the systems and techniques described in this disclosure is da, manufactured by Intuitive Surgical, inc.

A surgical system.

The teleoperational assembly 12 supports a medical instrument system 14 and may include one or more non-servo controlled linked kinematic structures (e.g., one or more links that may be manually positioned and locked in place, commonly referred to as a set-up structure) and teleoperational manipulators. The teleoperational assembly 12 includes a plurality of motors that drive inputs on the medical instrument system 14. These motors move in response to commands from control system 22. The motor includes a drive system that, when coupled to the medical instrument system 14, can advance the medical instrument into a natural or surgically created anatomical orifice. Other motorized drive systems may move the distal end of the medical instrument in multiple degrees of freedom, which may include three degrees of linear motion (e.g., linear motion along X, Y, Z cartesian axes) and three degrees of rotational motion (e.g., rotation about X, Y, Z cartesian axes). Additionally, the motor can be used to actuate an articulatable end effector of the instrument.

Teleoperational medical system 10 also includes an image capture system 18, image capture system 18 including an image capture or imaging device, such as an endoscope, and associated image processing hardware and software. The imaging device may be integrally or removably coupled to the medical instrument system 14. Additionally or alternatively, a separate imaging device attached to a separate manipulator assembly may be used with the medical instrument system to image the surgical site.

Teleoperational medical system 10 also includes a control system 22 operatively linked to the sensors, motors, actuators, and other components of teleoperational assembly 12, operator input system 16, and image capture system 18. Operator input system 16 may be located at a surgeon's console, which is typically located in the same room as operating table O. However, it should be understood that surgeon S can be located in a different room or a completely different building than patient P. The operator input system 16 generally includes one or more control devices for controlling the medical instrument system 14. More specifically, in response to input commands from the surgeon, the control system 22 implements the servo-mechanical motion medical instrument system 14. The control device(s) may include one or more of any number of various input devices, such as a handle, joystick, trackball, data glove, trigger gun, hand control, foot-operated controller, voice recognition device, touch screen, body motion or presence sensor, and the like. In some embodiments, the control device(s) will be provided with the same degrees of freedom as the medical instruments of the teleoperational assembly to provide telepresence to the surgeon, i.e., the perception that the control device(s) are integral with the instruments, such that the surgeon has a strong sense of directly controlling the instruments as if positioned at the surgical site. In other embodiments, the control device(s) may have more or fewer degrees of freedom than the associated medical instrument and still provide the surgeon with telepresence. In some embodiments, the control device(s) are manual input devices that move in six degrees of freedom, and may also include an actuatable handle for actuating an instrument (e.g., for closing the jaws, applying an electrical potential to the electrodes, delivering a drug therapy, etc.).

The system operator sees an image, which is captured by image capture system 18, presented for viewing on display system 20 operatively coupled to or incorporated into operator input system 16. Display system 20 displays images or representations of the surgical site and medical instrument system(s) 14 generated by the subsystems of image capture system 18. Display system 20 and operator input system 16 may be oriented to enable an operator to control medical instrument system 14 and operator input system 16 with the perception of telepresence. Display system 20 may include multiple displays, such as separate left and right displays for presenting separate images to each eye of the operator, allowing the operator to view stereoscopic images.

Alternatively or additionally, display system 20 may use imaging techniques (e.g., Computed Tomography (CT), Magnetic Resonance Imaging (MRI), fluoroscopy, thermal infrared imaging, ultrasound, Optical Coherence Tomography (OCT), thermal imaging, impedance imaging, laser imaging, nanotube X-ray imaging, etc.) to present images of the preoperatively or intra-operatively recorded and/or imaged surgical site. The presented preoperative or intraoperative images may include two-, three-, or four-dimensional (including, for example, time-based or velocity-based information) images and associated image datasets used to render the images. The image may be, for example, a two-dimensional (2D) or three-dimensional (3D) image captured by an imaging device, such as an endoscope positioned within the surgical site. In some embodiments, the display system 20 may display a virtual navigation image in which the actual position of the medical instrument is dynamically referenced using the preoperative image to present the surgeon S with a virtual image of the surgical site at the position of the medical instrument tip. An image of the tip or other graphical or alphanumeric indicator of the medical instrument may be superimposed on the virtual image to assist the surgeon in controlling the medical instrument. The display system 20 may be implemented as hardware, firmware, software, or a combination thereof that interacts with or is otherwise executed by one or more computer processors, which may include the processors of the control system 22.

The control system 22 includes at least one memory and at least one processor (not shown), and typically a plurality of processors, for effecting control between the teleoperational system 12, the medical instrument system 14, the operator input system 16, the image capture system 18, and the display system 20. The control system 22 also includes programmed instructions (e.g., a computer-readable medium storing the instructions) to implement some or all of the methods described in accordance with aspects disclosed herein. Although control system 22 is shown as a single block in the simplified schematic of fig. 1, the system may include two or more data processing circuits, with a portion of the processing optionally being performed on or near teleoperational assembly 12, another portion of the processing being performed at operator input system 16, and so forth. Any of a variety of centralized or distributed data processing architectures may be employed. Similarly, the programmed instructions may be implemented as a number of separate programs or subroutines, or they may be integrated into many other aspects of the remote operating system described herein. In one embodiment, control system 22 supports wireless communication protocols such as Bluetooth, IrDA, HomeRF, IEEE802.11, DECT, and wireless telemetry.

In some embodiments, the control system 22 may include one or more servo controllers that receive force and/or torque feedback from the medical instrument system 104. In response to the feedback, the servo controller transmits a signal to the operator input system 16. The servo controller(s) may also transmit signals instructing teleoperational assembly 12 to move medical instrument system(s) 14 extending to an internal surgical site within the patient's body via an opening in the body. Any suitable conventional or dedicated servo controller may be used. The servo controller may be separate from the teleoperational assembly 12 or integrated with the teleoperational assembly 12. In some embodiments, the servo controller and teleoperational assembly are provided as part of a teleoperational arm cart positioned adjacent to the patient's body.

