阅读说明：本技术 包括机器人远程操纵器和集成的腹腔镜检查的外科手术机器人系统 (Surgical robotic system including robotic telemanipulator and integrated laparoscopy ) 是由 J·查索特 M·弗里德里希 P·舍尼希 M·萨利安 于 2020-01-04 设计创作，主要内容包括：提供了一种具有机器人远程操纵器的用于远程操纵的外科手术机器人系统。外科手术机器人系统非常适合外科医生使用,可无缝集成到手术室中,允许外科医生在整个外科手术中以无菌方式在机器人和患者之间工作,成本相对低,和/或允许集成的腹腔镜检查。该系统优选地包括主控制台,该主控制台具有通过多个主关节互连的多个主连杆,以及耦接到该主控制台以操作该远程操纵器的手柄。该系统还包括从控制台,该从控制台可操作地耦接到主控制台,并且具有通过多个从关节互连的多个从连杆,该从连杆响应于在主控制台处的移动而移动,以允许末端执行器执行外科手术。(A surgical robotic system for remote manipulation having a robotic telemanipulator is provided. The surgical robotic system is well suited for use by surgeons, may be seamlessly integrated into an operating room, allows surgeons to work between the robot and the patient in a sterile manner throughout the surgery, is relatively low cost, and/or allows integrated laparoscopy. The system preferably includes a master console having a plurality of master links interconnected by a plurality of master joints, and a handle coupled to the master console to operate the remote manipulator. The system also includes a slave console operably coupled to the master console and having a plurality of slave links interconnected by a plurality of slave joints, the slave links moving in response to movement at the master console to allow the end effector to perform a surgical procedure.)

1. A system for remote manipulation to perform a surgical procedure, the system comprising:

a patient console including a plurality of patient links coupled to a base;

a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a patient at a surgical site to perform a robotic surgical procedure; and

a controller configured to execute instructions to:

in a surgical mode, moving at least one of the plurality of patient links in response to movement imparted at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform the robotic surgical procedure; and is

Transitioning the patient console from the surgical mode to a laparoscopic mode in which the plurality of patient links are retracted from the patient while the base of the patient console remains stationary to expose the surgical site, thereby allowing a surgeon to perform a non-robotic surgical procedure at the surgical site without interference from the plurality of patient links.

2. The system of claim 1, wherein the controller is further configured to execute instructions to:

determining that the surgical instrument has been removed from the patient at the surgical site; and is

Transitioning the patient console from the surgical mode to the laparoscopic mode only if the surgical instrument has been removed.

3. The system of claim 2, wherein the controller determines that the surgical instrument has been removed from the patient by determining that the surgical instrument has been decoupled from the patient console.

4. The system of claim 1, wherein the controller transitions the patient console from the surgical mode to the laparoscopic mode in response to a user input received at the patient console.

5. The system of claim 1, wherein the handle is removably coupled to the surgeon console such that the handle is sterile during the surgical procedure and sterilizable when removed for additional surgical procedures.

6. The system of claim 5, further comprising a sterile drape interface having a ring defining an opening, wherein the handle, when coupled to the surgeon console, holds the ring in place such that the sterile drape of the sterile drape interface covers a portion of the surgeon console.

7. The system of claim 1, wherein the controller is configured to execute instructions to: in the surgical mode, at least one of the plurality of patient links is moved in response to movement applied at the handle of the surgeon console at a scaled degree.

8. The system of claim 7, wherein the controller is configured to execute instructions to: in the surgical mode, scaled micro-movements at the surgical instrument in micro-degrees of freedom are caused in response to corresponding movements applied at the handle of the surgeon console.

9. The system of claim 8, wherein micro-movements applied at the surgical instrument are independently scalable for each of the micro-degrees of freedom such that the scaled micro-movements at the micro-degrees of freedom are at a different scale than second scaled micro-movements at the surgical instrument at a second micro-degree of freedom.

10. The system of claim 1, wherein the surgeon console comprises a clutch configured to prevent micro-movement at the surgical instrument in response to micro-movement applied at the handle of the surgeon console when the clutch is actuated.

