阅读说明：本技术 用于医疗系统和应用的倾斜机构 (Tilt mechanism for medical systems and applications ) 是由 C·D·J·鲁伊斯 于 2020-03-05 设计创作，主要内容包括：本发明公开了一种机器人医疗系统,该机器人医疗系统可包括患者平台。该患者平台包括倾斜机构。该倾斜机构可包括侧向倾斜机构和纵向倾斜机构。该侧向倾斜机构可包括倾斜板和枢转外壳。安装在该倾斜板上的线性致动器可向该枢转外壳施加线性力。该侧向倾斜机构还可包括沿着第一轴线延伸的第一线性引导件,并且该枢转外壳可沿着该第一线性引导件平移。向该枢转外壳施加线性力通过使该枢转外壳沿着该第一线性引导件平移而使该倾斜板倾斜。(A robotic medical system may include a patient platform. The patient platform includes a tilt mechanism. The tilting mechanism may include a lateral tilting mechanism and a longitudinal tilting mechanism. The side tilting mechanism may include a tilting plate and a pivot housing. A linear actuator mounted on the tilt plate may apply a linear force to the pivot housing. The lateral tilt mechanism may also include a first linear guide extending along the first axis, and the pivot housing may translate along the first linear guide. Applying a linear force to the pivot housing tilts the tilt plate by translating the pivot housing along the first linear guide.)

1. A tilt mechanism for a medical platform, the tilt mechanism comprising:

an inclined plate;

a linear actuator mounted on the tilt plate and configured to apply a linear force to a pivot housing; and

a first linear guide attached to a gimbal, wherein the first linear guide extends along a first axis and the pivot housing is configured to translate along the first linear guide;

wherein applying a linear force to the pivot housing tilts the tilt plate relative to the gimbal by translating the pivot housing along the first linear guide.

2. The tilt mechanism of claim 1, wherein the pivot housing is further configured to pivot relative to the first linear guide as the pivot housing translates along the first linear guide.

3. The tilt mechanism of claim 1, wherein the linear actuator applies the linear force in a direction along a second axis.

4. The tilt mechanism of claim 3, wherein the first axis and the second axis are non-parallel.

5. The tilt mechanism of claim 1, wherein:

the linear actuator includes a motor configured to rotate a lead screw; and is

The pivot housing includes a nut housing mounted on the lead screw.

6. The tilt mechanism of claim 1, wherein:

the tilt plate is configured to pivot about a pivot axis relative to the gimbal and the pivot axis is configured to translate along the first axis relative to the gimbal.

7. The tilt mechanism of claim 1, further comprising a second linear guide attached to the tilt plate, wherein:

the first linear guide comprises a first set of rails; and is

The second linear guide includes a second set of guide rails.

8. The tilt mechanism of claim 7, wherein the first set of rails is positioned between the second set of rails.

9. The tilt mechanism of claim 1, wherein:

the tilt plate is attached to a patient platform; and is

The gimbal is attached to a column that supports the patient platform.

10. A robotic medical system, comprising:

a patient platform configured to support a patient during a medical procedure;

a column supporting the patient platform; and

a tilt mechanism connecting the column to the patient platform, the tilt mechanism comprising:

a lateral tilt mechanism configured to pivot the patient platform about a lateral tilt axis of the patient platform; and

a longitudinal tilt mechanism configured to pivot the patient platform about a longitudinal tilt axis of the patient platform.

11. The system of claim 10, wherein the lateral tilt mechanism and the longitudinal tilt mechanism are configured to operate simultaneously.

12. The system of claim 10, wherein the lateral tilt mechanism is positioned on top of the longitudinal tilt mechanism.

13. The system of claim 10, wherein the lateral tilt mechanism comprises a linear actuator configured to apply a linear force in a direction perpendicular to the lateral tilt axis to pivot the patient platform about the lateral tilt axis.

14. The system of claim 10, wherein the lateral tilt mechanism comprises:

a tilt plate attached to the patient platform;

a linear actuator mounted on the tilt plate and configured to apply a linear force to a pivot housing;

a first linear guide attached to a gimbal, wherein the first linear guide extends along a first axis and the pivot housing is configured to translate along the first linear guide; and

a second linear guide attached to the tilt plate, wherein the second linear guide extends along a second axis and the pivot housing is configured to translate along the second linear guide;

wherein applying a linear force to the pivot housing tilts the tilt plate relative to the gimbal by translating the pivot housing along the first and second linear guides.

15. The system of claim 14, wherein the linear actuator applies the linear force in a direction parallel to the second axis.

16. The system of claim 14, wherein the first axis and the second axis are non-parallel.

17. The system of claim 14, wherein:

the linear actuator includes a motor configured to rotate a lead screw; and is

The pivot housing includes a nut housing mounted on the lead screw.

18. The system of claim 14, wherein:

the tilt plate is configured to pivot relative to the gimbal about the lateral tilt axis, and the lateral tilt axis is configured to translate relative to the gimbal along the first axis.

19. The system of claim 14, wherein the longitudinal tilt mechanism comprises:

a longitudinally inclined link extending between the column and the gimbal; and

an actuator configured to actuate the longitudinal tilt link to pivot the gimbal relative to the column to tilt the patient platform about the longitudinal tilt axis.

20. The system of claim 19, wherein the actuator comprises a longitudinal linear actuator configured to translate along an axis of the post to actuate the longitudinal tilt link.

21. The system of claim 10, wherein:

the lateral tilt mechanism is configured to allow tilting about the lateral tilt axis by at least 15 degrees; and is

The longitudinal tilting mechanism is configured to allow tilting at least 30 degrees about the longitudinal tilting axis.

22. The system of claim 10, wherein:

the lateral tilt mechanism is configured to allow tilting about the lateral tilt axis by about 30 degrees; and is

The longitudinal tilting mechanism is configured to allow tilting about 45 degrees about the longitudinal tilting axis.

23. A method for controlling tilt of a patient platform, the method comprising:

tilting the patient platform about a lateral tilt axis based on:

actuating a linear actuator to apply a linear force to the pivot housing;

translating the pivot housing along a first linear guide along a first axis; and

translating the pivot housing along a second linear guide along a second axis.

24. The method of claim 23, wherein the first axis is parallel to the linear force and the second axis is not parallel to the first axis.

25. The method of claim 23, wherein actuating the linear actuator comprises driving a lead screw with a motor, and wherein the pivot housing comprises a nut housing mounted on the lead screw.

26. The method of claim 25, wherein the motor is attached to a tilt plate that supports the patient platform, and wherein the first linear guide is attached to the tilt plate.

27. The method of claim 26, wherein the second linear guide is attached to a gimbal.

28. The method of claim 27, further comprising:

pivoting the gimbal relative to a column supporting the patient platform to tilt the patient platform about a longitudinal tilt axis.

29. The method of claim 28, wherein pivoting the gimbal relative to a post comprises driving a longitudinally-sloped link with a longitudinal linear actuator that translates along an axis of the post.

30. The method of claim 29, further comprising tilting the patient platform about the lateral tilt axis and the longitudinal tilt axis simultaneously.

31. The method of claim 30, further comprising performing a robotic medical procedure on a patient supported on the patient platform.

Technical Field

The present application relates generally to robotic medical systems and, in particular, to a tilt mechanism for a patient platform of a robotic medical system.

Background

A patient platform such as a table or bed may be used to support the patient during a medical procedure. For example, patient platforms are typically used during manual medical procedures as well as during robotic medical procedures. Generally, such patient platforms are horizontally oriented.

Disclosure of Invention

A surgical or medical robotic system having a robotic arm and a patient platform can be configured to perform a variety of surgical or medical procedures. In a first aspect, a tilt mechanism for a medical platform comprises: an inclined plate; a linear actuator mounted on the tilt plate and configured to apply a linear force to the pivot housing; and a first linear guide attached to the gimbal. The first linear guide extends along a first axis, and the pivot housing is configured to translate along the first linear guide, and applying a linear force to the pivot housing tilts the tilt plate relative to the gimbal by translating the pivot housing along the first linear guide.

The tilt mechanism may include one or more of the following features in any combination: (a) wherein the pivot housing is further configured to pivot relative to the first linear guide as the pivot housing translates along the first linear guide; (b) wherein the linear actuator exerts a linear force in a direction along the second axis; (c) wherein the first axis and the second axis are non-parallel; (d) wherein the linear actuator comprises a motor configured to rotate a lead screw, and the pivot housing comprises a nut housing mounted on the lead screw; (e) wherein the tilt plate is configured to pivot about a pivot axis relative to the gimbal and the pivot axis is configured to translate along a first axis relative to the gimbal; (f) a second linear guide attached to the tilt plate, wherein the first linear guide comprises a first set of rails and the second linear guide comprises a second set of rails; (g) wherein the first set of rails is positioned between the second set of rails; and/or (h) wherein the tilt plate is attached to a patient platform and the gimbal is attached to a column supporting the patient platform.

In another aspect, a robotic medical system includes: a patient platform configured to support a patient during a medical procedure; a column supporting a patient platform; and a tilt mechanism connecting the column to the patient platform. The tilt mechanism comprises a lateral tilt mechanism configured to pivot the patient platform about a lateral tilt axis of the patient platform; and a longitudinal tilt mechanism configured to pivot the patient platform about a longitudinal tilt axis of the patient platform.

The system may include one or more of the following features in any combination: (a) wherein the lateral tilt mechanism and the longitudinal tilt mechanism are configured to operate simultaneously; (b) wherein the lateral tilt mechanism is positioned on top of the longitudinal tilt mechanism; (c) wherein the lateral tilt mechanism comprises a linear actuator configured to apply a linear force in a direction perpendicular to the lateral tilt axis to pivot the patient platform about the lateral tilt axis; (d) wherein the lateral tilt mechanism comprises: a tilt plate attached to the patient platform; a linear actuator mounted on the tilt plate and configured to apply a linear force to the pivot housing; a first linear guide attached to the gimbal, wherein the first linear guide extends along a first axis and the pivot housing is configured to translate along the first linear guide; and a second linear guide attached to the tilt plate, wherein the second linear guide extends along a second axis and the pivot housing is configured to translate along the second linear guide; (e) wherein applying a linear force to the pivot housing tilts the tilt plate relative to the gimbal by translating the pivot housing along the first linear guide and the second linear guide; (f) wherein the linear actuator exerts a linear force in a direction parallel to the second axis; (g) wherein the first axis and the second axis are non-parallel; (h) wherein the linear actuator comprises a motor configured to rotate a lead screw, and the pivot housing comprises a nut housing mounted on the lead screw; (i) wherein the tilt plate is configured to pivot relative to the gimbal about a lateral tilt axis, and the lateral tilt axis is configured to translate relative to the gimbal along a first axis; (j) wherein the longitudinal tilting mechanism comprises: a longitudinally inclined link extending between the column and the gimbal; and an actuator configured to actuate the longitudinal tilt link to pivot the gimbal relative to the column to tilt the patient platform about the longitudinal tilt axis; (k) wherein the actuator comprises a longitudinal linear actuator configured to translate along the axis of the post to actuate the longitudinal tilt link; (l) Wherein the lateral tilt mechanism is configured to permit tilting about a lateral tilt axis by at least 15 degrees and the longitudinal tilt mechanism is configured to permit tilting about a longitudinal tilt axis by at least 30 degrees; and/or (m) wherein the lateral tilt mechanism is configured to allow tilting about the lateral tilt axis by about 30 degrees and the longitudinal tilt mechanism is configured to allow tilting about the longitudinal tilt axis by about 45 degrees.

In another aspect, a method for controlling tilt of a patient platform includes: tilting the patient platform about a lateral tilt axis based on: actuating a linear actuator to apply a linear force to the pivot housing; translating the pivot housing along a first linear guide along a first axis; and translating the pivot housing along a second linear guide along a second axis.

The method may include one or more of the following features in any combination: (a) wherein the first axis is parallel to the linear force and the second axis is not parallel to the first axis; (b) wherein actuating the linear actuator comprises driving a lead screw with a motor, and wherein the pivot housing comprises a nut housing mounted on the lead screw; (c) wherein the motor is attached to a tilt plate supporting the patient platform, and wherein the first linear guide is attached to the tilt plate; (d) wherein the second linear guide is attached to the gimbal; (e) pivoting the gimbal relative to the column supporting the patient platform to tilt the patient platform about a longitudinal tilt axis; (f) wherein pivoting the gimbal relative to the column comprises driving a longitudinally-inclined link with a longitudinal linear actuator that translates along an axis of the column; (g) tilting the patient platform about both the lateral tilt axis and the longitudinal tilt axis; and/or (h) performing a robotic medical procedure on a patient supported on the patient platform.

Drawings

The disclosed aspects will hereinafter be described in conjunction with the appended drawings, provided to illustrate and not to limit the disclosed aspects, wherein like designations denote like elements.

Fig. 1 shows an embodiment of a cart-based robotic system arranged for diagnostic and/or therapeutic bronchoscopy.