The teleoperational medical system 10 may further include optional operational and support systems 24, such as an illumination system, an eye tracking system, a steering control system, an irrigation system, and/or a suction system. These systems may be operably coupled to or incorporated into operator input system 16. In alternative embodiments, the teleoperational system may include more than one teleoperational component and/or more than one operator input system. The exact number of manipulator assemblies depends on the surgical procedure and space constraints within the operating room, among other factors. The operator input systems may be collocated, or they may be located in separate locations. The multiple operator input systems allow more than one operator to control one or more manipulator assemblies in various combinations.

Fig. 2 shows a shape sensing device 118 including the medical instrument system 14 and its interface system. The medical instrument system 14 includes a steerable instrument 120 coupled to the teleoperational assembly 12 and the image capture system 18 through an interface 122. In the embodiment of fig. 2, the instrument 118 is teleoperated within the teleoperated surgical system 10. In an alternative embodiment, the teleoperational assembly 12 may be replaced by direct operator control. In a direct operation alternative, various handles and operator interfaces may be included for handheld operation of the instrument.

The instrument 120 has a flexible body 124 (e.g., a cannula), a steerable tip 126 at its distal end 128 and a hub 122 at its proximal end 130. The body 124 houses cables, linkages (linkages) or other steering controls (not shown) that extend between the interface 122 and the tip 126 to controllably bend or rotate the tip, such as shown by the dashed line form of the bent tip 126, and in some embodiments controls an optional end effector 132. The end effector is a steerable working distal portion for medical functions (e.g., for performing a predetermined treatment on a target tissue). For example, some end effectors have a single working member, such as a scalpel, a blade, or an electrode. For example, other end effectors (such as the embodiment of fig. 2) have a pair or more working members, such as forceps, graspers, scissors, or a clamp device. Examples of electrically activated end effectors include electrosurgical electrodes, transducers, sensors, and the like. The end effector may also include conduits for delivering fluids, gases, or solids, for example, for aspiration, insufflation, irrigation, treatment requiring fluid delivery, accessory introduction, biopsy extraction, and the like. In other embodiments, the flexible body 124 can define one or more lumens through which medical instruments can be deployed and used at the target surgical site.

Instrument 120 can also include an image capture element 134, which can include a stereoscopic or monoscopic camera disposed at distal end 128 for capturing images transmitted to image capture system 18 and processed by image capture system 18 for display by display system 20. Alternatively, the image capture element 134 may be a coherent fiber optic bundle coupled to an imaging and processing system on the proximal end of the instrument 120, such as a fiberscope. The image capture element 134 may be single spectrum or multi-spectrum for capturing image data in the visible or infrared/ultraviolet spectrum.

The tracking system 136 is coupled to a sensor system 138 for determining the shape (and optionally, pose) of the distal end 128 and/or one or more segments 137 along the instrument 120. Although only an exemplary set of segments 137 is depicted in fig. 2, the entire length of the instrument 120 between the distal end 128 and the proximal end 130, and including the tip 126, may be effectively divided into a plurality of segments whose shape (and position, pose, and/or location) may be determined by the sensor system 138. The tracking system 136 may be implemented as hardware, firmware, software, or a combination thereof, which may interact with or may be otherwise executed by one or more computer processors, which may include the processors of the control system 22.

The sensor system 138 includes a fiber optic shape sensor 140 (e.g., disposed within an internal channel (not shown) or externally mounted) aligned with the flexible body 124. The tracking system 136 is coupled to the proximal end of the fiber optic shape sensor 140. In this embodiment, the fiber optic shape sensor 140 has a diameter of about 200 μm. In other embodiments, the dimensions may be larger or smaller.

The fiber optic shape sensor 140 forms a fiber optic bend sensor for determining the shape of the instrument 120. In one example, an optical fiber including a Fiber Bragg Grating (FBG) is used to provide strain measurements in a structure in one or more dimensions. Various systems and methods for monitoring the shape and relative position of an optical fiber in three dimensions are described in U.S. patent application publication No.2006/0013523 filed on 7/13/2005, U.S. patent application serial No. 60/588,336 filed on 7/16/2004, and U.S. patent No.6,389,187 filed on 6/17/1998, the disclosures of which are all incorporated herein. In other alternatives, sensors employing other strain sensing techniques such as rayleigh scattering, raman scattering, brillouin scattering, and fluorescence scattering may be suitable. In other alternative embodiments, other techniques may be used to determine the shape of the instrument 120. For example, if the history of the pose of the instrument tip is stored for a time interval that is less than the period of a refreshed navigational display or alternating motion (e.g., inhalation and exhalation), the pose history can be used to reconstruct the shape of the device over the time interval. As another example, historical posture, position, or orientation data may be stored for known points of the instrument along a cycle of alternating motion (e.g., breathing). The stored data can be used to develop shape information about the instrument.

The fiber optic shape sensor 140 is used to monitor the shape of at least a portion of the instrument 120. More specifically, light passing through the fiber optic shape sensor 140 is processed by the tracking system 136 for detecting the shape of the medical instrument 120 and for utilizing this information to assist in the surgical procedure. The tracking system 136 may include a detection system for generating and detecting light for determining the shape of the instrument 120. This information can in turn be used to determine other relevant variables, such as the velocity and acceleration of the part of the medical instrument. By obtaining accurate measurements of one or more of these variables in real time, the controller can improve the accuracy of the robotic surgical system and compensate for errors introduced in the drive component parts. Sensing may be limited to only the degrees of freedom actuated by the robotic system, or may be applied to both passive (e.g., unactuated bending of rigid members between joints) and active (e.g., actuated motion of an instrument) degrees of freedom.

Information from the tracking system 136 may be sent to the navigation system 142 where it is combined with information from the image capture system 18 and/or pre-operatively taken images to provide real-time position information to the surgeon or other operator on the display system 20 for control of the instrument 120. The navigation system 142 may be part of the control system 22 shown in fig. 1. Alternatively, the navigation system 142 may be part of the optional system 24 shown in FIG. 1. Navigation system 142 and/or control system 22 may utilize the position information as feedback for positioning instrument 120. Various systems for registering and displaying Medical instruments and surgical images using fiber optic sensors are provided in U.S. patent application No.13/107,562 entitled "Medical system providing Dynamic Registration of a Model of an Anatomical Structure for image-Guided Surgery," the entire contents of which are incorporated herein by reference.