11. A method for remotely performing a surgical procedure, the method comprising:

coupling a surgical instrument to a patient console, the patient console including a plurality of patient links coupled to a base;

inserting a distal region of the surgical instrument into a patient at a surgical site to perform a robotic surgical procedure;

in a surgical mode, moving at least one of the plurality of patient links, thereby moving the surgical instrument to perform the robotic surgical procedure, in response to movement imparted at a handle of a surgeon console operably coupled to the patient console; and

transitioning the patient console from the surgical mode to a laparoscopic mode in which the plurality of patient links are retracted from the patient while the base of the patient console remains stationary to expose the surgical site, thereby allowing a surgeon to perform a non-robotic surgical procedure at the surgical site without interference from the plurality of patient links.

12. The method of claim 11, further comprising: determining that the surgical instrument has been removed from the patient at the surgical site, wherein transitioning the patient console from the surgical mode to the laparoscopic mode occurs only if the surgical instrument has been removed.

13. The method of claim 12, wherein determining that the surgical instrument has been removed from the patient at the surgical site comprises determining that the surgical instrument has been decoupled from the patient console.

14. The method of claim 11, further comprising receiving a user input at the patient console, wherein transitioning the patient console from the surgical mode to the laparoscopic mode is in response to the user input received at the patient console.

15. The method of claim 11, wherein the handle is removably coupled to the surgeon console, the method further comprising removing the handle for sterilization between surgeries.

16. A system for remote manipulation to perform a surgical procedure, the system comprising:

a patient console including an alignment joint and a plurality of patient links coupled to a base;

a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a patient at a surgical site to perform a robotic surgical procedure; and

a controller configured to execute instructions to:

setting a virtual center of motion based on the alignment of the alignment joint and the surgical site; and is

Moving at least one of the plurality of patient links in response to movement imparted at a handle of a surgeon console operably coupled to the patient console to move the surgical instrument to perform the robotic surgical procedure,

wherein movement of the surgical instrument is restricted near the virtual remote center of motion to maintain alignment of the patient joint with the surgical site during the surgical procedure.

17. The system of claim 16, further comprising a cut-out indicator configured to be removably coupled to the alignment joint to allow the alignment joint and the surgical site to be aligned.

18. The system of claim 17, wherein the cut indicator is configured to be removably coupled to the alignment joint via a magnetic attachment.

19. The system of claim 16, wherein the virtual center of motion is set based on the alignment of the alignment joint and a trocar positioned within the patient at the surgical site.

20. The system of claim 16, wherein the handle is removably coupled to the surgeon console such that the handle is sterile during the surgical procedure and sterilizable when removed for additional surgical procedures.

21. A method for remotely performing a surgical procedure, the method comprising:

aligning one of a plurality of patient joints of a patient console with a trocar insertion site, the plurality of patient joints interconnected by a plurality of patient links, the patient console operably coupled to a surgeon console and configured to move in response to movement applied at a handle of the surgeon console;

setting a virtual remote center of motion based on the alignment of the patient joint with the trocar insertion site; and

moving at least one of the plurality of patient links in response to movement applied at the handle to move a surgical instrument coupled to the patient console to perform the surgical procedure,

wherein movement of the surgical instrument is limited near the virtual remote center of motion to maintain alignment of the patient joint with the trocar insertion site during the surgical procedure.

22. The method of claim 21, further comprising coupling a cut indicator to the alignment joint, wherein aligning the one of the plurality of patient joints of the patient console with the trocar insertion site comprises aligning the cut indicator with the trocar insertion site.

23. The method of claim 22, wherein coupling the cut indicator to the alignment joint comprises coupling the cut indicator to the alignment joint via a magnetic attachment.

24. The method of claim 21, further comprising removing the handle for sterilization between surgeries.

25. A system for remote manipulation to perform a surgical procedure, the system comprising:

a patient console including a plurality of patient links coupled to a base;

a surgical instrument coupled to the patient console, a distal region of the surgical instrument configured to be inserted into a patient at a surgical site to perform a robotic surgical procedure; and

a controller configured to execute instructions to cause scaled micro-movements at the surgical instrument in micro-degrees of freedom in response to corresponding movements applied at the handle of the surgeon console in the surgical mode,

wherein the scaled micro-movement at the surgical instrument in the micro-degree of freedom is greater than the corresponding movement applied at the handle of the surgical console.

26. The system of claim 25, wherein the micro-movements applied at the surgical instrument are independently scalable for each of the micro-degrees of freedom such that the scaled micro-movements at a first micro-degree of freedom are at a different scale than second scaled micro-movements at the surgical instrument at a second micro-degree of freedom.