Fig. 2 depicts additional aspects of the robotic system of fig. 1.

Fig. 3 shows an embodiment of the robotic system of fig. 1 arranged for ureteroscopy.

Fig. 4 shows an embodiment of the robotic system of fig. 1 arranged for a vascular procedure.

Fig. 5 shows an embodiment of a table-based robotic system arranged for bronchoscopy procedures.

Fig. 6 provides an alternative view of the robotic system of fig. 5.

FIG. 7 illustrates an exemplary system configured to stow a robotic arm.

Fig. 8 illustrates an embodiment of a table-based robotic system configured for a ureteroscopy procedure.

FIG. 9 illustrates an embodiment of a table-based robotic system configured for laparoscopic procedures.

Fig. 10 illustrates an embodiment of the table-based robotic system of fig. 5-9 with pitch or tilt adjustments.

Fig. 11 provides a detailed illustration of the interface between the stage and the column of the stage-based robotic system of fig. 5-10.

Fig. 12 shows an alternative embodiment of a table-based robotic system.

Fig. 13 shows an end view of the table-based robotic system of fig. 12.

FIG. 14 shows an end view of a table-based robotic system with a robotic arm attached thereto.

Fig. 15 illustrates an exemplary mechanical driver.

FIG. 16 illustrates an exemplary medical instrument having a pair of instrument drivers.

Fig. 17 shows an alternative design of the instrument driver and instrument, in which the axis of the drive unit is parallel to the axis of the elongate shaft of the instrument.

Fig. 18 illustrates an instrument having an instrument-based insertion architecture.

Fig. 19 shows an exemplary controller.

Fig. 20 depicts a block diagram showing a positioning system that estimates a position of one or more elements of the robotic system of fig. 1-10, such as the instrument of fig. 16-18, according to an exemplary embodiment.

Fig. 21A illustrates an embodiment of a robotic medical system including a patient platform in a first configuration.

Fig. 21B illustrates a robotic medical system including the patient platform of fig. 21A in a second configuration.

Fig. 22A is an end view of an embodiment of a patient platform of the robotic medical system and illustrates lateral tilting of the patient platform.

Fig. 22B is a side view of the patient platform of the robotic medical system of fig. 22A and illustrates a longitudinal tilt of the patient platform.

Fig. 23 illustrates an embodiment of a platform including a tilt mechanism according to an embodiment.

Fig. 24A shows an end view of an embodiment of a lateral tilt mechanism in an untilted state for a patient platform of a robotic medical system.

Fig. 24B is an end view of the lateral tilt mechanism of fig. 24A in a first tilted configuration.

Fig. 24C is an end view of the lateral tilt mechanism of fig. 24A in a second tilted configuration.

Fig. 25 is an isometric view of an embodiment of a lateral tilt mechanism for a patient platform of a robotic medical system, showing a linear actuator, a pivot housing, and a linear guide thereof.

FIG. 26 is an isometric view of the lateral tilt mechanism of FIG. 25, showing a nut housing thereof.

Fig. 27 is an isometric view of the nut housing of fig. 26.

FIG. 28A is an isometric view of the lateral tilt mechanism of FIG. 25, illustrating the application of a linear force.

FIG. 28B is an end view of the side-tilt mechanism of FIG. 25 showing a component of the linear force shown in FIG. 28A.

Fig. 29 schematically illustrates the movement of a lateral tilt mechanism according to one embodiment.

Fig. 30A is an isometric view of an embodiment of a tilt mechanism for a patient platform of a robotic medical system, the tilt mechanism including a lateral tilt mechanism and a longitudinal tilt mechanism.

FIG. 30B shows a side view of the tilt mechanism of FIG. 30A.

Fig. 31 is an isometric view of an embodiment of a patient platform of a robotic medical system including a tilt mechanism configured for simultaneous lateral and longitudinal tilting.

Fig. 32 is a flow diagram illustrating an embodiment of a method for controlling tilt of a patient platform of a robotic medical system.

Fig. 33A illustrates a side view of an embodiment of a large arc tilt mechanism for a patient platform of a robotic medical system.

Fig. 33B shows the large arc tilt mechanism of fig. 33A in a tilted configuration.

Fig. 33C shows a cross-sectional view of the large arc tilting mechanism of fig. 33A.

Fig. 33D is a top view of the large arc tilt mechanism of fig. 33A.

Fig. 33E is a top isometric view of the large arc tilt mechanism of fig. 33A installed in a patient platform of a robotic medical system.

Detailed Description

1. Overview。

Aspects of the present disclosure may be integrated into a robotically-enabled medical system that is capable of performing a variety of medical procedures, including both minimally invasive procedures, such as laparoscopy, and non-invasive procedures, such as endoscopy. In endoscopic procedures, the system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, and the like.

In addition to performing a wide range of procedures, the system may provide additional benefits, such as enhanced imaging and guidance to assist the physician. In addition, the system may provide the physician with the ability to perform procedures from an ergonomic orientation without requiring awkward arm movements and orientations. Additionally, the system may provide the physician with the ability to perform a procedure with improved ease of use such that one or more of the instruments of the system may be controlled by a single user.

For purposes of illustration, various embodiments are described below in connection with the following figures. It should be understood that many other embodiments of the disclosed concept are possible and that various advantages can be achieved with the disclosed embodiments. Headings are included herein for reference and to aid in locating the various sections. These headings are not intended to limit the scope of the concepts described with respect thereto. Such concepts may have applicability throughout the present specification.

A. Robotic system-cart。

The robot-enabled medical system may be configured in a variety of ways, depending on the particular protocol. Fig. 1 shows an embodiment of a cart-based robotically enabled system 10 arranged for diagnostic and/or therapeutic bronchoscopy. During bronchoscopy, the system 10 may include a cart 11 having one or more robotic arms 12 to deliver medical instruments, such as a steerable endoscope 13 (which may be a protocol-specific bronchoscope for bronchoscopy), to a natural orifice entry point (i.e., the mouth of a patient positioned on a table in this example) to deliver diagnostic and/or therapeutic tools. As shown, the cart 11 may be positioned near the upper torso of the patient in order to provide access to the access point. Similarly, the robotic arm 12 may be actuated to position the bronchoscope relative to the entry point. The arrangement of fig. 1 may also be utilized when performing a Gastrointestinal (GI) protocol with a gastroscope, a dedicated endoscope for GI protocols. Fig. 2 depicts an exemplary embodiment of a cart in more detail.

With continued reference to fig. 1, once the cart 11 is properly positioned, the robotic arm 12 may robotically, manually, or a combination thereof insert the steerable endoscope 13 into the patient. As shown, the steerable endoscope 13 can include at least two telescoping sections, such as an inner guide section and an outer sheath section, each coupled to a separate instrument driver from a set of instrument drivers 28, each coupled to the distal end of a separate robotic arm. This linear arrangement of the instrument driver 28, which facilitates coaxial alignment of the guide portion with the sheath portion, creates a "virtual track" 29 that can be repositioned in space by manipulating one or more robotic arms 12 to different angles and/or orientations. The virtual tracks described herein are depicted in the figures using dashed lines, and thus the dashed lines do not depict any physical structure of the system. Translation of the instrument driver 28 along the virtual track 29 causes the inner guide member portion to telescope relative to the outer sheath portion, or the endoscope 13 to be advanced or retracted from the patient. The angle of the virtual track 29 may be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and orientation of virtual track 29 as shown represents a compromise between providing the physician with access to endoscope 13 while minimizing friction caused by bending endoscope 13 into the patient's mouth.

After insertion, the endoscope 13 may be directed down the patient's trachea and lungs using precise commands from the robotic system until the target destination or surgical site is reached. To enhance navigation through the patient's pulmonary network and/or to a desired target, the endoscope 13 can be manipulated to telescopically extend the inner guide member portion from the outer sheath portion to achieve enhanced articulation and a larger bend radius. The use of a separate instrument driver 28 also allows the guide portion and sheath portion to be driven independently of each other.

For example, endoscope 13 may be guided to deliver a biopsy needle to a target, such as a lesion or nodule within a patient's lung. The needle may be deployed down a working channel that extends the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathological outcome, additional tools may be deployed down the working channel of the endoscope for additional biopsies. After identifying that the nodule is malignant, the endoscope 13 may pass an endoscopic delivery tool to resect the potentially cancerous tissue. In some cases, the diagnostic and therapeutic treatments may be delivered in separate protocols. In these cases, the endoscope 13 may also be used to deliver fiducials to "mark" the location of the target nodule. In other cases, the diagnostic and therapeutic treatments may be delivered during the same protocol.

The system 10 may also include a movable tower 30 that may be connected to the cart 11 via support cables to provide control, electronic, fluidic, optical, sensor, and/or electrical support to the cart 11. Placing such functionality in the tower 30 allows for a smaller form factor cart 11 that can be more easily adjusted and/or repositioned by the operating physician and his/her staff. Additionally, dividing functionality between the carts/tables and the support towers 30 reduces operating room clutter and facilitates improved clinical workflow. While the cart 11 may be positioned close to the patient, the tower 30 may be stowed in a remote location to not block the way during the procedure.

To support the above-described robotic system, the tower 30 may include components of a computer-based control system that stores computer program instructions, for example, within a non-transitory computer-readable storage medium such as a permanent magnet storage drive, a solid state drive, or the like. Whether execution occurs in the tower 30 or in the cart 11, execution of these instructions may control the entire system or its subsystems. For example, when executed by a processor of a computer system, the instructions may cause components of the robotic system to actuate an associated carriage and arm mount, actuate a robotic arm, and control a medical instrument. For example, in response to receiving a control signal, a motor in a joint of the robotic arm may position the arm in a particular pose.

The turret 30 may also include pumps, flow meters, valve controllers, and/or fluid passageways to provide controlled irrigation and aspiration capabilities to the system that may be deployed through the endoscope 13. These components may also be controlled using the computer system of the tower 30. In some embodiments, irrigation and aspiration capabilities may be delivered directly to endoscope 13 through separate cables.

The tower 30 may include a voltage and surge protector designed to provide filtered and protected power to the cart 11, thereby avoiding the placement of power transformers and other auxiliary power components in the cart 11, resulting in a smaller, more mobile cart 11.

The tower 30 may also include support equipment for sensors deployed throughout the robotic system 10. For example, the tower 30 may include optoelectronic devices for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In conjunction with the control system, such optoelectronic devices may be used to generate real-time images for display in any number of consoles deployed throughout the system (including in the tower 30). Similarly, the tower 30 may also include an electronics subsystem for receiving and processing signals received from deployed Electromagnetic (EM) sensors. The turret 30 may also be used to house and position an EM field generator for detection by an EM sensor in or on the medical instrument.

The tower 30 may include a console 31 in addition to other consoles available in the rest of the system (e.g., a console mounted on top of the cart). The console 31 may include a user interface and display screen, such as a touch screen, for the physician operator. The console in system 10 is typically designed to provide both robotic control and preoperative and real-time information for the procedure, such as navigation and positioning information for endoscope 13. When console 31 is not the only console available to the physician, it may be used by a second operator (such as a nurse) to monitor the patient's health or vital signs and operation of system 10, as well as to provide protocol-specific data, such as navigation and positioning information. In other embodiments, the console 30 is housed in a body separate from the tower 30.

The tower 30 may be coupled to the cart 11 and endoscope 13 by one or more cables or connectors (not shown). In some embodiments, the support function from tower 30 may be provided to cart 11 by a single cable, thereby simplifying the operating room and eliminating operating room clutter. In other embodiments, specific functions may be coupled in separate wires and connections. For example, while the cart 11 may be powered by a single cable, support for controls, optics, fluids, and/or navigation may be provided by separate cables.

Fig. 2 provides a detailed illustration of an embodiment of the cart 11 from the cart-based robot-enabled system shown in fig. 1. The cart 11 generally includes an elongated support structure 14 (commonly referred to as a "column"), a cart base 15, and a console 16 at the top of the column 14. The column 14 may include one or more carriages, such as carriages 17 (alternatively "arm supports") for supporting the deployment of one or more robotic arms 12 (three shown in fig. 2). The carriage 17 may include a separately configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 12 for better positioning relative to the patient. The carriage 17 also includes a carriage interface 19 that allows the carriage 17 to translate vertically along the column 14.

The carriage interface 19 is connected to the column 14 by slots, such as slots 20, positioned on opposite sides of the column 14 to guide vertical translation of the carriage 17. The slot 20 includes a vertical translation interface to position and maintain the carriage 17 at various vertical heights relative to the cart base 15. Vertical translation of the carriage 17 allows the cart 11 to adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, the separately configurable arm mount on the carriage 17 allows the robotic arm base 21 of the robotic arm 12 to be angled in a variety of configurations.