In some embodiments, a series of position sensors (such as Electromagnetic (EM) sensors) positioned along the instrument can additionally or alternatively be used for shape sensing. The data history during surgery from a position sensor on the instrument (such as an EM sensor) can be used to represent the shape of the instrument, particularly if the anatomical passageways are generally static. For example, in the depicted embodiment, the instrument 118 includes a position sensor 150 (e.g., an Electromagnetic (EM) sensor system), the position sensor 150 may be disabled by an operator or an automated system (e.g., controlling the functions of the system 22) if the position sensor 150 becomes unreliable due to, for example, magnetic interference from other devices in the surgical suite, or if other navigational tracking systems are more reliable. The position sensor 150 may be an EM sensor system that includes one or more conductive coils that may be subjected to an externally generated electromagnetic field. Each coil of the EM sensor system 150 then generates an induced electrical signal having characteristics that depend on the position and orientation of the coil relative to the externally generated electromagnetic field. In one embodiment, the EM sensor system may be configured and positioned to measure six degrees of freedom ("6-DOF"), e.g., three position coordinates X, Y, Z and three orientation angles indicating pitch, yaw, and roll of the base point, or five degrees of freedom, e.g., three position coordinates X, Y, Z and two orientation angles indicating pitch, yaw of the base point. A further description of an EM sensor System is provided in U.S. Pat. No.6,380,732, filed on 11.8.1999, and published as "Six-Degree-of-Freedom Tracking System with Passive Transponder on the Object bearing Tracked", which is incorporated herein by reference in its entirety. In the depicted embodiment, the position sensor 150 is shown positioned within the body 124 near the distal end 128 of the instrument 118. In other embodiments, the position sensor 150 may be positioned at any of a variety of locations along the instrument 118, inside the instrument 118, or outside the instrument 118.

In some embodiments, alternatively or additionally, wireless devices in which position or orientation is controlled by an external magnetic field may be used for shape sensing. The history of its location can be used to determine the shape of the channel for navigation.

Fig. 3 and 4 are cross-sectional views of a medical instrument 120 including a fiber optic shape sensor 140 according to one embodiment of the present disclosure. Details of the steering components and the vision imaging system have been omitted to simplify the description. The description is not to scale. In the present embodiment, the optical fiber shape sensor 140 includes four cores 144a-144d contained within a single cladding 146. Each core may be a single mode with sufficient distance and cladding to separate the cores so that light in each core does not significantly interact with light carried in other cores. In other embodiments, the number of cores may vary or each core may be contained in a separate optical fiber. In the embodiment of fig. 3 and 4, the fiber cores are arranged at 90 ° intervals around the center of the optical fiber shape sensor 140. In other embodiments, four cores may be arranged with one core at the center of the fiber and three cores spaced at 120 ° intervals around the center.

In some embodiments, an array of FBGs is disposed within each core. Each FBG comprises a series of modulations of the refractive index of the core in order to produce a spatial periodicity of the refractive index. The spacing may be chosen such that the partial reflection from each index change increases coherently for a narrow band of wavelengths and thus reflects only this narrow band of wavelengths while passing through a much wider band. During the manufacture of FBGs, the modulations are spaced apart by a known distance, causing reflection of a known band of wavelengths. However, when strain is induced on the fiber core, the pitch of the modulation will change depending on the amount of strain in the core. Alternatively, backscatter or other optical phenomena that change with the bending of the fiber can be used to determine the strain within each core.

Thus, to measure strain, light is sent underneath the fiber and the characteristics of the returning light are measured. For example, FBGs produce a reflected wavelength that is a function of the strain on the fiber and its temperature. Such FBG technology is commercially available from various sources, such as smart fiber limited of brakennell, uk. The use of FBG technology in position sensors for robotic surgery is described in U.S. patent No.7,930,065, which is incorporated herein by reference in its entirety.

The shape sensor may provide shape data in the form of strain data to the tracking system 136 shown in fig. 2. Further, the strain data may be supplemented with data relating to torsional error, optical response, temperature error, or other data that may be helpful in determining shape. When applied to a multi-core fiber, the bending of the fiber induces a strain on the cores, which can be measured by monitoring the wavelength shift in each core. By having two or more cores disposed off-axis in the fiber, the bending of the fiber induces a different strain on each of the cores. These strains are a function of the local bend radius of the fiber, the radial position of the core relative to the fiber centerline, and the angular position of the core about the core centerline relative to the plane in which the fiber bends. For example, strain induced wavelength shifts in the region of the core containing FBGs located at points where the fiber bends can be used to determine the amount of bending at those points. These data, combined with the known spacing of the FBG regions, can be used to reconstruct the shape of the fiber. This system has been described by Luna innovations, inc.

In the embodiment shown in fig. 3 and 4, the optical fiber shape sensor 140 includes four optical cores 144a-144d disposed at equal radial distances and equal angular intervals about the axis of the optical fiber shape sensor 140 such that, in cross-section, an opposing pair of cores 144a-144C and 144b-144d form orthogonal axes. The sensing locations along the four optical cores are aligned such that the measurements from each core are from an axial region of interest substantially along the optical fiber. The fiber core 144 may include a plurality of FBGs or groups thereof distributed axially along each core 144a-144 d. In various embodiments, the FBGs may be continuous, overlapping or partially overlapping. For example, in one embodiment, each core 144a-144d includes an array of collinear FBGs disposed at known locations along the length of each core 144a-144d such that the FBGs 144a-d for all four cores 144a-144d are longitudinally aligned (e.g., relative to the distance from the distal end 128 of the medical instrument 120) at a plurality of sensor segments 137 (including the steerable tip 126).

Bending of the optical fiber shape sensor 140 in one of the sensor segments 137 will lengthen at least one core 144a-144d relative to the opposing core 144a-144 d. Demodulation (interpolation) of the length difference along the fiber enables the angle and radius of the bend to be extracted. The demodulation may be performed using the tracking system 136. There are various ways of multiplexing FBGs so that a single fiber core can carry many sensors and can distinguish the readings of each sensor. Some of the various methods are described in U.S. patent application serial No. 13/049,012, which is incorporated herein by reference in its entirety.