27. The system of claim 25, wherein the surgeon console comprises a clutch configured to prevent micro-movement at the surgical instrument in response to micro-movement applied at the handle of the surgeon console when the clutch is actuated.

28. The system of claim 27, wherein an end effector of the surgical instrument is movable to a first position via the handle, the clutch is then actuated, the handle is movable to a second position while the end effector remains stationary, and then, upon release of the clutch, the patient console resumes relative micro-movement from the handle to the end effector of the surgical instrument.

29. The system of claim 25, wherein the scaled micromotion at the surgical instrument in a roll degree of freedom of the micro degrees of freedom is at least twice as large as the corresponding movement in the roll degree of freedom applied at the handle of the surgeon console.

Technical Field

The present application relates generally to a remotely actuated surgical robotic system having a robotic telemanipulator.

Background

A variety of environments and applications require remote actuation with teleoperated surgical devices. These applications include the ability to perform delicate manipulations, manipulations in enclosed spaces, manipulations in hazardous or contaminated environments, in clean or sterile environments, and in surgical environments (whether open field or minimally invasive). Although these applications and parameters (such as precise tolerances and end-user skill levels) are varying, each application requires many of the same functions of the remote operating system, such as the ability to perform dexterous manipulations with high precision.

Surgical applications will be discussed in more detail in the following disclosure as an example of an application of teleoperational device systems, where there are known devices, but there are significant disadvantages in previously known systems and methods.

Open surgery remains the preferred method for many surgical procedures. It has been used for decades by the medical community and typically requires a long incision in the abdomen or other area of the body through which a conventional surgical tool is inserted. Due to this incision, this extremely invasive approach results in significant blood loss during surgery and often a lengthy and painful rest period in the hospital environment.

Laparoscopy is a minimally invasive technique that has been developed to overcome some of the disadvantages of open surgery. Instead of a large transmural incision, several small openings are made in the patient through which elongated surgical instruments and endoscopic cameras are inserted. The minimally invasive nature of the laparoscopic procedure reduces blood loss and pain and shortens hospital stays. When performed by experienced surgeons, laparoscopic techniques can achieve clinical results similar to open surgery. However, despite the above advantages, laparoscopy still requires a high degree of skill to successfully manipulate the rigid and long instruments used in such procedures. Typically, the entry incision serves as a point of rotation, reducing the freedom to position and orient the instrument within the patient. The movement of the surgeon's hand about this incision point is reversed and scaled up relative to the instrument tip ("fulcrum effect"), which reduces dexterity and sensitivity, and amplifies any tremor of the surgeon's hand. In addition, long, straight instruments force the surgeon to work in an uncomfortable posture with hands, arms, and body, which can be very tiring during long routines. Thus, due to these shortcomings of laparoscopic instruments, minimally invasive techniques are limited primarily to use in simple surgical procedures, and only a very few surgeons are able to use such instruments and methods in complex procedures.

To overcome the foregoing limitations of previously known systems, surgical robotic systems have been developed to provide an easy-to-use approach to complex minimally invasive surgery. These systems enable remote laparoscopy to be performed by means of a computerized robotic interface, in which the surgeon sits on a console, manipulating two master manipulators to perform operations through several small incisions. Like laparoscopy, robotic methods are also minimally invasive, providing the above advantages over open surgery in terms of pain relief, blood loss, and recovery time. In addition, it provides better ergonomics for the surgeon, increased flexibility, accuracy and tremor suppression, and eliminates the fulcrum effect compared to open and laparoscopic techniques. Although technically easier, robotic surgery still suffers from several drawbacks. One major drawback of previously known robotic surgical systems relates to the extremely high complexity of such systems, which include four to five robotic arms for replacing the hands of surgeons and assistants, integrated endoscopic imaging systems, and the ability to perform telesurgery, resulting in significant capital costs for acquisition and maintenance, and limiting the affordability of most surgical departments worldwide. Another disadvantage of these systems is the bulky size of previously known surgical robots, which compete for valuable space in the operating room environment and significantly increase preparation time. Thus possibly hampering patient access, which creates a safety hazard.

For example, daA Surgical system, available from Intuitive Surgical Inc (Intuitive Surgical Inc., of sony, ca), is a robotic Surgical system that allows a surgeon to perform remote laparoscopy. However, daSurgical systems are very complex robotic systems with a cost of approximately $ 200 million per robot per system, a maintenance cost of $ 15 million per year, and a surgical instrument cost of $ 2000 per procedure. daSurgical systems also require a significant amount of space to be left in the operating room, making it difficult to move the surgical system in the operating room to the vicinity of the desired location, and to switch between a forward surgical workspace and a reverse surgical workspace (also referred to as multi-quadrant surgery).