In some embodiments, the slot 20 may be supplemented with a slot cover that is flush and parallel with the slot surface to prevent dust and fluid from entering the internal cavity of the column 14 and the vertical translation interface as the carriage 17 translates vertically. The slot cover may be deployed by a pair of spring spools positioned near the vertical top and bottom of the slot 20. The lid is coiled within the reel until deployed to extend and retract from the coiled state of the lid as the carriage 17 translates vertically up and down. The spring loading of the spool provides a force to retract the cover into the spool as the carriage 17 translates toward the spool, while also maintaining a tight seal as the carriage 17 translates away from the spool. The cover may be connected to the carriage 17 using, for example, a bracket in the carriage interface 19 to ensure proper extension and retraction of the cover as the carriage 17 translates.

The column 14 may internally include a mechanism, such as a gear and motor, designed to use a vertically aligned lead screw to mechanically translate the carriage 17 in response to control signals generated in response to user inputs (e.g., inputs from the console 16).

The robotic arm 12 may generally include a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24, each joint including an independent actuator, each actuator including an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm 12. Each of the robotic arms 12 may have seven joints and thus provide seven degrees of freedom. Multiple joints result in multiple degrees of freedom, allowing for "redundant" degrees of freedom. Having redundant degrees of freedom allows the robotic arm 12 to position its respective end effector 22 at a particular position, orientation, and trajectory in space using different link positions and joint angles. This allows the system to position and guide the medical instrument from a desired point in space while allowing the physician to move the arm joint to a clinically advantageous orientation away from the patient to create greater proximity while avoiding arm collisions.

The cart base 15 balances the weight of the column 14, carriage 17, and robotic arm 12 on the floor. Thus, the cart base 15 houses heavy components such as electronics, motors, power supplies, and components that enable the cart 11 to be moved and/or secured. For example, the cart base 15 includes rollable wheel casters 25 that allow the cart 11 to be easily moved around a room prior to a procedure. After reaching the proper orientation, the caster 25 may be secured using a wheel lock to hold the cart 11 in the proper orientation during the procedure.

The console 16, positioned at the vertical end of the column 14, allows both a user interface for receiving user input and a display screen (or dual-purpose device such as, for example, a touch screen 26) to provide both pre-operative and intra-operative data to the physician user. Potential preoperative data on touchscreen 26 may include preoperative planning, navigation and mapping data derived from preoperative Computerized Tomography (CT) scans, and/or records from preoperative patient interviews. The intraoperative data on the display may include optical information provided from the tool, sensors and coordinate information from the sensors as well as important patient statistics such as respiration, heart rate and/or pulse. The console 16 may be positioned and tilted to allow the physician to access the console 16 from the side of the column 14 opposite the carriage 17. From this orientation, the physician can view the console 16, the robotic arm 12, and the patient while manipulating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 to assist in maneuvering and stabilizing the cart 11.

Fig. 3 shows an embodiment of a robot-enabled system 10 arranged for ureteroscopy. In a ureteroscopy procedure, the cart 11 may be positioned to deliver a ureteroscope 32 (a procedure-specific endoscope designed to traverse the patient's urethra and ureter) to the lower abdominal region of the patient. In ureteroscopy, it may be desirable for the ureteroscope 32 to be directly aligned with the patient's urethra to reduce friction and forces on sensitive anatomical structures in this region. As shown, the cart 11 may be aligned at the foot of the table to allow the robotic arm 12 to position the ureteroscope 32 for direct linear access to the patient's urethra. The robotic arm 12 may insert the ureteroscope 32 from the foot of the table along a virtual track 33 directly into the lower abdomen of the patient through the urethra.

After insertion into the urethra, ureteroscope 32 may be navigated into the bladder, ureter, and/or kidney for diagnostic and/or therapeutic applications using similar control techniques as in bronchoscopy. For example, the ureteroscope 32 may be guided into the ureter and kidney to break up accumulated kidney stones using a laser or ultrasonic lithotripsy device deployed down the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments may be removed using a basket deployed down ureteroscope 32.

Fig. 4 shows an embodiment of a robot-enabled system 10 similarly arranged for a vascular procedure. In a vascular procedure, the system 10 may be configured such that the cart 11 may deliver a medical device 34 (such as a steerable catheter) to an entry point in the femoral artery of the patient's leg. The femoral artery presents both a larger diameter for navigation and a relatively less tortuous and tortuous path to the patient's heart, which simplifies navigation. As in the ureteroscopy procedure, the cart 11 may be positioned towards the patient's legs and lower abdomen to allow the robotic arm 12 to provide a virtual track 35 of direct linear access to the femoral access point in the thigh/hip region of the patient. After insertion into the artery, the medical device 34 may be guided and inserted by translating the device driver 28. Alternatively, the cart may be positioned around the patient's upper abdomen to access alternative vascular access points, such as the carotid and brachial arteries near the shoulder and wrist.

B. Robot system-table。

Embodiments of the robot-enabled medical system may also incorporate a patient table. The bond table reduces the amount of capital equipment in the operating room by removing the cart, which allows for greater access to the patient. Fig. 5 shows an embodiment of such a robot-enabled system arranged for bronchoscopy procedures. The system 36 includes a support structure or column 37 for supporting a platform 38 (shown as a "table" or "bed") on the floor. Much like the cart-based system, the end effector of robotic arm 39 of system 36 includes an instrument driver 42 designed to manipulate an elongate medical instrument, such as bronchoscope 40 in fig. 5, through or along a virtual track 41 formed by the linear alignment of instrument driver 42. In practice, a C-arm for providing fluoroscopic imaging may be positioned over the upper abdominal region of the patient by placing the emitter and detector around table 38.

Fig. 6 provides an alternative view of the system 36 without the patient and medical instruments for discussion purposes. As shown, the column 37 may include one or more carriages 43, shown as rings in the system 36, upon which one or more robotic arms 39 may be based. The carriage 43 may translate along a vertical column interface 44 extending along the length of the column 37 to provide different vantage points from which the robotic arm 39 may be positioned to reach the patient. Carriage 43 may be rotated about column 37 using a mechanical motor positioned within column 37 to allow robotic arm 39 access to multiple sides of table 38, such as both sides of a patient. In embodiments having multiple carriages, the carriages may be positioned individually on the column and may be translated and/or rotated independently of the other carriages. While the bracket 43 need not be circular or even circular about the post 37, the circular shape as shown facilitates rotation of the bracket 43 about the post 37 while maintaining structural balance. The rotation and translation of carriage 43 allows system 36 to align medical instruments, such as endoscopes and laparoscopes, into different entry points on a patient. In other embodiments (not shown), system 36 may include a patient table or bed with an adjustable arm support in the form of a rod or rail extending alongside the patient table or bed. One or more robotic arms 39 may be attached (e.g., via a shoulder having an elbow joint) to an adjustable arm support that may be vertically adjusted. By providing vertical adjustment, the robotic arm 39 advantageously can be compactly stored under a patient table or bed, and subsequently raised during a procedure.

The robotic arm 39 may be mounted on the carriage 43 by a set of arm mounts 45 that include a series of joints that are individually rotatable and/or telescopically extendable to provide additional constructability to the robotic arm 39. In addition, the arm mounts 45 may be positioned on the carriage 43 such that when the carriage 43 is properly rotated, the arm mounts 45 may be positioned on the same side of the table 38 (as shown in FIG. 6), on the opposite side of the table 38 (as shown in FIG. 9), or on adjacent sides of the table 38 (not shown).

The post 37 structurally provides support for the table 38 and provides a path for vertical translation of the carriage 43. Internally, the column 37 may be equipped with a lead screw for guiding the vertical translation of the carriage, and a motor to mechanize the translation of the lead screw based carriage 43. The post 37 may also transmit power and control signals to the carriage 43 and the robotic arm 39 mounted thereon.

The table base 46 has a similar function to the cart base 15 in the cart 11 shown in fig. 2, accommodating the heavier components to balance the table/bed 38, column 37, carriage 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during the procedure. Casters deployed from the bottom of table base 46 may extend in opposite directions on both sides of base 46 and retract when system 36 needs to be moved.

Continuing with FIG. 6, system 36 may also include a tower (not shown) that divides the functionality of system 36 between the stage and the tower to reduce the form factor and volume of the stage. As in the previously disclosed embodiments, the tower may provide a variety of support functions to the stage, such as processing, computing and control capabilities, electrical, fluidic and/or optical, and sensor processing. The tower may also be movable to be positioned away from the patient, thereby improving physician access and eliminating operating room clutter. In addition, placing the components in the tower allows more storage space in the table base 46 for potential stowing of the robotic arm 39. The tower may also include a master controller or console that provides both a user interface for user input, such as a keyboard and/or pendant, and a display screen (or touch screen) for pre-operative and intra-operative information, such as real-time imaging, navigation, and tracking information. In some embodiments, the column may also comprise a holder for a gas tank to be used for gas injection.

In some embodiments, the table base may stow and store the robotic arm when not in use. Fig. 7 shows a system 47 for stowing a robotic arm in an embodiment of the table-based system. In the system 47, the carriage 48 may be vertically translated into the base 49 to stow the robotic arm 50, arm mount 51, and carriage 48 within the base 49. The base cover 52 can translate and retract open to deploy the carriage 48, arm mount 51, and robotic arm 50 about the post 53, and close to stow the carriage, arm mount, and robotic arm to protect them when not in use. The base cover 52 may be sealed with a membrane 54 along the edges of its opening to prevent ingress of dust and fluids when closed.

Fig. 8 illustrates an embodiment of a robot-enabled table-based system configured for a ureteroscopy procedure. In ureteroscopy, table 38 may include a rotating portion 55 for positioning the patient at an angle off of column 37 and table base 46. The rotating portion 55 can rotate or pivot about a pivot point (e.g., located under the patient's head) to position a bottom portion of the rotating portion 55 away from the post 37. For example, pivoting of rotating portion 55 allows a C-arm (not shown) to be positioned over the patient's lower abdomen without competing for space with a post (not shown) below table 38. By rotating the bracket 35 (not shown) about the post 37, the robotic arm 39 can insert the ureteroscope 56 directly into the patient's groin area along the virtual track 57 to reach the urethra. In ureteroscopy, the stirrup 58 may also be fixed to the rotating portion 55 of the table 38 to support the orientation of the patient's leg during the procedure and to allow full access to the patient's groin area.

In laparoscopic procedures, minimally invasive instruments are inserted into a patient's anatomy through a small incision in the abdominal wall of the patient. In some embodiments, a minimally invasive instrument includes an elongated rigid member, such as a shaft, for accessing anatomical structures within a patient. After inflation of the patient's abdominal cavity, the instrument may be guided to perform surgical or medical tasks, such as grasping, cutting, ablating, suturing, and the like. In some embodiments, the instrument may comprise a scope, such as a laparoscope. FIG. 9 illustrates an embodiment of a robot-enabled table-based system configured for laparoscopic procedures. As shown in fig. 9, the carriage 43 of the system 36 may be rotated and vertically adjusted to position the pair of robotic arms 39 on opposite sides of the table 38 so that the instrument 59 may be positioned through the smallest incision on both sides of the patient using the arm mounts 45 to reach his/her abdominal cavity.

To accommodate laparoscopic procedures, the robot-enabled table system may also tilt the platform to a desired angle. Fig. 10 illustrates an embodiment of a robot-enabled medical system with pitch or tilt adjustment. As shown in FIG. 10, system 36 may accommodate the tilt of table 38 to position one portion of the table at a greater distance from the base plate than another portion. In addition, arm mount 45 may be rotated to match the tilt so that robotic arm 39 maintains the same planar relationship with table 38. To accommodate the steeper angle, column 37 may also include a telescoping portion 60 that allows vertical extension of column 37 to prevent table 38 from contacting the floor or colliding with table base 46.

Fig. 11 provides a detailed illustration of the interface between table 38 and column 37. Pitch rotation mechanism 61 may be configured to change the pitch angle of table 38 relative to column 37 in multiple degrees of freedom. The pitch rotation mechanism 61 may be implemented by positioning orthogonal axes 1, 2 at the pylon interface, each axis being actuated by a separate motor 3, 4 in response to an electrical pitch angle command. Rotation along one screw 5 will enable tilt adjustment in one axis 1, while rotation along the other screw 6 will enable tilt adjustment along the other axis 2. In some embodiments, a spherical joint may be used to change the pitch angle of table 38 relative to column 37 in multiple degrees of freedom.

For example, pitch adjustment is particularly useful when attempting to position the table in a low-head position (i.e., to position the patient's lower abdomen at a higher elevation from the floor than the patient's upper abdomen) for lower abdominal procedures. The low head and feet position causes the patient's internal organs to slide by gravity toward his/her upper abdomen, clearing the abdominal cavity for minimally invasive tools to enter and perform lower abdominal surgery or medical procedures, such as laparoscopic prostatectomy.