In alternative embodiments, fibers having fewer or more cores may be used. Likewise, the fiber cores may be arranged in different patterns, such as a central core with (axial refers to fiber orientation, not spacing) additional cores spaced at angular intervals around the central core. In one embodiment, the hollow utility channel may provide access to a removable device (including removable medical instruments, removable steering components, removable visualization components, etc.). In some embodiments, the instrument body 124 may include an internal channel or fiber lumen sized to receive the optical fiber 140 and separate it from the steering or visualization component, which itself may be received through a separate channel. In fig. 3 and 4, for example, the fiber optic shape sensor 140 is positioned within the fiber lumen 162. The fiber lumen 162 may extend the entire length of the medical instrument 120.

In fig. 3, the fiber optic shape sensor 140 is centered at a radial distance D1 from the neutral axis 160, which neutral axis 160 extends longitudinally through the instrument 120 along the instrument's longitudinal axis LA in this embodiment. The neutral axis 160 is an axis of the instrument 120 along which no or little axial strain (due to tension, torsion, or compression) occurs along the neutral axis 160 during bending. In other embodiments, the fiber optic shape sensor 140 may be positioned at the neutral axis 160, or along the neutral axis 160. In alternative embodiments, the fiber optic shape sensor 140 (and the fiber cavity 162) may be centered on the neutral axis 160 or located at different radial distances. In this embodiment, the fiber optic shape sensor 140 may be offset from the neutral axis 160 to accommodate other components of the instrument 120, such as cables or other steering or visualization components (not shown) that may be centered about the neutral axis 160 or otherwise wrapped around the neutral axis 160. In this embodiment, the neutral axis 160 extends substantially along the central axis of the instrument 120. In alternative embodiments, the fiber optic shape sensor 140 may be positioned within the instrument 120 (e.g., within the fiber lumen 162) at other distances from the neutral axis or at other angular displacements from the neutral axis.

When the optical fiber shape sensor 140 is positioned offset from the neutral axis, the optical fiber shape sensor 140 experiences axial tensile and compressive forces during bending that strain all of the fiber cores and can introduce bending measurement errors. The torsion in the optical fiber shape sensor 140 may cause strain or stress on the optical fiber shape sensor 140 (e.g., in addition to strain caused by bending of the medical instrument 120), which introduces bending measurement error. The twist in the optical fiber shape sensor 140 may be caused by (e.g., by torsional or rotational displacement of the medical instrument 120 when the medical instrument is steered or guided in multiple directions. the twist occurs in the optical fiber shape sensor when the proximal portion 164 of the optical fiber shape sensor 140 is rotated about the longitudinal axis OA of the optical fiber shape sensor 140 relative to the distal portion 166 of the optical fiber shape sensor. for example, the optical core 168 may be located in the distal portion 166 and the proximal portion 164 at different radial angles relative to the longitudinal axis OA. because the strain on the optical fiber shape sensor 140 due to axial forces may be indistinguishable from the apparent strain caused by torsion, it may be difficult to determine the magnitude of the bend measurement error due to axial forces versus torsion (versus) The discernible component of the varying reflected optical reading, the displacement information determined from the optical data can include inaccuracies or errors in estimating the position or shape of the medical instrument 120.

Accordingly, in order to accurately estimate or predict the position or shape of the elongated medical instrument 120 as described above using the optical fiber 120, it may be desirable to reduce the likelihood of twisting or rotation of the optical fiber 120 during manipulation (e.g., steering and/or bending) of the medical instrument 120. In some embodiments described herein, the optical fiber shape sensor 140 is mechanically constrained to prevent or reduce twisting of the proximal portion 164 relative to the distal portion 166 of the optical fiber shape sensor 140 while allowing axial translation along the longitudinal axis (e.g., parallel to the longitudinal axis LA) through the medical instrument 120. In some cases, the optical fiber shape sensor 140 is mechanically prevented or limited from twisting about the longitudinal axis OA by the twist resistant feature 170.

For example, fig. 5 illustrates a cross-sectional view of an example twist resistant feature 170 associated with an example medical instrument 173, the example medical instrument 173 including an optical fiber shape sensor extending within a fiber lumen 175, according to an embodiment of the present disclosure. The medical instrument 173 may be the same as the medical instrument 120 shown in fig. 2. In the illustrated embodiment, the twist resistant feature 170 is disposed between the optical fiber shape sensor 140 and a cavity wall 174 of the fiber cavity 175. The twist resistant feature 170 may include any of a variety of mechanical elements configured to minimize or prevent twisting of the optical fiber shape sensor 140, including features of the optical fiber shape sensor 140 itself, features of the fiber lumen 175, and independent features (such as, by way of non-limiting example, coatings, sheaths, and keying features).

In the illustrated embodiment, the fiber lumen 175 comprises a hollow tubular space formed within the body 176 of the instrument 173. The body 176 forms an elongated flexible tube having an inner surface 177 and an outer surface 178. Inner surface 177 of body 176 defines a central cavity 179. The central lumen 179 may include a working channel for the medical instrument 173. The medical instrument 173 includes a plurality of actuation channels 180 extending within the body 176, the plurality of actuation channels 180 configured to receive an actuation cable 182.

In alternative embodiments, the optical fiber shape sensor 140 can be coupled, bonded, or attached to the inner surface 177 or the outer surface 178 as appropriate. In other alternative embodiments, the inner surface 177 may also define a groove in which the optical fiber shape sensor 140 may be positioned. In still other embodiments, the optical fiber shape sensor 140 can be coupled to the outer surface 178 or integrally formed with the outer surface 178 using, for example, a suitable adhesive or bonding agent, and/or the optical fiber shape sensor 140 can be positioned within a hole or recess formed within the outer surface 178. Further, the optical fiber 140 may be coupled to the instrument 173 in a manner that couples a portion of the optical fiber 140 at a known reference location on a proximal portion of the instrument 173.