In addition, since the surgeon's operating console is typically located remotely from the surgical site, the surgeon and operating console are not within the sterile field of the operating room. If the surgeon's operating console is not sterile, the surgeon is not allowed to attend to the patient without additional sterilization routines, if necessary. During certain surgical procedures, surgeons may need immediate intervention, and current cumbersome robotic systems may prevent surgeons from quickly accessing the surgical site on the patient in a life-saving manner.

WO97/43942 to Madhani, WO98/25666 to Cooper, and U.S. patent application publication No.2010/0011900 to Burbank each disclose a robotic teleoperated surgical instrument designed to replicate the movement of a surgeon's hand within a patient. Through a computerized robotic interface, the instrument is capable of performing remote laparoscopy, wherein a surgeon sitting on a console and manipulating two joysticks performs the operation through several small incisions. These systems have no self-righting or artificial intelligence and are essentially complex tools that are fully controlled by the surgeon. Control commands are transmitted between the robot master and slave parts through a complex computer controlled mechatronic system that is extremely costly to produce and maintain and requires extensive training of hospital staff.

WO2013/014621 to Beira, the entire content of which is incorporated herein by reference, describes a mechanical teleoperated device for remote manipulation comprising a master-slave arrangement comprising slave units driven by a kinematically equivalent master unit, such that each part of a slave unit mimics the movement of a corresponding part of the master unit. A typical master-slave telemanipulator provides seven degrees of freedom of movement. In particular, these degrees of freedom include three translational macro movements (e.g., inward/outward, upward/downward, and leftward/rightward degrees of freedom) and four micro movements, including one rotational degree of freedom (e.g., pronation and supination), two articulated degrees of freedom (e.g., yaw and pitch), and one actuation degree of freedom (e.g., open/close). Although the mechanical transmission system described in this publication is well suited for this device, the low friction wiring of the cable from the handle through the entire kinematic chain to the instrument is expensive, complex, cumbersome, and requires precise calibration and careful handling and maintenance.

In addition, previously known purely mechanical solutions do not provide wrist alignment, low device complexity, low mass and inertia, high surgical volume, and good tactile feedback. For example, for a purely mechanical teleoperated device, in order to perform a pure pronation/roll movement of the instrument, the surgeon typically has to perform a combined pronation/roll movement of his hand/forearm and a translational movement on a curved path with his wrist. Such movements are complicated to perform correctly and, if not performed properly, the pitch and yaw of the end effector create undesirable parasitic movements.

Furthermore, the routing of articulation and actuation degree of freedom cables through the mechanical telemanipulator may limit the flexibility of the angular range of the telemanipulator links and the various joints of the joint structure. This in turn limits the amount of surgical available for instruments that can be used in a patient. During rapid movement of the mechanical telemanipulator, the inertia of the telemanipulator may also interfere and cause target overshoot and surgeon hand fatigue. Part of this mass can be attributed to the parts and components required to route the actuation and articulation degrees of freedom.

Accordingly, it is desirable to provide a remotely actuated surgical robotic system having a robotic telemanipulator that is well suited for use by a surgeon, seamlessly integrates into an operating room, allows the surgeon to work in a sterile manner between the robot and the patient, is relatively low cost, and/or allows integrated laparoscopy.

It is further desirable to provide a remotely actuated surgical robot having a mechanical and/or electromechanical telemanipulator.

Disclosure of Invention

The present invention overcomes the disadvantages of previously known systems by providing a remotely actuated surgical robotic system having a robotic telemanipulator that is preferably well suited for use by a surgeon, can be seamlessly integrated into an operating room, allows the surgeon to work between the robot and the patient in a sterile manner throughout the surgical procedure, is relatively low cost, and/or allows for integrated laparoscopy.