Figures 12 and 13 show isometric and end views of an alternative embodiment of a table-based surgical robotic system 100. The surgical robotic system 100 includes one or more adjustable arm supports 105 that may be configured to support one or more robotic arms (see, e.g., fig. 14) relative to the table 101. In the illustrated embodiment, a single adjustable arm support 105 is shown, but additional arm supports may be provided on opposite sides of the table 101. The adjustable arm support 105 may be configured such that it is movable relative to the table 101 to adjust and/or change the orientation of the adjustable arm support 105 and/or any robotic arm mounted thereto relative to the table 101. For example, the adjustable arm support 105 may be adjusted in one or more degrees of freedom relative to the table 101. The adjustable arm supports 105 provide the system 100 with high flexibility, including the ability to easily stow the one or more adjustable arm supports 105 and any robotic arms attached thereto below the table 101. The adjustable arm support 105 may be raised from a stowed orientation to an orientation below the upper surface of the table 101. In other embodiments, the adjustable arm support 105 may be raised from a stowed orientation to an orientation above the upper surface of the table 101.

The adjustable arm support 105 may provide several degrees of freedom including lift, lateral translation, tilt, and the like. In the illustrated embodiment of fig. 12 and 13, the arm support 105 is configured to have four degrees of freedom, which are shown by the arrows in fig. 12. The first degree of freedom allows adjustment of the adjustable arm support 105 in the Z direction ("Z lift"). For example, the adjustable arm support 105 may include a carriage 109 configured to move up or down along or relative to the column 102 of the support table 101. The second degree of freedom may allow the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 may include a swivel that may allow the adjustable arm support 105 to be aligned with the bed in a low head position. The third degree of freedom may allow adjustable arm support 105 to "pivot upward," which may be used to adjust the distance between one side of table 101 and adjustable arm support 105. The fourth degree of freedom may allow the adjustable arm support 105 to translate along the longitudinal length of the table.

The surgical robotic system 100 in fig. 12 and 13 may include a table supported by a post 102 mounted to a base 103. The base 103 and the column 102 support the table 101 relative to a support surface. The floor axis 131 and the support axis 133 are shown in fig. 13.

The adjustable arm support 105 may be mounted to the post 102. In other embodiments, the arm support 105 may be mounted to the table 101 or the base 103. The adjustable arm support 105 may include a bracket 109, a rod or rail connector 111, and a rod or rail 107. In some embodiments, one or more robotic arms mounted to the track 107 may translate and move relative to each other.

The bracket 109 may be attached to the post 102 by a first joint 113 that allows the bracket 109 to move relative to the post 102 (e.g., such as up and down along a first or vertical axis 123). The first joint 113 may provide a first degree of freedom ("Z lift") to the adjustable arm support 105. Adjustable arm support 105 may include a second joint 115 that provides a second degree of freedom (tilt) for adjustable arm support 105. Adjustable arm support 105 may include a third joint 117 that may provide a third degree of freedom ("pivot upward") to adjustable arm support 105. An additional joint 119 (shown in fig. 13) may be provided that mechanically constrains the third joint 117 to maintain the orientation of the rail 107 as the rail connector 111 rotates about the third axis 127. Adjustable arm support 105 may include a fourth joint 121 that may provide a fourth degree of freedom (translation) for adjustable arm support 105 along a fourth axis 129.

Fig. 14 shows an end view of a surgical robotic system 140A having two adjustable arm supports 105A, 105B mounted on opposite sides of the table 101, according to one embodiment. The first robotic arm 142A is attached to the rod or rail 107A of the first adjustable arm support 105B. The first robot arm 142A includes a base 144A attached to the guide rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that is attachable to one or more robotic medical instruments or tools. Similarly, the second robotic arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B may be configured to attach to one or more robotic medical instruments or tools.

In some embodiments, one or more of the robotic arms 142A, 142B includes an arm having seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B may include eight degrees of freedom, including an insertion axis (including 1 degree of freedom for insertion), a wrist (including 3 degrees of freedom for wrist pitch, yaw, and roll), an elbow (including 1 degree of freedom for elbow pitch), a shoulder (including 2 degrees of freedom for shoulder pitch and yaw), and a base 144A, 144B (including 1 degree of freedom for translation). In some embodiments, the insertion freedom may be provided by the robotic arms 142A, 142B, while in other embodiments the instrument itself provides insertion via an instrument-based insertion architecture.

C. Instrument driver and interface。

An end effector of a robotic arm of the system may include: (i) an instrument driver (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator") that incorporates an electromechanical device for actuating a medical instrument; and (ii) a removable or detachable medical instrument that may be devoid of any electromechanical components, such as a motor. The bisection may be driven by: the need to sterilize medical instruments used in medical procedures; and the inability to adequately sterilize expensive capital equipment due to its complex mechanical components and sensitive electronics. Thus, the medical instrument may be designed to be detached, removed, and interchanged from the instrument driver (and thus from the system) for individual sterilization or disposal by the physician or a physician's staff. In contrast, the instrument driver need not be changed or sterilized and may be covered for protection.

FIG. 15 illustrates an example instrument driver. A device driver 62 positioned at the distal end of the robotic arm includes one or more drive units 63 arranged in parallel axes to provide a controlled torque to the medical device via a drive shaft 64. Each drive unit 63 comprises a separate drive shaft 64 for interacting with the instrument, a gear head 65 for converting motor shaft rotation into a desired torque, a motor 66 for generating the drive torque, an encoder 67 to measure the speed of the motor shaft and provide feedback to the control circuit, and a control circuit 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument driver 62 can provide a plurality (e.g., four as shown in fig. 15) of independent drive outputs to the medical instrument. In operation, the control circuit 68 will receive the control signal, transmit the motor signal to the motor 66, compare the resulting motor speed measured by the encoder 67 to a desired speed, and modulate the motor signal to generate a desired torque.

For procedures requiring a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile cover, located between the instrument driver and the medical instrument. The primary purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument driver to the drive input of the instrument while maintaining a physical separation between the drive shaft and the drive input and thus maintaining sterility. Thus, an exemplary sterile adapter may include a series of rotational inputs and rotational outputs intended to mate with a drive shaft of a device driver and a drive input on a device. A sterile cover composed of a thin flexible material (such as transparent or translucent plastic) connected to a sterile adaptor is designed to cover capital equipment such as instrument drivers, robotic arms and carts (in cart-based systems) or tables (in table-based systems). The use of a cover would allow capital equipment to be located near the patient while still being located in areas where sterilization is not required (i.e., non-sterile areas). On the other side of the sterile cover, the medical instrument may be docked with the patient in the area that requires sterilization (i.e., the sterile field).

D. Medical instrument。

FIG. 16 illustrates an example medical instrument having a pair of instrument drivers. Similar to other instruments designed for use with robotic systems, the medical instrument 70 includes an elongate shaft 71 (or elongate body) and an instrument base 72. The instrument base 72, also referred to as the "instrument handle" due to its intended design for manual interaction by a physician, may generally include a rotatable drive input 73 (e.g., a socket, pulley, or reel) designed to mate with a drive output 74 extending through a drive interface on an instrument driver 75 at the distal end of the robotic arm 76. When physically connected, latched and/or coupled, the mating drive input 73 of the instrument base 72 may share an axis of rotation with the drive output 74 in the instrument driver 75 to allow torque to be transferred from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may include splines designed to mate with a socket on the drive input 73.

Elongate shaft 71 is designed to be delivered through an anatomical opening or lumen (e.g., as in endoscopy) or through a minimally invasive incision (e.g., as in laparoscopy). Elongate shaft 71 may be flexible (e.g., having endoscopic-like characteristics) or rigid (e.g., having laparoscopic-like characteristics), or comprise a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of the rigid elongate shaft may be connected to an end effector that extends from an articulated wrist formed by a clevis having at least one degree of freedom and a surgical tool or medical instrument (e.g., a grasper or scissors) that may be actuated based on forces from the tendons as the drive input rotates in response to torque received from the drive output 74 of the instrument driver 75. When designed for endoscopy, the distal end of the flexible elongate shaft may include a steerable or controllable bending section that articulates and bends based on torque received from the drive output 74 of the instrument driver 75.

The torque from instrument driver 75 is transmitted along elongate shaft 71 using tendons along elongate shaft 71. These separate tendons (e.g., pull wires) may be separately anchored to separate drive inputs 73 within the instrument handle 72. From handle 72, the tendons are guided down one or more pull lumens of elongate shaft 71 and anchored at a distal portion of elongate shaft 71, or in a wrist at a distal portion of the elongate shaft. During surgical procedures such as laparoscopic, endoscopic, or hybrid procedures, these tendons may be coupled to a distally mounted end effector such as a wrist, grasper, or scissors. With such an arrangement, torque applied to the drive input 73 transfers tension to the tendons, causing the end effector to actuate in some manner. In some embodiments, during a surgical procedure, a tendon can cause a joint to rotate about an axis, thereby causing an end effector to move in one direction or another. Alternatively, the tendon may be connected to one or more jaws of a grasper at the distal end of the elongate shaft 71, wherein tension from the tendon causes the grasper to close.

In endoscopy, the tendons can be coupled to a bending or articulation section located along (e.g., at the distal end of) elongate shaft 71 via an adhesive, control loop, or other mechanical fastener. When fixedly attached to the distal end of the bending section, the torque applied to the drive input 73 will be transmitted down the tendons, causing the softer bending section (sometimes referred to as the articulatable section or region) to bend or articulate. Along the unbent section, it may be advantageous to spiral or spiral a separate pull lumen that guides a separate tendon along the wall of the endoscope shaft (or internally) to balance the radial forces caused by the tension in the pull wire. The angle of the spirals and/or the spacing therebetween may be varied or designed for a particular purpose, with tighter spirals exhibiting less shaft compression under load forces and lower amounts of spirals causing more shaft compression under load forces but limiting bending. In another instance, the distraction cavity can be directed parallel to the longitudinal axis of the elongate shaft 71 to allow for controlled articulation in a desired bending or articulatable segment.

In endoscopy, elongate shaft 71 houses a number of components to assist in robotic procedures. The shaft 71 may include a working channel at the distal end of the shaft 71 for deploying a surgical tool (or medical instrument), irrigating and/or aspirating a surgical area. The shaft 71 may also house wires and/or optical fibers to transmit signals to/from an optical assembly at the distal tip, which may include an optical camera. The shaft 71 may also house optical fibers to carry light from a proximally located light source (e.g., a light emitting diode) to the distal end of the shaft 71.

At the distal end of the instrument 70, the distal tip may also include an opening for a working channel for delivering tools for diagnosis and/or treatment, irrigation and aspiration of the surgical site. The distal tip may also include a port for a camera, such as a fiberscope or digital camera, to capture images of the internal anatomical space. Relatedly, the distal tip may also include a port for a light source for illuminating the anatomical space when the camera is in use.

In the example of fig. 16, the drive shaft axis, and thus the drive input axis, is orthogonal to the axis of elongate shaft 71. However, this arrangement complicates the rolling ability of elongate shaft 71. Rolling elongate shaft 71 along its axis while holding drive input 73 stationary can cause undesirable tangling of tendons as they extend out of drive input 73 and into a pull lumen within elongate shaft 71. The resulting entanglement of such tendons may disrupt any control algorithm intended to predict movement of the flexible elongate shaft 71 during an endoscopic procedure.

Fig. 17 shows an alternative design of the instrument driver and instrument, in which the axis of the drive unit is parallel to the axis of the elongate shaft of the instrument. As shown, the circular instrument driver 80 includes four drive units whose drive outputs 81 are aligned in parallel at the end of a robotic arm 82. The drive units and their respective drive outputs 81 are housed in a rotation assembly 83 of the instrument driver 80 driven by one of the drive units within the assembly 83. In response to the torque provided by the rotational drive unit, the rotation assembly 83 rotates along a circular bearing that connects the rotation assembly 83 to the non-rotating portion 84 of the instrument driver 80. Power and control signals may be transmitted from the non-rotating portion 84 of the instrument driver 80 to the rotating assembly 83 through electrical contacts that may be maintained through rotation of a brush-slip ring connection (not shown). In other embodiments, the rotation assembly 83 may be responsive to a separate drive unit integrated into the non-rotatable portion 84, and thus not parallel to the other drive units. Rotation mechanism 83 allows instrument driver 80 to allow the drive unit and its corresponding drive output 81 to rotate as a single unit about instrument driver axis 85.

Similar to the previously disclosed embodiments, instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown with a transparent outer skin for discussion purposes) that includes a plurality of drive inputs 89 (such as sockets, pulleys, and spools) configured to receive drive outputs 81 in instrument driver 80. Unlike the previously disclosed embodiment, the instrument shaft 88 extends from the center of the instrument base 87, which has an axis that is substantially parallel to the axis of the drive input 89, rather than orthogonal as in the design of fig. 16.

When coupled to the rotation assembly 83 of the instrument driver 80, the medical instrument 86, including the instrument base 87 and the instrument shaft 88, rotates about the instrument driver axis 85 in combination with the rotation assembly 83. Since the instrument shaft 88 is positioned at the center of the instrument base 87, the instrument shaft 88 is coaxial with the instrument driver axis 85 when attached. Thus, rotation of the rotation assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, when instrument base 87 rotates with instrument shaft 88, any tendons connected to drive inputs 89 in instrument base 87 do not tangle during rotation. Thus, the parallelism of the axes of drive output 81, drive input 89 and instrument shaft 88 allows the shaft to rotate without tangling any control tendons.