Fig. 6A and 6B illustrate the optical fiber shape sensor 140 coupled to an example twist resistant feature 170' according to one embodiment of the present disclosure. Fig. 6A shows a perspective view of the optical fiber shape sensor 140 and the twist resistant feature 170', and fig. 6B shows a cross-sectional view of the optical fiber shape sensor 140 and the twist resistant feature 170' through line 6B-6B in fig. 6A. In some embodiments, as shown in fig. 6A and 6B, the twist resistant feature 170' includes a twist resistant sheath or covering 171, such as, by way of non-limiting example, a hypotube or a braided sheath, coupled to at least a portion of the optical fiber shape sensor 140. This sheath 171 can create friction between the shape sensor 140 and the fiber lumen 175, thereby limiting torsional motion. The sheath 171 thus makes the shape sensor 140 resistant to twisting within the fiber lumen 175 along at least a portion of the length of the medical instrument 120. In an alternative embodiment, the twist resistant feature 170' may be a textured surface of the fiber lumen 175 that limits twisting of the shape sensor 140. In still other alternatives, the texture of sheath 171 or lumen 175 may be selected to create greater resistance to torsional movement than to axial sliding movement. In alternative embodiments, the sheath 171 may include a structural configuration that inherently resists twisting, thereby reducing twisting of the optical fiber shape sensor 140 coupled thereto.

Alternatively, as shown in fig. 7A-7C, the twist resistant feature 170 "may include a coating 172 made of a material having a relatively low coefficient of friction, such as, by way of non-limiting example, a teflon coating, a lubricant coating, or a polymer coating. By reducing the coefficient of friction between the fiber optic shape sensor 140 and the walls of the fiber lumen (e.g., the fiber lumen 175 shown in fig. 5), the coating 172 can facilitate free rotation of the fiber optic shape sensor 140 (e.g., of both the proximal portion 164 and the distal portion 166 of the fiber optic shape sensor 140) within the fiber lumen 175 as the medical instrument meanders, bends, and twists during use.

Fig. 7A and 7B illustrate the optical fiber shape sensor 140 surrounded by the coating 172 along at least a portion of its length L1. Fig. 7A illustrates a perspective view of the optical fiber shape sensor 140 and the twist resistant feature 170 ", and fig. 7B illustrates a cross-sectional view of the optical fiber shape sensor 140 and the twist resistant feature 170" through line 7B-7B in fig. 7A. In other embodiments, instead of the coating 172 being coupled to the optical fiber shape sensor 140, the coating 172 is coupled to the fiber lumen. Fig. 7C shows a cross-sectional view of an exemplary fiber lumen 185 coated along at least a portion of its length with a coating 172. In the illustrated embodiment, the fiber lumen 185 includes an inner wall 187, and the coating 172 covers or coats the inner wall 187 along at least a portion of the length of the fiber lumen 185. The optical fiber shape sensor 140 is shown extending within the central cavity 189 of the fiber cavity 185.

Additionally or alternatively, as shown in fig. 8A, 8B, and 8C, the twist resistant feature includes a keying feature 195, the keying feature 195 extending along at least a portion of the length of the optical fiber shape sensor 140 and configured to limit twisting of the optical fiber shape sensor about the longitudinal axis OA. Fig. 8A and 8B illustrate the optical fiber shape sensor 140 coupled to the keying feature 195. Fig. 8A shows a perspective view of the optical fiber shape sensor 140 and the keying feature 195, and fig. 8B shows a cross-sectional view of the optical fiber shape sensor 140 and the keying feature 195 through line 8B-8B in fig. 8A. The keying feature 195 includes a rotation stop wedge 200 coupled to the shape sensor 140. The rotation stop wedge 200 may comprise a length of wire, polymer rod, fiberglass, or other suitable rigid or semi-rigid member. The anti-rotation wedge 200 may be cylindrical in shape or may include an elongated flat or curved surface. The anti-rotation wedge 200 may be secured to the shape sensor 140 with an adhesive and/or other mechanical coupling or binding, such as an anti-rotation wedge sheath 205. The rotation stop wedge 200 cooperates with an outer surface of the optical fiber shape sensor 140 to limit rotation or twisting of the optical fiber shape sensor 140 at least at the location of the keying feature 195.

Fig. 8C illustrates a cross-sectional view of an example medical instrument 400 including the optical fiber shape sensor 140, the keying feature 195, and a reference sensor (e.g., the position sensor 150 as shown in fig. 2) according to one embodiment of the present disclosure. The medical instrument 400 is substantially similar to the medical instrument 173 shown in fig. 5, except for the differences described herein. In the medical instrument 400, the keying feature 195 may function to limit or eliminate torsional or rotational displacement of the fiber optic shape sensor 140 by securing an arrangement of the sensor 140 within the fiber lumen 405, the fiber lumen 405 having an elliptical or other elongated cross-sectional shape similar to the cross-sectional shape of the keying feature 195. As shown in fig. 8C, the keying feature 195 limits rotational displacement or twisting of the fiber optic shape sensor 140, generally relative to the medical instrument 400 and/or specifically relative to the position sensor 150. Other embodiments may lack position sensor 150. As shown in fig. 8C, the fiber lumen 405 may be disposed within the body wall 410 of the medical instrument 400, thereby providing a conduit for the fiber optic shape sensor 140 that minimizes twisting without increasing the overall outer diameter D1 of the medical instrument 400.

As shown in the embodiment of fig. 8A-8C, the rotation stop wedge 200 optionally includes a concave curved outer mating surface 215 shaped and configured to mate (e.g., sit flush) with the outer surface 210 of the fiber optic shape sensor 140. The rotation stop wedge sheath 205 is shaped and configured to tightly surround the optical fiber shape sensor 140 and the rotation stop wedge 200 and maintain their mated configuration. As best shown in fig. 8B, the bonding material 220 may optionally be included in the space remaining inside the rotation stop wedge sheath 205 (i.e., the space not occupied by the optical fiber shape sensor 140 or the rotation stop wedge 200). The adhesive material may be formed of any of a variety of materials including, but not limited to, adhesive and non-adhesive filler materials.

As shown in the illustrated embodiment of fig. 8A, the rotation stop wedge 200 includes a length L2 that is generally at least as long as the length of the position sensor 150 (e.g., length L3 shown in fig. 11A). In some embodiments, the length L2 of the keying feature 195 is slightly longer than the length L3 of the position sensor 150 to account for the expected translation of the keying feature 195 (e.g., the anti-rotation wedge 200) within the fiber lumen 405 of the instrument 400. In a given embodiment, the length L1 of the keying feature 195 may be up to a desired length for a fixed rotation of the optical fiber shape sensor 140.

In various embodiments, the keying feature 195 may be shaped and sized in any of a variety of shapes and sizes suitable for limiting rotation and twisting of the fiber optic shape sensor 140. For example, although the keying feature 195 shown in fig. 8A and 8B is shaped as a parallel cylinder, the keying feature 195 may comprise any of a variety of shapes or structural features, such as, by way of non-limiting example, a wire, lever arm, notch, or protrusion that is shaped and configured to engage with an inner surface or corresponding structural attribute of the medical instrument 120 (e.g., within the fiber lumen 405) to form a keyed arrangement that limits or prevents twisting or rotational movement of the optical fiber shape sensor 140 within the medical instrument 400.

In one embodiment, as shown in fig. 9A, the keying feature 195' comprises a series of individual anti-rotation wedges 250. In various embodiments, the keying feature 195' may comprise any number of individual anti-rotation wedges of any shape and size. In the illustrated embodiment, the keying feature 195' includes four detent wedges 250a, 250b, 250c, and 250d of similar shape and size. The anti-rotation wedges 250a, 250b, 250c, and 250d are each attached to the optical fiber shape sensor 140 in series with a small space between each anti-rotation wedge. The configuration of multiple anti-rotation wedges coupled in series to the fiber optic shape sensor 140 may allow the sensor 140 to bend and maintain a low bending stiffness while preserving the long ribbon key portion of the sensor 140 to prevent twisting of the sensor.

FIG. 9B shows a keying feature 195 ". The keying feature 195" comprising a series of individual anti-rotation wedges 260a, 260B, 260C, and 260 d. except for the differences described herein, this keying feature 195 "is substantially similar to the keying feature 195' shown in FIG. 9A. the anti-rotation wedges 260a, 260B, 260C, and 260d are offset from each other such that adjacent anti-rotation wedges are oriented at slightly different angles relative to each other (at slightly different radial angles relative to the longitudinal axis OA of the optical fiber shape sensor 140. for example, in the illustrated embodiment, the anti-rotation wedges 260a and 260C are oriented at an angle α to the anti-rotation wedges 260B and 260 d. in some embodiments, the offset may be accomplished by elastic fasteners coupling the individual anti-rotation wedges together. the elastic fasteners may comprise any of a variety of fastening materials, such as, by way of non-limiting example, an adhesive.

Fig. 10 illustrates a cross-sectional view of an exemplary medical instrument 300 including a fiber lumen 305 according to one embodiment of the present disclosure. The medical instrument 300 may be the same as the medical instrument 120 described above with reference to fig. 2. The body 310 forms an elongated flexible tube having an inner surface 315 and an outer surface 320. The inner surface 315 of the body 310 defines a central cavity 325. Central lumen 325 may include a working channel of medical instrument 300. Medical instrument 300 includes a plurality of actuation channels 330 within body 310 configured to receive actuation cables 335. In other embodiments, the optical fiber shape sensor 140 can be coupled, bonded, or attached to the inner surface 315 or the outer surface 320 as appropriate. The inner surface 315 may also define a groove in which the optical fiber shape sensor 140 may be positioned. In still other embodiments, the optical fiber shape sensor 140 can be coupled to the outer surface 320 or integrally formed with the outer surface 320 using, for example, a suitable adhesive or bonding agent, and/or the optical fiber shape sensor 140 can be positioned within a hole or groove formed within the outer surface 320. Further, the optical fiber 140 can be coupled to the instrument 300 in a manner that couples a portion of the optical fiber 140 at a known reference location on a proximal portion of the instrument 300.

In the illustrated embodiment, the fiber lumen 305 comprises a hollow tubular space formed within the body 310 of the instrument 300 that is configured to receive the fiber optic shape sensor 140. In the illustrated embodiment, the fiber lumen has an elliptical cross-sectional shape. In other embodiments, the fiber lumen 305 may have any of a variety of cross-sectional shapes, including but not limited to oval, circular, rectangular, rhomboid, crescent, serpentine, and spiral. In some embodiments, as described above, the fiber lumen 305 may include at least one notch, recess, or protrusion configured to mate with a corresponding notch, recess, or protrusion formed along the optical fiber shape sensor 140 and/or the twist resistant feature 170. In some embodiments, the twist resistant feature 170 and the fiber lumen 305 may share a similar cross-sectional shape or profile to limit the twisting or rotational displacement of the optical fiber shape sensor 140 about the longitudinal axis OA of the optical fiber shape sensor 140 (as described above with reference to fig. 8C).

Some embodiments may lack a separate twist resistant feature 170 or keying feature 195, and the fiber optic shape sensor 140' may be shaped to have a cross-sectional shape corresponding to the fiber lumen 305. In other words, the cross-sectional shape of the fiber cavity 305 may substantially match the cross-sectional shape of the optical fiber shape sensor 140', such that the shape of the fiber cavity itself limits the torsional and rotational displacement of the optical fiber shape sensor 140'. In the illustrated embodiment, the cross-sectional profile of the fiber lumen 305 is elliptical, and the fiber lumen 305 closely and slidably receives the optical fiber shape sensor 140', the optical fiber shape sensor 140' also having an elliptical cross-sectional shape. In such embodiments, the twist resistant feature 170 includes corresponding cross-sectional shapes of the fiber optic shape sensor 140' and the fiber lumen 305.

Fig. 11A-11D are cross-sectional views of various medical instruments that each include an optical fiber shape sensor 140 and another sensor (e.g., a position sensor 150) according to various embodiments of the present disclosure. Fig. 11A-11D illustrate exemplary medical instruments 500, 600, 700, and 800, respectively. Medical instruments 500, 600, 700, and 800 may each be the same as medical instrument 120 shown in fig. 2. In some embodiments, medical instruments 500, 600, 700, and 800 may each be substantially similar to medical instruments 173, 300, or 400 described above. Each of the following figures demonstrate an exemplary arrangement of the optical fiber shape sensor 140, the twist resistant feature 170 (e.g., the twist resistant feature 170', twist resistant feature 170 ", and/or keying feature 195 described above), and the reference sensor (e.g., the position sensor 150) relative to each other and relative to a distal portion of a medical instrument according to various embodiments of the present disclosure. In some embodiments, the distal portion of the medical instrument is proximal to the actively steerable portion. In other embodiments, the distal portion of the medical instrument comprises a distal end of the medical instrument. In each of the illustrated embodiments, the optical fiber shape sensor 140 is secured to the position sensor 150 or medical instrument at a first location along its length (e.g., secured to create a standard reference relationship between the optical fiber shape sensor 140 and the position sensor 150), and is coupled to the anti-twist feature 170 at a second location along its length. This configuration allows registration of the optical fiber shape sensor 140 to at least one reference point and limits twisting of the optical fiber shape sensor 140 while enabling it to translate axially within the medical instrument.