Fig. 18 illustrates an instrument having an instrument-based insertion architecture, according to some embodiments. The instrument 150 may be coupled to any of the instrument drivers described above. The instrument 150 includes an elongate shaft 152, an end effector 162 connected to the shaft 152, and a handle 170 coupled to the shaft 152. The elongate shaft 152 includes a tubular member having a proximal portion 154 and a distal portion 156. The elongate shaft 152 includes one or more channels or grooves 158 along its outer surface. The groove 158 is configured to receive one or more wires or cables 180 therethrough. Accordingly, one or more cables 180 extend along an outer surface of the elongate shaft 152. In other embodiments, the cable 180 may also pass through the elongate shaft 152. Manipulation of the one or more cables 180 (e.g., via an instrument driver) causes actuation of the end effector 162.

The instrument handle 170 (which may also be referred to as an instrument base) may generally include an attachment interface 172 having one or more mechanical inputs 174, such as a socket, pulley, or reel, designed to reciprocally mate with one or more torque couplers on an attachment surface of the instrument driver.

In some embodiments, the instrument 150 includes a series of pulleys or cables that enable the elongate shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself includes an instrument-based insertion architecture that accommodates insertion of the instrument, thereby minimizing reliance on robotic arms to provide for insertion of the instrument 150. In other embodiments, the robotic arm may be largely responsible for instrument insertion.

E. Controller。

Any of the robotic systems described herein may include an input device or controller for manipulating an instrument attached to the robotic arm. In some embodiments, the controller may be coupled (e.g., communicatively, electronically, electrically, wirelessly, and/or mechanically) with the instrument such that manipulation of the controller causes corresponding manipulation of the instrument, e.g., via master-slave control.

Fig. 19 is a perspective view of an embodiment of the controller 182. In this embodiment, the controller 182 comprises a hybrid controller that may have both impedance and admittance control. In other embodiments, the controller 182 may utilize only impedance or passive control. In other embodiments, the controller 182 may utilize admittance control only. By acting as a hybrid controller, the controller 182 advantageously may have a lower perceived inertia when in use.

In the exemplified embodiment, the controller 182 is configured to allow manipulation of two medical instruments and includes two handles 184. Each of the shanks 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.

As shown in fig. 19, each positioning stage 188 includes a SCARA arm (selective compliance assembly robot arm) 198 coupled to the post 194 by a prismatic joint 196. The prismatic joint 196 is configured to translate along the post 194 (e.g., along the guide track 197) to allow each of the shanks 184 to translate in the z-direction, thereby providing a first degree of freedom. The SCARA arm 198 is configured to allow the handle 184 to move in the x-y plane, providing two additional degrees of freedom.

In some embodiments, one or more load sensors are positioned in the controller. For example, in some embodiments, a load sensor (not shown) is positioned in the body of each of the gimbals 186. By providing a load sensor, portions of the controller 182 can operate under admittance control, advantageously reducing the perceived inertia of the controller when in use. In some embodiments, positioning stage 188 is configured for admittance control, while gimbal 186 is configured for impedance control. In other embodiments, gimbal 186 is configured for admittance control, while positioning stage 188 is configured for impedance control. Thus, for some embodiments, the translational or azimuthal degree of freedom of positioning stage 188 may depend on admittance control, while the rotational degree of freedom of gimbal 186 depends on impedance control.

F. Navigation and control。

Conventional endoscopy may involve the use of fluoroscopy (e.g., as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide intraluminal guidance to the operating physician. In contrast, robotic systems contemplated by the present disclosure may provide non-radiation based navigation and positioning means to reduce physician exposure to radiation and reduce the amount of equipment in the operating room. As used herein, the term "positioning" may refer to determining and/or monitoring the orientation of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robotic command data may be used alone or in combination to achieve a radiation-free operating environment. In still other cases where a radiation-based imaging modality is used, preoperative mapping, computer vision, real-time EM tracking, and robot command data may be used, alone or in combination, to improve the information obtained only by the radiation-based imaging modality.

Fig. 20 is a block diagram illustrating a positioning system 90 that estimates a position of one or more elements of a robotic system, such as a position of an instrument, according to an example embodiment. Positioning system 90 may be a set of one or more computer devices configured to execute one or more instructions. The computer apparatus may be embodied by a processor (or multiple processors) and computer readable memory in one or more of the components discussed above. By way of example and not limitation, the computer device may be located in the tower 30 shown in fig. 1, the cart 11 shown in fig. 1-4, the bed shown in fig. 5-14, or the like.

As shown in fig. 20, the localization system 90 may include a localization module 95 that processes the input data 91-94 to generate position data 96 for the distal tip of the medical instrument. The position data 96 may be data or logic representing the position and/or orientation of the distal end of the instrument relative to a reference frame. The reference frame may be a reference frame relative to a patient anatomy or a known object, such as an EM field generator (see discussion below for EM field generators).

The various input data 91-94 will now be described in more detail. Preoperative mapping can be accomplished by using a set of low dose CT scans. The pre-operative CT scan is reconstructed into a three-dimensional image that is visualized, for example, as a "slice" of a cross-sectional view of the patient's internal anatomy. When analyzed in general, an image-based model of the anatomical cavities, spaces, and structures for a patient's anatomy (such as a patient's lung network) may be generated. Techniques such as centerline geometry may be determined and approximated from the CT images to form a three-dimensional volume of the patient anatomy, referred to as model data 91 (also referred to as "pre-operative model data" when generated using only pre-operative CT scans). The use of centerline geometry is discussed in U.S. patent application No. 14/523760, the contents of which are incorporated herein in their entirety. The network topology model can also be derived from CT images and is particularly suitable for bronchoscopy.

In some embodiments, the instrument may be equipped with a camera to provide visual data (or image data) 92. The positioning module 95 may process the visual data 92 to implement one or more vision-based (or image-based) location tracking modules or features. For example, the pre-operative model data 91 may be used in conjunction with the vision data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope or an instrument advanced through a working channel of an endoscope). For example, using the pre-operative model data 91, the robotic system may generate a library of expected endoscope images from the model based on the expected path of travel of the endoscope, each image connected to a location within the model. As the surgery progresses, the robotic system may reference the library in order to compare real-time images captured at a camera (e.g., a camera at the distal end of the endoscope) to those in the image library to assist in positioning.

Other computer vision based tracking techniques use feature tracking to determine the motion of the camera, and thus the endoscope. Some features of the localization module 95 may identify circular geometries in the pre-operative model data 91 that correspond to anatomical cavities and track changes in those geometries to determine which anatomical cavity was selected, as well as track relative rotational and/or translational motion of the cameras. The use of a topological map may further enhance the vision-based algorithms or techniques.

Optical flow (another computer vision-based technique) may analyze the displacement and translation of image pixels in a video sequence in visual data 92 to infer camera motion. Examples of optical flow techniques may include motion detection, object segmentation computation, luminance, motion compensated coding, stereo disparity measurement, and so forth. Through multiple frame comparisons for multiple iterations, the movement and position of the camera (and thus the endoscope) can be determined.

The localization module 95 may use real-time EM tracking to generate a real-time location of the endoscope in a global coordinate system that may be registered to the patient's anatomy represented by the pre-operative model. In EM tracking, an EM sensor (or tracker) comprising one or more sensor coils embedded in one or more positions and orientations in a medical instrument (e.g., an endoscopic tool) measures changes in the EM field generated by one or more static EM field generators positioned at known locations. The position information detected by the EM sensor is stored as EM data 93. An EM field generator (or transmitter) may be placed close to the patient to generate a low-intensity magnetic field that the embedded sensor can detect. The magnetic field induces small currents in the sensor coils of the EM sensor, which may be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations may be "registered" to the patient anatomy (e.g., the pre-operative model) at the time of the surgical procedure to determine a geometric transformation that aligns a single location in the coordinate system with a position in the pre-operative model of the patient's anatomy. Once registered, embedded EM trackers in one or more positions of the medical instrument (e.g., the distal tip of an endoscope) may provide real-time indications of the progress of the medical instrument through the patient's anatomy.

The robot commands and kinematic data 94 may also be used by the positioning module 95 to provide position data 96 for the robotic system. Device pitch and yaw derived from the articulation commands may be determined during pre-operative calibration. These calibration measurements may be used in conjunction with known insertion depth information to estimate the position of the instrument as the surgery progresses. Alternatively, these calculations may be analyzed in conjunction with EM, visual, and/or topological modeling to estimate the position of the medical instrument within the network.

As shown in fig. 20, the location module 95 may use a number of other input data. For example, although not shown in fig. 20, an instrument utilizing shape sensing fibers may provide shape data that may be used by the localization module 95 to determine the position and shape of the instrument.

The positioning module 95 may use the input data 91-94 in combination. In some cases, such a combination may use a probabilistic approach in which the localization module 95 assigns confidence weights to locations determined from each of the input data 91-94. Thus, in situations where the EM data may be unreliable (as may be the case with EM interference), the confidence in the location determined by EM data 93 may be reduced, and positioning module 95 may rely more heavily on vision data 92 and/or robot commands and kinematic data 94.

As discussed above, the robotic systems discussed herein may be designed to incorporate a combination of one or more of the above techniques. The computer-based control system of the robotic system located in the tower, bed and/or cart may store computer program instructions within, for example, a non-transitory computer-readable storage medium (such as a permanent magnetic storage drive, solid state drive, etc.) that, when executed, cause the system to receive and analyze sensor data and user commands, generate control signals for the entire system, and display navigation and positioning data, such as the position of the instrument within a global coordinate system, anatomical maps, etc.

2. Tilt mechanism for a patient platform of a robotic medical system

As shown in several of the above examples, the robotic medical system may include a patient platform (also referred to as a bed or table). The patient platform may be configured to support a patient during a medical procedure, such as robotic endoscopy, robotic laparoscopy, patency procedures, or other procedures (see, e.g., fig. 1, 3, 4, 5,8, and 9, above). Generally, a patient lies on (or is otherwise positioned on) a patient table during a procedure. The procedure may then be performed using one or more robotic arms and one or more robotically-controllable medical instruments that may access a patient positioned on a patient platform. Patient platforms are also used in many non-robotic (i.e., manual) medical procedures.

In some embodiments, the patient platform includes a substantially horizontal surface for supporting the patient. That is, in some embodiments, the patient platform includes a surface for supporting the patient that is substantially parallel to a surface (e.g., the ground or floor) supporting the patient platform.

However, during some medical procedures, it may be beneficial to position the patient platform at other locations (e.g., non-horizontal positions) or at other angles (e.g., angles that are not parallel to the surface or floor supporting the patient platform). More specifically, for some medical procedures, it may be desirable to pivot, rotate, or tilt the patient platform laterally (from side to side) or longitudinally (from head to foot) relative to a horizontal or default position. In some cases, it may be beneficial to tilt the patient platform in both the lateral and longitudinal directions simultaneously.

For example, during a cholecystectomy procedure, a physician may desire to laterally tilt the patient platform. This may allow access to the gallbladder.

Tilting the patient platform longitudinally may place a patient positioned on the patient platform in a low-head position (with the patient's feet higher than the head) or a high-head position (with the patient's head higher than the feet). As one example, during a hysterectomy procedure, a physician may desire to longitudinally tilt the patient platform. This allows access to the uterus.

During the Roux-en-Y gastric bypass (RYGB) procedure, it may be desirable to simultaneously perform lateral tilting and longitudinal tilting in order to access the target anatomy. The medical procedures listed herein provide examples during which lateral tilting and/or longitudinal tilting may be desirable or beneficial. This list is not exhaustive and lateral tilt and/or longitudinal tilt may be beneficially used during many other medical procedures. Additionally, while the examples provided show application in robotic medical procedures, lateral tilting and/or longitudinal tilting may also be beneficially implemented in non-robotic or manual medical procedures, as well as endoscopic and/or percutaneous procedures in general.

The present application relates to a novel tilt mechanism for a patient platform. The tilt mechanism may be configured to provide lateral tilting and/or longitudinal tilting. In some embodiments, the tilt mechanism is configured for use with robotic medical systems, such as those described above with reference to fig. 1-20, as well as other robotic medical systems. However, this is not true in all embodiments, and the tilt mechanism for a patient platform described herein may also be configured for use with non-robotic or manual medical systems. In some embodiments, the tilt mechanism is advantageously configured to have a low profile. The low profile of the tilt mechanism may allow the tilt mechanism to fit within a small form factor while still providing sufficient range of motion, as described above and herein. Additionally, in some embodiments, the tilting mechanisms described herein may be advantageously configured to allow for both lateral tilting and longitudinal tilting to occur simultaneously.