In some embodiments, as shown in fig. 11A, the optical fiber shape sensor 140 is secured to the body 505 of the medical instrument 500 at the same axial position as the position sensor 150 of the medical instrument 500 (e.g., at the same axial distance from the distal end of the medical instrument 500 along the longitudinal axis LA of the medical instrument 500) to create at least one fixed reference point for the optical fiber shape sensor 140. In the illustrated embodiment, the fiber optic sensor shape 140 (within the fiber lumen 510) is coupled to the body 505 via a bonding agent 515 (such as, by way of non-limiting example, an adhesive). The fiber optic shape sensor 140 is coupled to the twist resistant feature 170 near or adjacent to the distal portion 520 of the medical instrument 500. Thus, the fiber optic shape sensor 140 is mechanically prevented or limited from twisting at the distal portion 520 while still being allowed to translate within the fiber lumen 510 at the distal portion 520.

In some embodiments, as shown in fig. 11B, the optical fiber shape sensor 140 is mechanically prevented or limited from twisting at the axial position of the position sensor 150 by coupling to a twist resistant feature 170 at the axial position of the position sensor 150. In the illustrated embodiment, the fiber optic shape sensor 140 is secured to the body 605 of the medical instrument 600 (within the fiber lumen 602) near or adjacent to the distal portion 610 of the medical instrument 600. In the illustrated embodiment, the fiber optic shape sensor 140 is coupled to the body 605 via a bonding agent 615.

In some embodiments, as shown in fig. 11C, the optical fiber shape sensor 140 is secured to the position sensor 150, and the position sensor 150 adheres itself to the body 705 of the medical instrument 700 to provide a reference point for the shape sensor 140. In the illustrated embodiment, the position sensor 150 and the optical fiber shape sensor 140 are adhered to the body 705 via a bonding agent 710a, and the optical fiber shape sensor 140 is adhered directly to the position sensor 150 via a bonding agent 710 b. The fiber optic shape sensor 140 is mechanically constrained from twisting at a distal portion 715 (e.g., near a steerable tip) of the medical instrument 700 by a twist resistant feature 170. The twist resistant feature 170 is coupled to the fiber shape sensor 140 at the distal portion 715.

In some embodiments, as shown in fig. 11D, the optical fiber shape sensor 140 is adhered to the position sensor 150 via a bonding agent 805. The twist resistant feature 170 is coupled to the optical fiber shape sensor 140 at the same axial position as the position sensor 150. However, both the optical fiber shape sensor 140 and the position sensor 150 are allowed to translate along the longitudinal axis LA of the medical instrument 800 (e.g., neither the optical fiber shape sensor 140 nor the position sensor 150 is affixed to an axial position within the body 810 of the medical instrument).

In some embodiments, knowledge of the axial forces that produce compression and tension in the optical fiber shape sensor 140 may be used to identify the magnitude and/or effect of torsional forces and rotational displacement in bending measurements, and may also be used to isolate measurement errors produced by the axial forces on torsion. The information about the effect of the axial force and the degree of twist can then be used to create a mathematical model to algorithmically describe the twist between the fixed point of the fiber optic shape sensor 140 and the reference sensor (i.e., the position sensor 150) to compensate for the calculated bend measurements for the instrument. Knowledge of the torsional measurement error within the instrument may also allow the effects of torsional and axial forces to be separated and their respective effects on the bending measurement to be identified. An algorithmic compensation technique is then used to remove the effects of torsion from the final bending measurements.

Twisting of the optical fiber can also be mitigated by reducing the overall sensed length of the shape sensor 140. Fig. 12A and 12B illustrate a medical instrument 900, 910, the medical instrument 900, 910 mitigating twist in the sensing portion of the fiber optic shape sensor 140 by reducing the sensed portion to a length between the distal end of the instrument and a known reference point. The medical instruments 900, 910 may each be the same as the medical instrument 120 shown in fig. 2. Fig. 12A shows a medical instrument 900 in which fiducial markers 902 of the fiber optic shape sensor 140 are coupled to the position sensor 150. Fiducial marker 902 may be a bend, a ring, or other marker detectable by tracking system 136. Fiducial marker 902 coupled to position sensor 150 provides an axial reference point. The shape of the optical fiber 140 may be measured from the fiducial marker 902 to the distal tip 904 of the optical fiber. In this embodiment, the distal tip of the optical fiber is located at the distal tip of the medical instrument 900, but in alternative embodiments, the optical fiber may terminate at the proximal end of the distal tip of the instrument. Fixing the position of the fiducial marker 902 in the measurable position may eliminate the need to measure the shape of the torsionally prone length of the optical fiber 140 between the fiducial marker 902 and the proximal end of the optical fiber 140.

Fig. 12B shows a medical instrument 910 in which the fiducial marker 912 of the fiber optic shape sensor 140 is held at a fixed axially offset distance D from the distal tip of the instrument 910. The length D of the fiber optic shape sensor 140 passes through the lumen of the fiber of the instrument 910 without constraint. The free movement of the fiber within the fiber lumen may reduce twisting of the length D of the fiber.

Fig. 13 illustrates a medical instrument 920 that mitigates twisting and/or improves measurement of the length for the instrument by helically winding a fiber optic shape sensor 140 around the longitudinal axis of the distal portion of the instrument (e.g., steerable tip 126). The medical instrument 920 may be the same as the medical instrument 120 shown in fig. 2. Position sensor 150 is shown located near the proximal end of distal portion 126, but may be located at other locations along the catheter. Alternatively, the position sensor may be omitted. As shown in fig. 13, the fiber optic shape sensor 140 may be helically wound and secured within the wall of the flexible body 124 in the steerable tip 126. The characteristics of the helical winding, including the angle of the winding relative to the longitudinal axis of the flexible body and the minimum allowable radius of the bend, are selected to minimize axial strain (compression or elongation) on the optical fiber. For example, the characteristics of the spiral pattern may be selected to limit the axial strain to less than about 1%. In this embodiment, axial movement of the fiber 140 at the proximal end 130 of the instrument may be unconstrained. The fiber may be moved into and out of the proximal end 130 of the instrument, experiencing minimal axial strain near the proximal end of the instrument. The optical fiber 140 may optionally include an auxiliary bundle loop (serviceloop)922 proximal to the proximal end 130 of the instrument, the auxiliary bundle loop 922 allowing the optical fiber to move axially in and out of the proximal end of the instrument as needed to accommodate movement of the instrument without stretching the optical fiber. The auxiliary bundle loop 922 may be any slack portion of the optical fiber and need not be a complete loop. Optionally, mechanical fiducials 924 (such as markers or sensors) may be attached to the optical fiber 140 proximal to the instrument proximal end 130. Tracking the mechanical reference provides data for determining the twist of the proximal portion of the optical fiber. Axial strain in the fiber optic shape sensor obscures the twist measurement, but because the fiber axial strain is minimized in the steerable portion 126 of the instrument, the fiber 140 is able to measure the twist of the distal portion 126 of the instrument 920. This twist measurement can be combined with the twist measured at the proximal end of the instrument to calculate the total twist in the instrument 920.

In an alternative embodiment, the optical fiber may be helically wound and embedded in the wall along the entire length of the flexible body 124. In the case of winding the fiber along the entire length, the axial strain is minimized to allow the twist to be measured over the length of the instrument. In this embodiment, the twist can be measured without fixing the proximal end of the fiber to a mechanical reference.

Fig. 14 shows a medical instrument 930 that mitigates torsion and/or improves measurement for any torsion by securing the distal end of the fiber optic shape sensor 140 to the distal end of the flexible body 124 and securing the proximal end of the fiber optic shape sensor in a known or measurable position. The medical instrument 930 may be the same as the medical instrument 120 shown in fig. 2. Position sensor 150 is shown located near the proximal end of distal portion 126, but it may be located at other locations along the catheter. Alternatively, the position sensor may be omitted. The optical fiber may be attached to the distal end of the flexible body, for example, using an adhesive, mechanical coupling, or by embedding the fiber in the wall of the flexible body. In this embodiment, the portion of the fiber 140 within the flexible body 124 and the proximal side of the distal fixation location may float freely within the shape sensor lumen of the flexible body. The fiber 140 may include an auxiliary bundle loop 922 proximal to the instrument proximal end 130, the auxiliary bundle loop 922 allowing the optical fiber to move axially in and out of the instrument proximal end as needed when the instrument is bent. Because the fiber is allowed to move in and out of the proximal end 130 of the instrument, it can experience minimal axial strain when the instrument is bent. The proximal end of the optical fiber 140 may be coupled to a fixture 933 that is fixed in a known position with reference to a known coordinate system. The coordinate system may be fixed relative to the teleoperational arm 934 holding the instrument. The teleoperational arm 934 may reference patient images, such as preoperative CT images, or reference position sensors attached to the patient that relate to the coordinate system of the teleoperational arm 934. In this embodiment, the torsion of the catheter is measured with the fiber shape sensor 140 from the fixture 933 to the distal fixation point of the fiber.

In some configurations, it may be desirable to infer twist at a particular location using a mathematical or empirical model of twist along the length of the fiber. In one such embodiment, the fiber may be secured at both ends with an amount of slack to allow for sliding along the fiber axis (e.g., fig. 14). The torsion at the reference frame (reference frame) along the catheter (e.g., at the EM sensor 150) may be calculated. While the twist can be measured directly by the fiber, the mathematical model can help measure the twist of the fiber relative to the lumen or catheter, which can be freely twisted relative to a desired reference frame on the catheter. One model assumes that the twist of the fiber relative to the lumen is linearly proportional to the distance from a fixed point (e.g., the catheter tip). Other mathematical models may include polynomial or exponential fits of the relative twist. Alternatively, the twist may be measured empirically by some other method to measure the twist of the fiber relative to the catheter for a particular bend angle or direction.

If two or more shape sensors are used at known locations within the catheter, the measurement of catheter twist can be measured using the relative shapes (locations) of the fibers, without regard to the twist profile of any individual shape sensor. In this configuration, the fibers may be allowed to float freely in the lumen to allow for the mitigation of any applied twist. After the measurement of the torsion, a reference frame on the catheter, such as an EM sensor, may be measured at a point relative to the plurality of sensors.

Although the fiber optic shape sensor and position sensor system have been described herein with respect to teleoperated or manually operated surgical systems, these sensors can find application in a variety of medical and non-medical instruments where accurate instrument bend measurements would otherwise be compromised due to torsional or other rotational displacement of the shape sensor.

One or more elements in embodiments of the invention may be implemented in software for execution on a processor of a computer system, such as control system 108. When implemented in software, the elements of an embodiment of the invention are essentially the code segments to perform the necessary tasks. The program or code segments can be stored in a processor readable storage medium or device and downloaded via a computer data signal embodied in a carrier wave over a transmission medium or communication link. The processor readable storage device may include any medium capable of storing information, including optical media, semiconductor media, and magnetic media. Examples of a processor-readable storage device include electronic circuitry; semiconductor devices, semiconductor memory devices, Read Only Memories (ROMs), flash memories, Erasable Programmable Read Only Memories (EPROMs); floppy disks, CD-ROMs, optical disks, hard disks, or other memory devices. The code segments may be downloaded via computer networks such as the internet, intranets, etc.

Note that the processes and displays presented may not be inherently related to any particular computer or other apparatus. Various general-purpose systems may be used with programs in accordance with the teachings herein, or it may prove convenient to construct a more specialized apparatus to perform the operations described. The required structure for a variety of these systems will appear as elements of the invention. In addition, embodiments of the present invention are not described with reference to any particular programming language. It will be appreciated that a variety of programming languages may be used to implement the teachings of the invention as described herein.

While certain exemplary embodiments of the invention have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that embodiments of the invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art.