Fig. 21A and 21B illustrate an embodiment of a robotic medical system 200 that includes a patient platform 201 and a tilt mechanism 207. In this example, the patient platform 201 is supported by a column 203 extending between a base 205 and the patient platform 201. A tilt mechanism 207 may be positioned between the column 203 and the patient platform 201 to allow the patient platform to pivot, rotate, or tilt relative to the column 203. The tilt mechanism 207 is not shown in detail in fig. 21A and 21B, but several exemplary tilt mechanisms will be described in more detail below with reference to fig. 24A-33E. As will be described below, the tilt mechanism 207 may be configured to allow for lateral and/or longitudinal tilting of the patient platform 201. In some embodiments, the tilt mechanism 207 allows the patient platform 201 to tilt laterally and longitudinally simultaneously. Fig. 21A and 21B show the patient platform 201 in an untilted state or position. In some embodiments, the untilted state or position may be a default position of the patient platform 201. In some embodiments, the default position of patient platform 201 is a substantially horizontal position as shown. As shown, in an untilted state, the patient platform 201 may be positioned horizontally or parallel to a surface (e.g., the ground or floor) supporting the robotic medical system 200. Fig. 22A and 22B show examples of lateral tilting and longitudinal tilting, respectively, and will be described below.

With continued reference to fig. 21A and 21B, in the illustrated example of the system 200, the patient platform 201 includes a rigid support structure or frame 209. The frame 209 may support one or more surfaces, pads, or cushions 211. The upper surface of the patient platform 201 may include a support surface 213. During a medical procedure, a patient may be placed on the support surface 213. The base 205 may be configured to support the system 200. In the illustrated embodiment, the base 205 includes wheels 215. The wheels 215 may allow the system 200 to be easily moved or repositioned. In some embodiments, wheels 215 are omitted, and base 205 may rest directly on the ground or floor. In some embodiments, the wheels 215 are replaced with feet.

Fig. 21A and 21B illustrate that in some embodiments, the system 200 may include one or more robotic arms 217. The robotic arm 217 may be configured to perform a robotic medical procedure as described above with reference to fig. 1-20. In some embodiments, one or more robotically-controllable instruments (not shown in fig. 21A and 21B) may be coupled to the robotic arm 217 as described above. As shown in fig. 21A and 21B, in some embodiments, the robotic arm 217 may be supported on an adjustable arm support 219. The adjustable arm support 219 may be configured to position one or more of the robotic arms 217 for robotic medical procedures, or to position one or more of the robotic arms 217 for stowing. Fig. 21A shows the robotic arm 217 and adjustable arm support 219 in a stowed configuration below the patient platform 201 and proximal to the base 205. Fig. 21B shows the robotic arm 217 and adjustable arm support 219 in an exemplary deployed configuration, where, for example, the robotic arm 217 is brought above the patient platform 201. In some embodiments, the robotic arm 217 and arm support 219 may occupy space below the patient platform 201 due to the configuration of the system 200 that enables the different components to be stowed below the patient platform 201 (see fig. 21A). Accordingly, in some embodiments, it may be advantageous to configure the tilt mechanism 207 to have a low profile and/or a small volume to maximize the space available for storage under the patient platform 201, as described below.

Fig. 21A and 21B illustrate exemplary x, y, and z coordinate systems that will be used to describe certain features of the embodiments disclosed herein. It should be understood that this coordinate system is provided for purposes of example and explanation only, and that other coordinate systems may be used. In the illustrated example, the x-direction or x-axis extends across the patient platform 201 in a lateral direction when the patient platform 201 is in an untilted state. That is, the x-direction extends across the patient platform 201 from one lateral side (e.g., the right side) to the other lateral side (e.g., the left side) when the patient platform 201 is in an untilted state. The y-direction or y-axis extends in the longitudinal direction along the patient platform 201 when the patient platform 201 is in an untilted state. That is, the y-direction extends along the patient platform 201 from one longitudinal end (e.g., the head end) to the other longitudinal end (e.g., the foot end) when the patient platform 201 is in an untilted state. In an untilted state, the patient platform 201 may lie in or be parallel to an x-y plane, which may be parallel to the floor or ground. In the illustrated example, the z-direction or z-axis extends in a vertical direction along the column 203. As described below with reference to fig. 22A and 22B, in some embodiments, the tilt mechanism 207 is configured to tilt the patient platform 201 laterally by rotating the patient platform 201 about a lateral tilt axis that is parallel to the y-axis. The tilt mechanism 207 may be further configured to tilt the patient platform 201 longitudinally by rotating the patient platform 201 about a longitudinal tilt axis parallel to the x-axis.

Fig. 22A is an end view of an embodiment of the robotic medical system 200, illustrating lateral tilting of the patient platform 201. As previously described, the medical system 200 includes a patient platform 201 supported above a base 205 by a column 203. A tilt mechanism 207 may be positioned between the patient platform 201 and the column 203 to allow the patient platform 201 to tilt relative to the column 203. FIG. 22A shows an end view with the y-axis extending into the page. The patient platform 201 is shown in three different positions. The patient platform 201 is shown in solid lines in an untilted state. The patient platform 201 is shown in dashed lines in a first laterally tilted state. In a first lateral tilt state, the patient platform 201 is shown tilted to a lateral tilt angle α. In some embodiments, the tilt mechanism 207 can be configured to allow a lateral tilt angle a of at least about 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, or more, relative to an untilted state. In some embodiments, the tilt mechanism 207 may be configured to allow the patient platform 201 to tilt in both lateral directions from an untilted state. That is, the lateral tilt angle α may be positive or negative. The second side-tilt state with negative angle alpha is shown in dash-dot lines. In some embodiments, the patient platform 201 may be tilted laterally to any angle between the positions shown in dashed and dotted lines. As shown in fig. 22A, lateral tilting may involve pivoting or tilting the patient platform 201 about a lateral tilt axis. The lateral tilt axis may be parallel to the y-axis. For example, in FIG. 22A, the lateral tilt axis extends into and out of the page.

Fig. 22B is a side view of an embodiment of the robotic medical system 200, illustrating longitudinal tilting of the patient platform 201. In FIG. 22B, the x-axis extends into the page. Fig. 22B shows the patient platform 201 in three different positions. The patient platform 201 is shown in solid lines in an untilted state. The patient platform 201 is shown in dashed lines in a first longitudinally inclined state. In a first longitudinally-inclined state, the patient platform 201 is shown inclined at a longitudinal inclination angle β. In some embodiments, the tilt mechanism 207 can be configured to allow a longitudinal tilt angle β of at least about 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, 50 degrees, 55 degrees, 60 degrees, or more, relative to an untilted state (shown in solid lines). In some embodiments, the tilt mechanism 207 may be configured to allow the patient platform 201 to tilt in both longitudinal directions from an untilted state. That is, the longitudinal inclination angle β may be positive or negative. A second longitudinally inclined state with a negative angle beta is shown in dash-dot lines. In some embodiments, the patient platform 201 may be longitudinally tilted to any angle between the positions shown in dashed and dotted lines. As shown in fig. 22B, longitudinal tilting may involve pivoting or tilting the patient platform 201 about a longitudinal tilt axis. The longitudinal tilt axis may be parallel to the x-axis. For example, in FIG. 22B, the longitudinal tilt axis extends into and out of the page.

As previously described, in some embodiments, the tilting mechanism 207 is configured to allow for simultaneous lateral tilting (fig. 22A) and longitudinal tilting (fig. 22B). For example, in some embodiments, the tilt mechanism 207 is configured to allow a lateral tilt angle α of at least about 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, or greater relative to an untilted state while allowing a longitudinal tilt angle β of at least about 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, 50 degrees, 55 degrees, 60 degrees, or greater relative to the untilted state. In some embodiments, to achieve simultaneous lateral and longitudinal tilting, the tilt mechanism 207 may include a lateral tilt mechanism and a longitudinal tilt mechanism that are operable simultaneously. An exemplary lateral tilt mechanism 400 will be described below with reference to fig. 24A-29, and an exemplary tilt mechanism 500 including the lateral tilt mechanism 400 and a longitudinal tilt mechanism 510 will be described with reference to fig. 30A-31. Another tilt mechanism 700 configured to provide both lateral and longitudinal tilting is shown in fig. 33A-33E.

In some embodiments, the tilt mechanism 207 is configured to support significant loads in order to support patients of various sizes as well as the weight of the patient platform 201 itself. In some embodiments, the tilt mechanism 207 is configured to accommodate at least 300 pounds, at least 400 pounds, at least 500 pounds, at least 600 pounds, at least 700 pounds, or more.

Fig. 23 shows an embodiment of a robotic system 300 comprising a hydraulic tilt mechanism 307 for tilting its patient platform 301. In this example, the patient platform 301 is supported above a base 305 by a column 303. The hydraulic tilt mechanism 307 includes a lateral tilt hydraulic piston 317 configured to actuate to laterally tilt the patient platform 301 and a longitudinal tilt hydraulic piston 319 configured to actuate to longitudinally tilt the patient platform 301. Additionally, because the hydraulic tilt mechanism 307 uses hydraulic pistons 317, 319, the system 300 also includes a fluid reservoir 321 that holds hydraulic fluid and a pump 323 for actuating the hydraulic pistons 317, 319. As shown, the system 300 is configured to fit under a patient platform 301. However, the hydraulic tilt mechanism 307 (including hydraulic pistons 317, 319, fluid reservoir 321, and pump 323) occupies significant space below the patient platform 301. In particular, the hydraulic tilt mechanism 307 occupies a significant "swept" volume below the patient platform 301. As used herein, a "swept" volume is the space occupied by a particular mechanism (e.g., a hydraulic piston) during tilting. Such a hydraulic tilt mechanism 307 may make it difficult, if not impossible, to fit the robotic arm and adjustable arm support under the patient platform in the stowed configuration (see fig. 21A). Accordingly, a tilt mechanism having a smaller form factor may be desirable.

Fig. 24A-29 relate to embodiments of a lateral tilt mechanism 400 that may be used with a longitudinal tilt mechanism 510 as shown in fig. 30A-31 in some embodiments. In some cases, a patient platform using the lateral tilt mechanism 400 may provide a number of improvements to the hydraulic tilt mechanism 307 of fig. 23, as the lateral tilt mechanism 400 is constructed with a much lower profile and small form factor. This allows it to be adapted for use with a robotic medical system that uses the space under the patient platform to stow the robotic arm (see fig. 21A). Additionally, although the lateral tilt mechanism 400 is described below as being configured for lateral tilting. A similar mechanism may be configured for longitudinal tilting.

Fig. 24A shows an end view of the side-tilt mechanism 400 in an untilted state. As shown, the untilted state may be a horizontal state. The untilted state may be a default position of the lateral tilt mechanism 400. Fig. 24B and 24C are end views showing the lateral tilt mechanism 400 in the first tilt state and the second tilt state. Referring first to fig. 24A, the lateral tilt mechanism 400 includes a pivot or tilt plate 401. The inclined plate 401 may comprise a substantially flat or planar plate (see, e.g., fig. 30A). The tilt plate 401 may include various features, such as recesses, cutouts, or protrusions, that provide space for or support one or more additional components of the lateral tilt mechanism 400. Thus, while the angled plate 401 is described as being generally flat or planar, this may refer to a general shape, it being understood that additional features may be formed on the angled plate 401. For example, in some embodiments, the inclined plate 401 need not be completely flat. In some embodiments, the inclined plate 401 comprises a plate that extends substantially in a plane.

As shown in fig. 24A, the tilt plate 401 may be connected to a gimbal 450. Gimbal 450 may be part of or coupled to column 203. Thus, in some embodiments, the gimbal 450 is positioned between the column 203 and the tilt plate 401. The gimbal 450 may be configured to allow the tilt plate 401 to pivot, rotate, or tilt relative to the column 203. In some embodiments, the gimbal 450 is configured to allow the tilt plate 401 to tilt in more than one direction. For example, in some embodiments, the gimbal 450 is configured to allow the tilt plate 401 to tilt in both the lateral and longitudinal directions. In some embodiments, the gimbal 450 is configured to allow the tilt plate 401 to tilt in both the lateral and longitudinal directions simultaneously (see, e.g., fig. 31).

In the embodiment shown in FIG. 24A, gimbal 450 is configured to allow tilt plate 401 to tilt laterally about lateral tilt axis 451. The lateral tilt axis 451 may extend in a direction parallel to the y-axis (i.e., into the page). The tilting plate 401 is tiltable about a lateral tilting axis 451 in a lateral tilting direction 453 indicated by an arrow. As previously described, fig. 24B and 24C show the inclined plate 401 inclined laterally at two different positions. The gimbal 450 of the embodiment shown in fig. 24A may also be configured to provide longitudinal tilt, as will be described below with reference to fig. 30A-31.

The tilt plate 401 may be configured to attach to the underside of the patient platform 201 (not shown in fig. 24A, but see, e.g., fig. 20A-21B and 31). Thus, in some embodiments, gimbal 450 and tilt plate 401 are positioned between column 203 and patient platform 201 so as to allow patient platform 201 to tilt relative to column 203.

With continued reference to fig. 24A, the lateral tilt mechanism 400 may also include a linear actuator 403 mounted on the tilt plate 401. The linear actuator 403 may be configured to apply a force to the pivot housing 405. The linear actuator 403 may be fixedly mounted to the tilt plate 401. When the linear actuator 403 applies a force to the pivot housing 405, the pivot housing 405 may move back and forth along the tilt plate 401. For example, the pivot housing 405 may move back and forth in the direction 455 indicated by the arrow in fig. 24A. As will be described in more detail below, the tilt plate 401 tilts laterally about the lateral tilt axis 451 as the pivot housing 405 moves back and forth (see fig. 24B and 24C).

In the illustrated embodiment, the linear actuator 403 includes a screw drive assembly. The screw drive assembly may include a motor 407, a lead screw 409 and a nut housing 411 (located within the pivot housing 405 but not visible in fig. 24A; see fig. 25-27, which show the nut housing 411). The motor 407 may be fixedly mounted to the tilt plate 401. The motor 407 may be configured to rotate the lead screw 409. The lead screw 409 may extend along the x-axis in an untilted state. More generally, the lead screw 409 may extend along the plane of the tilt plate 401 (e.g., in or parallel to the plate of the tilt plate 401) and in a direction orthogonal to the lateral tilt axis 451. The nut housing 411 may be mounted on the lead screw 409. As the lead screw 409 rotates, the nut housing 411 may travel forward and backward along the lead screw 409. The nut housing 411 may be mounted within the pivot housing 405 (see fig. 25). Accordingly, the force transferred to the nut housing 411 may also be transferred to the pivot housing 405, and as the nut housing 411 moves back and forth along the lead screw 409, the pivot housing 405 may move back and forth with it (e.g., in direction 455). An exemplary screw drive assembly is shown in more detail in fig. 25 and 26, described below. Although the linear actuator 403 is shown as a screw drive assembly, other types of linear actuators may be used.

As shown in fig. 24A, in some embodiments, the lateral tilt mechanism 400 may include one or more linear guides 413 extending in a direction parallel to the lead screw 409. The linear guide 413 may include a guide rail. The pivot housing 405 may include one or more brackets 415 mounted on one or more linear guides 413. One or more brackets 415 may be configured to translate along one or more linear guides 413 as pivot housing 405 moves back and forth in direction 455. In some embodiments, one or more linear guides 413 provide stability to the lateral tilt mechanism 400. In some embodiments, one or more linear guides 413 may be omitted. The one or more linear guides 413 will be described in more detail with reference to fig. 25 and 26, which show the one or more linear guides 413 in more detail.

The linear actuator 403 is configured to apply a linear force to the pivot housing 405 at a location above the lateral tilt axis 451. For example, as shown in FIG. 24A, when the tilt plate 401 is in the untilted state, the linear actuator 403 is a distance D above the lateral tilt axis 451₀Applies a linear force to the pivot housing 405. Distance D₀May be measured along axis 457 as shown. In the untilted state, axis 457 is aligned with the vertical or z-axis. More generally, however, if the inclined plate 401 is inclined longitudinally, the axis 457 may extend at an angle that is perpendicular to the longitudinal inclination. In other words, axis 457 may be perpendicular to a lateral tilt axis in the z-y plane. As will be shown with reference to the following figures, as the tilt plate 401 tilts laterally, the distance (measured along axis 457) between the lateral tilt axis 451 and the application of a linear force to the pivot housing 405 changes (fig. 24A, D)₀D from FIG. 24B₁And D of FIG. 24C₂Comparing; see also fig. 29 and corresponding description). That is, when the linear actuator 403 is applied to the pivot housing 405Linear force, the distance between the points at which the linear force is applied to the pivot housing 405 varies, which causes the tilt plate 401 to tilt about the lateral tilt axis 451, as described below.

FIG. 24B is an end view of the lateral tilt mechanism of FIG. 24A in a first tilted state. In the illustrated state, the motor 407 of the linear actuator 403 drives the pivot housing 405 in a direction along direction 455 in a direction away from the motor 407. As shown, direction 455 remains parallel to the plane of pivot plate 401. This may be because pivot housing 405 moves along lead screw 409 and linear guide 413, each of which is fixed relative to pivot plate 401. The nut housing 411 (located within the pivot housing 405) has moved along the lead screw 409 causing the pivot housing 405 to translate along the linear guide 413. Such movement causes the tilt plate 401 to tilt as shown. In the illustrated embodiment, the inclined plate 401 is shown inclined in a first direction at a lateral inclination angle α. In some embodiments, the range of lateral tilt angle α can be as described above with reference to fig. 21A.

As shown in fig. 24B, during tilting of the tilt plate 24B, the pivot housing 405 remains positioned above the lateral tilt axis 451 along axis 457. This may be because, as described below, the pivot housing is also slidably mounted on an additional linear guide 417 (see fig. 25-27) that may be fixed relative to gimbal 450 so as to extend along axis 457. Distance D measured along axis 457 between lateral tilt axis 451 and application of linear force to pivot housing 405₁Shown in fig. 24B. Notably, the distance D₁(FIG. 24B) is greater than the distance D₀(FIG. 24A). As will be described in more detail below, this is because the pivot housing 405 translates upward along the axis 457 when the tilt plate 401 tilts. This upward translation of the pivot housing 405 is a unique feature of the tilt mechanism 400. As the linear actuator 403 applies a linear force to the pivot housing 405 along the plane of the tilt plate, the distance between the linear actuator 403 (e.g., motor 407) and the pivot housing 405 increases along direction 455. As previously described, the linear actuator 403 may be fixed to the tilt plate 401, while the pivot housing 405 is not fixed to the tilt plate. The pivot housing 405 may be in direction 455Free to move along the plane of the tilting plate 401. Additionally, the pivot housing 405 may be constrained such that it is always positioned on the axis 457. For example, tilt mechanism 400 may include a linear guide 417 as shown in fig. 25-27 (described below) that constrains pivot housing 405 such that it moves along axis 457.

FIG. 24C is an end view of the lateral tilt mechanism of FIG. 24A in a second tilted state. In the illustrated state, the motor 407 of the linear actuator 403 drives the pivot housing 405 in a direction toward the motor 407 along a direction 455. The nut housing 411 (located within the pivot housing 405) has moved along the lead screw 409 causing the pivot housing 405 to translate along the linear guide 413 towards the motor 407. Such movement causes the tilt plate 401 to tilt as shown. In the illustrated embodiment, the inclined plate 401 is shown inclined in a second direction at a lateral inclination angle α. Also, the lateral inclination angle α may have the aforementioned range.

Similar to the position shown in fig. 24B, in the position of fig. 24C, the pivot housing 401 remains positioned above the lateral tilt axis 451 along axis 457. As described above, this may be because pivot housing 405 is further constrained by linear guide 417 so that it may translate along axis 457. Distance D measured along axis 457 between lateral tilt axis 451 and application of linear force to pivot housing 405₂Shown in fig. 24C. Notably, the distance D₂(FIG. 24B) is greater than the distance D₀(FIG. 24A). This is because the pivot housing 405 translates upward along axis 457 when the tilt plate 401 is tilted. In some embodiments, if angle α of fig. 24C is equal to angle α of fig. 24B, then distance D is₂(FIG. 24C) may be equal to distance D₁(FIG. 24B).

Fig. 25 is an isometric view of an embodiment of a lateral tilt mechanism 400. Fig. 25 shows a linear actuator 403, a pivot housing 405 and its linear guides 413, 417 according to one embodiment. In fig. 25, the pivot housing 405 is shown as transparent so that internal features of the pivot housing 405 and components below the pivot housing 405 can be seen. Fig. 25 shows the reclining mechanism 400 in a tilted state similar to the state shown in fig. 24C.

As shown in fig. 25, linear actuator 403 may include a motor 407, a lead screw 409, and a nut housing 411. As shown, the nut housing 411 is mounted on the lead screw 409 (see also fig. 26). As the motor 407 rotates the lead screw 409, the nut housing 411 moves back and forth along the lead screw 409 in direction 455. The nut housing 411 may be positioned within the pivot housing 405. Additionally, a nut housing 411 may be connected to the pivot housing 405. In the illustrated embodiment, the nut housing 411 is bolted to the pivot housing 405, but other methods of attachment are possible. Because the nut housing 411 is connected to the pivot housing 405, when the nut housing 411 moves along the lead screw 409, the pivot housing 405 moves along the lead screw 409 along with the nut housing. As such, linear actuator 403 may be configured to move pivot housing 409 back and forth in direction 455.

As shown in fig. 25, the pivot housing 405 may include a bracket 415 that may be slidably engaged with the linear guide 413. The linear guide 413 may extend in a direction 455 along the inclined plate 401. The linear guide 413 may be attached to or otherwise fixed relative to the tilt plate 401. In the illustrated embodiment, the tilt mechanism 400 includes a pair of linear guides 413 positioned on opposite sides of the nut housing 411. In some embodiments, other numbers of linear guides 413 may be used. For example, one, two, three, four, or more linear guides 413 may be used. In some embodiments, linear guide 413 provides stability as pivot housing 405 translates back and forth along linear guide 413 in direction 455. In some embodiments, linear guide 413 may be omitted. For example, even without the linear guide 413, the pivoting housing 405 would translate back and forth along the lead screw 409 in the direction 455. The linear guide 413 may be configured as a guide rail.

Fig. 25 further illustrates a linear guide 417. As described above, linear guide 417 may further constrain the motion of pivot housing 405 such that it translates up and down along axis 457. The linear guide 417 may be attached to or otherwise fixed relative to a component of the gimbal 450. A carriage 419 connected to pivot housing 405 may be configured to translate along linear guide 417. Because the tilt plate 401 is tilted with respect to the gimbal 450 and the linear guide 417 is attached to the gimbal 450, the tilt plate 401 is also tilted with respect to the linear guide 417. That is, linear guide 417 extends along axis 457 regardless of the lateral tilt angle of tilt plate 401. This constrains the movement of the pivot housing 405 so that it can move along axis 457. This also keeps the pivot housing 405 above the lateral pivot axis (see fig. 24A, 24B, and 24C) (measured along axis 457). The linear guide 417 may be configured as a guide rail.

In the illustrated embodiment, the tilt mechanism 400 includes a pair of linear guides 417, with one lateral guide 417 positioned on each side of the nut housing 411. In some embodiments, other numbers of linear guides 417 may be used. For example, one, two, three, four, or more linear guides 417 may be used. Additionally, in the illustrated embodiment, a pair of linear guides 417 are positioned within the pair of linear guides 413. This is not required in all embodiments. For example, the pair of linear guides 413 may be positioned inside the pair of linear guides 417. As previously described, the linear guide 413 may provide additional stability to the tilt mechanism 400, which may be omitted in some embodiments.

Fig. 26 is an isometric view of the lateral tilt mechanism 400 showing a more detailed view of the linear guide 417 and nut housing 411. In fig. 26, the pivot housing 405 is removed to better illustrate the linear guide 417 and the nut housing 411. As shown, the nut housing 411 is positioned on the lead screw 409. Nut housing 411 is also slidingly engaged with linear guide 417 via bracket 419. Nut housing 411 may be coupled to bracket 419 in a manner that allows nut housing 411 to rotate relative to bracket 419 and linear guide 417.

Fig. 27 is an isometric view of the nut housing 411. As shown, the nut housing 411 may include a base member or body 421. In the illustrated embodiment, the body 421 is rectangular, but other shapes of the body 421 are possible. The opening 425 may extend through the main body 421. The opening 425 may be configured to receive the lead screw 409. In some embodiments, the inner surface of the opening 425 is threaded to engage corresponding threads on the lead screw 409. As shown, the posts 423 can extend laterally from the main body 421. The posts 423 may be configured to be received within corresponding recesses formed on the bracket 419. The posts 423 may rotate within corresponding recesses to allow the nut housing 411 to rotate relative to the bracket 419.

Fig. 28A and 28B illustrate the transfer of force from the linear actuator 403 to the pivot housing 405 and the nut housing 411. Fig. 28A is an isometric view of the side-tilt mechanism 400 showing the application of a linear force, while fig. 28B is an end view of the side-tilt mechanism 400 showing a component of the linear force.

As shown in fig. 28A, the linear actuator 403 is configured to apply a linear force F to the nut housing 411 (and correspondingly to the pivot housing 405)_{Screw rod}. Force F_{Screw rod}Acting in a direction parallel to the lead screw 409. Since the motor 407 and the lead screw 409 are fixedly mounted with respect to the tilt plate 401, F_{Screw rod}And the relative orientation of the inclined plate 401 is not dependent on the lateral inclination angle of the inclined plate 401. In contrast, F_{Screw rod}In a direction parallel to the plane of the inclined plate 401.

As shown in fig. 28B, force F_{Screw rod}Can be decomposed into component vectors F_xAnd F_y. Each of the linear guides 413, 417 is configured to couple two force components F_xAnd F_yOne of them reacts. For example, the linear guide 417 may be configured as a pair F_xReacts to cause vertical translation or translation along the axis 457 (see fig. 24A, 24B, and 24C) of the pivot housing 405. As previously described, translation along axis 457 causes tilt plate 401 to tilt about a lateral tilt axis. More specifically, in the illustrated embodiment, the force F is applied when the motor 407 drives the lead screw 409 to cause linear movement of the nut housing 411 and the tilt housing 405_xIs counteracted by the linear guide 417 to drive the carriage 419 up the fixed track. This results in a lateral tilt.

The linear guide 413 may be configured to oppose the force F_yReacts to cause the pivoting housing 405 to translate along direction 455 (see fig. 24A, 24B, and 24C). As mentioned above, the wireThe sexual guide 413 may advantageously provide stability. For example, linear guide 413 may protect lead screw 409 from bending or breaking beyond a maximum deviation.

Fig. 29 schematically illustrates exemplary movement of a lateral tilt mechanism 400 according to one embodiment. The motor 407, lead screw 409 and nut housing 411 are each schematically shown. The side-tilt mechanism 400 is shown in solid lines in an untilted state and in dashed lines in a tilted state. As shown, when the motor 407 is actuated, the distance between the motor 407 and the nut housing 411 changes by Δ d₁. This causes the nut housing 411 to be driven upward along a vertical trajectory produced by the linear guide 413, which causes the tilting plate 401 to tilt. As the nut housing 411 translates upward, the pivot point 470 of the nut housing 411 also translates vertically. Thus, from the untilted state to the tilted state, the position of the pivot point 470 of the nut housing has moved Δ d upward relative to the lateral tilt axis 451₂。

As previously described, the side-tilt mechanism 400 may include a low profile or a low profile. This may be because the lateral tilt mechanism 400 may be mounted on a substantially flat or planar tilt plate 401, and the linear actuator 403 acts in a direction parallel to the plane of the tilt plate 401. Due to the low profile of the lateral tilt mechanism 400, in some embodiments, the lateral tilt mechanism 400 may be coupled to a longitudinal (or low-head) tilt mechanism. In some embodiments, the lateral tilt mechanism 400 may be stacked on top of the longitudinal tilt mechanism. In this way, the tilt mechanism may be configured to allow both lateral tilting and longitudinal (or head-down) tilting.

Fig. 30A and 30B illustrate an embodiment of a tilt mechanism 500 for a patient platform 201 of a robotic medical system 200, the tilt mechanism including a lateral tilt mechanism 400 and a longitudinal tilt mechanism 510. Fig. 30A is an isometric view and fig. 30B is a side view. In the illustrated embodiment of the tilt mechanism 500, the lateral tilt mechanism 400 is stacked on top of the longitudinal tilt mechanism 510.

In the illustrated embodiment, the lateral tilt mechanism 400 is configured as described above, including, for example, a tilt plate 401, a linear actuator 403, and a pivot housing 405. To achieve longitudinal tilting, a longitudinal tilting mechanism 510 may also be included. In the illustrated embodiment, the longitudinal tilting mechanism 510 includes a longitudinal connector 512. The longitudinal connector 512 may be attached to the laterally inclined plate 410 (see fig. 30A). The longitudinal connector 512 may also be attached to the column 203. For example, in the illustrated embodiment, the longitudinal connector 512 is attached to the column 203 using a bracket 520 mounted on a lead screw 518. A motor 516 may be mounted to the column 203 and configured to rotate a lead screw 518. As the lead screw rotates, the carriage 520 is driven up and down along the post 203. The longitudinal link 512 acts on the inclined plate 401 to longitudinally tilt the inclined plate 401 as the carriage 520 is driven up and down along the column 203. As shown in fig. 30B, the longitudinal tilting mechanism 510 may be configured to tilt the tilting plate 401 about the longitudinal tilting axis 451.

Fig. 31 illustrates that the tilt mechanism 500 may be configured for simultaneous lateral and longitudinal tilting using the lateral tilt mechanism 400 and the longitudinal tilt mechanism 510, respectively. As previously described, in some embodiments, the tilting mechanism 500 is configured to allow a lateral tilt angle of at least about 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, or greater relative to an untilted state while allowing a longitudinal tilt angle of at least about 15 degrees, 20 degrees, 25 degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, 50 degrees, 55 degrees, 60 degrees, or greater relative to the untilted state. As a specific example, the tilt mechanism 500 may be configured such that all patient platforms 201 have a lateral tilt of 30 degrees and simultaneously have a longitudinal tilt of 45 degrees, as shown in fig. 31.

Fig. 32 is a flow diagram illustrating an embodiment of a method 600 for controlling tilt of a patient platform of a robotic medical system. Method 600 may begin at block 602, where the patient platform is tilted over a lateral tilt axis based on: the linear actuator is actuated to apply a linear force to the pivot housing, translating the pivot housing along a first linear guide along a first axis, and translating the pivot housing along a second linear guide along a second axis.

In some embodiments, the first linear guide may comprise the linear guide 413 discussed above, and the second linear guide may comprise the linear guide 417 discussed above. In some embodiments, the first linear guide 413 comprises a lead screw 409. In some embodiments, the first axis is parallel to the linear force and the second axis is not parallel to the first axis.

In some embodiments, actuating the linear actuator comprises driving a lead screw with a motor. In some embodiments, the pivot housing includes a nut housing mounted on the lead screw. In some embodiments, the motor is attached to a tilt plate that supports the patient platform, and wherein the first linear guide is attached to the tilt plate. In some embodiments, the second linear guide is attached to a gimbal, such as gimbal 450.

As shown in fig. 32, at block 604, the method 600 includes pivoting the gimbal relative to the column supporting the patient platform to tilt the patient platform about the longitudinal tilt axis. In some embodiments, pivoting the gimbal relative to the column includes driving a longitudinal link (such as longitudinal link 512) with a longitudinal linear actuator (such as motor 516, lead screw 518, and carriage 520) that translates along the axis of the column.

In some embodiments, blocks 602 and 604 may be performed simultaneously, such that method 600 includes tilting the patient platform about both the lateral tilt axis and the longitudinal tilt axis simultaneously.

In some embodiments, the method 600 further comprises performing a robotic medical procedure on a patient supported on a patient platform.

Fig. 33A-33E illustrate another embodiment of a tilt mechanism 700 configured to provide lateral tilting and longitudinal tilting. In the illustrated embodiment, the tilt mechanism 700 includes a large arc tilt mechanism for tilting a patient platform 701 of the robotic medical system. Fig. 33A shows a side view of the tilt mechanism 700 in an untilted position, and fig. 33B shows the tilt mechanism 700 in a tilted position. Fig. 33C is a cross-sectional view of the tilt mechanism 700.

Referring to fig. 33A-33C, the tilt mechanism 700 includes a large circular arc swivel that enables three rotational degrees of freedom, including a combination of a head-foot-high position (e.g., longitudinal tilt), a lateral tilt, and a position or angle therebetween. Specifically, the tilt mechanism 700 includes a first rotating portion 703 and a second rotating portion 705. The first rotating portion 703 and the second rotating portion 705 together form a substantially spherical shape. However, as shown in fig. 33A, the first rotating portion 703 and the second rotating portion 705 engage at a non-orthogonal angle with respect to the axis of the post to which they are attached. The first rotating portion 703 is rotatable with respect to the second rotating portion 705. Additionally, the patient platform 701 is rotatable relative to the first rotation portion 703. The second rotating portion 705 may be coupled to a post 707 (only a portion of the post 707 is shown in fig. 33A-33C). By rotating each of the patient table 701, the first rotational part 703 and the second rotational part 705 to different positions, a lateral tilt and a longitudinal tilt of the patient table 701 may be achieved. In one example, the tilt mechanism 700, three rotational degrees of freedom positions the patient with a combination of up to 52 degrees of longitudinal tilt, up to 52 degrees of tilt, and angles therebetween.

As shown in fig. 33C, the tilt mechanism 700 may include a motor 751 and a gearbox 750. The motor 751 and the gearbox 750 may be configured to drive rotation of the first rotating section 703 relative to the second rotating section 705. The tilt mechanism 700 may also include a brake 752, as shown. The brake 752 may be configured to secure the patient platform 701 in place after the tilt mechanism 700 has been rotated to a desired position in order to hold the patient platform 701 in a stable position. In some embodiments, additional motors and gearboxes (or other drive mechanisms) may be included to drive rotation of the second rotating portion 705 relative to the column 707. For example, a motor and gearbox may be included in space 754 to drive rotation of second rotating portion 705 relative to column 707. In other embodiments, the drive mechanism for rotating the second rotating portion 705 relative to the column 707 can be positioned at other locations, such as within the column 707 or within the second rotating portion 705. As described in more detail with reference to fig. 33D and 33E, the tilt mechanism 700 may include one or more worm drives 711 configured to drive rotation of the patient platform 701 relative to the first rotation portion 703. In some embodiments, other drive mechanisms (e.g., motors) may be used to rotate the patient platform 701 relative to the first rotation portion 705. Bearings 753 may be included to facilitate relative rotation of the various components of the tilt mechanism 700.

Fig. 33D and 33E show top views of the tilt mechanism 700 of fig. 33A-33C. As shown, the tilt mechanism 700 may use a double worm drive 711 to actuate the top and bottom axes, while the centrally located angled swivel mount is actuated via a harmonic drive. In some embodiments, only a single worm drive 711 is included. In some embodiments, the double worm drive 711 may be driven by a motor. Other mechanisms, such as any kind of motor and gearbox connected to the joint, may also be used. Spur gears, planetary gears, cables, or timing belts may also all be used as an alternative to the worm drive 711. Coordinated movement of the top and bottom axes in a direction opposite the angled axis forms an angle at the tabletop. By rotating the three axes at different rates, different combinations of angles can be achieved.

One advantage of the tilt mechanism 700 is that most of the mechanism and actuation is contained within a very small enclosure. In many other designs, some aspects of the lateral tilt mechanism and the longitudinal tilt mechanism are typically present in, on, or around the column, but the tilt mechanism 700 allows all associated mechanisms and motors to be neatly packaged above the column. The tilt mechanism 700 may be an electromechanical system. The hydraulic system may be provided in a package that may be small, but the electromechanical system may be difficult to compete with the power and size of a similarly sized hydraulic system. The tilt mechanism 700 provides a very small and robust enclosure in view of the torque requirements to support the patient with a certain safety factor.

3. Implementation System and terminology。

Implementations disclosed herein provide systems, methods, and apparatus for a robotic medical system including a patient platform. In particular, implementations disclosed herein provide systems, methods, and apparatus for a lateral tilt mechanism and/or a longitudinal tilt mechanism for a patient platform of a robotic medical system.

It should be noted that as used herein, the terms "couple," "coupling," "coupled," or other variations of the word couple may indicate an indirect connection or a direct connection. For example, if a first component is "coupled" to a second component, the first component may be indirectly connected to the second component via another component or directly connected to the second component.

Phrases referencing particular computer-implemented processes and functions described herein may be stored as one or more instructions on a processor-readable or computer-readable medium. The term "computer-readable medium" refers to any available medium that can be accessed by a computer or processor. By way of example, and not limitation, such media can include Random Access Memory (RAM), Read Only Memory (ROM), Electrically Erasable Programmable Read Only Memory (EEPROM), flash memory, compact disc read only memory (CD-ROM) or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that computer-readable media may be tangible and non-transitory. As used herein, the term "code" may refer to software, instructions, code or data that is executable by a computing device or processor.

The methods disclosed herein comprise one or more steps or actions for achieving the described method. The method steps and/or actions may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is required for proper operation of the method being described, the order and/or use of specific steps and/or actions may be modified without departing from the scope of the claims.

The term "plurality", as used herein, means two or more. For example, a plurality of components indicates two or more components. The term "determining" encompasses a variety of actions, and thus "determining" can include calculating, computing, processing, deriving, investigating, looking up (e.g., looking up in a table, a database or another data structure), ascertaining and the like. Additionally, "determining" may include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), and the like. Additionally, "determining" may include resolving, selecting, choosing, establishing, and the like.

The phrase "based on" does not mean "based only on," unless expressly specified otherwise. In other words, the phrase "based on" describes that "is based only on" and "is based at least on" both.

The previous embodiments of the disclosed embodiments are provided to enable any person skilled in the art to make or use the present invention. Various modifications to these implementations will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other implementations without departing from the scope of the invention. For example, it should be understood that one of ordinary skill in the art will be able to employ a number of corresponding alternative and equivalent structural details, such as equivalent ways of fastening, mounting, coupling or engaging tool components, equivalent mechanisms for generating specific actuation motions, and equivalent mechanisms for delivering electrical energy. Thus, the present invention is not intended to be limited to the implementations shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.