It will be understood by those of ordinary skill in the art that the term "master" as used herein refers to a component controlled by a surgeon and may be referred to as a "surgeon," and the term "slave" as used herein refers to a component that interacts with a patient undergoing a surgical procedure and may be referred to as a "patient. For example, the terms "master console" and "surgeon console" are interchangeable, and the terms "slave console" and "patient console" are interchangeable, and so forth. A surgical robotic system for remote manipulation comprising: a main console having a plurality of main links; and a handle coupled to the main console such that movement imparted at the handle moves at least one of the plurality of master links. The main console may be designed to remain sterile during the surgical procedure. According to one aspect, the handle may be removably coupled to the main console such that the handle is sterile during a surgical procedure and sterilizable when removed for additional surgical procedures. For example, the handle may be removably coupled to the main console via, for example, a clamping attachment or a threaded attachment. The removable handle may be purely mechanical without electronics such as circuitry, sensors, or electrically coupled buttons to facilitate sterilization between surgical procedures when the handle is removed from the main console. In this way, the master console may be sterile (e.g., covered with sterile drapes except at the handle) during surgery, while allowing the surgeon to have tactile feedback available from the handle in direct contact with the robot.

The surgical robotic system also includes a slave console having a plurality of slave links. According to one aspect, the distal end of the slave console may be rotatable about an alpha axis of an angled slave link of the plurality of slave links such that the distal end of the slave console may be positioned in a manner that allows a user to move from the master console in order to manually perform a laparoscopic routine on a patient undergoing a surgical procedure.

Additionally, the system includes an end effector coupled to the slave console, wherein the end effector moves in response to movement applied at the handle and in response to movement at the slave console to perform the surgical procedure. For example, the slave console may include a plurality of actuators, such as motors, operably coupled to the end effector that, when activated in response to an actuation at the handle, apply translational macro movements to the plurality of slave links during the macro synchronization state but not apply translational macro movements in the out-of-sync macro state, and apply micro movements to the end effector during the micro synchronization state but not apply micro movements in the out-of-sync micro state. Further, the surgical robotic system may include an instrument having a proximal end and a distal end, the proximal end having an instrument hub designed to be coupled to the distal end of the slave console, and the distal end having an end effector.

The handle may include a telescopic piston that moves in response to actuation of the handle. Thus, the at least one sensor of the master console is designed to sense the movement of the telescoping piston to cause the plurality of actuators to make corresponding micro-movements at the end effector. According to one aspect of the invention, the slave console does not respond to movement at the master console unless at least one sensor senses at least a predetermined amount of the telescoping piston. Furthermore, the at least one sensor coupled to the handle may be designed to sense an actuation pattern of the handle that transitions the robot from the unsynchronized micro-state to the micro-synchronized state. For example, in an unsynchronized micro-state, the movement at the handle sensed by the plurality of sensors does not cause the end effector to cause a corresponding micro-movement until the robot is transitioned to a micro-synchronized state due to the at least one sensor sensing the actuation pattern of the handle.

The master console may include a mechanical constraint designed to constrain movement of at least one of the plurality of master links, and may further include a clutch that, when actuated, prevents translational macro movement of the plurality of master links. The surgical robotic system may also include a display coupled to the master console that allows a user to visualize the end effector during operation of the telemanipulator. Additionally, the system may include a removable incision indicator that allows alignment from a distal end of the console with a trocar positioned within a patient undergoing a surgical procedure.

Further, the base of the slave console may be coupled to a proximal slave link of the plurality of slave links via a proximal slave joint of the plurality of slave joints such that the plurality of slave links and the joint are movable about the proximal slave joint to position the distal end of the slave console in a desired horizontal orientation prior to performing the surgical procedure while the base of the slave console remains stationary. Additionally, the base of the slave console may include an adjustable vertical post coupled to a proximal slave link of the plurality of slave links. The adjustable vertical column may adjust the height of the plurality of slave links and joints prior to operating the remote manipulator to position the distal end of the slave console in a desired vertical orientation.

According to one aspect of the application, a slave link and joint of the plurality of slave links and joints distal to a beta joint of the plurality of slave joints is designed to move relative to the beta joint to flip a distal end of the slave console between the forward surgical workspace and the reverse surgical workspace while a slave link of the plurality of slave links proximal to the beta joint and a base of the slave console remain stationary.

The surgical robotic system may also include a controller operably coupled to the plurality of actuators such that the plurality of actuators apply movement to the plurality of slave links of the slave console in response to instructions executed by the controller. For example, the controller may execute instructions to cause the plurality of actuators to move the plurality of slave links of the slave console to a home configuration in which the plurality of slave links are retracted such that the end effector is positionable within a trocar inserted into a patient undergoing a surgical procedure. In addition, the controller can execute instructions to cause the plurality of actuators to move the angulation in the plurality of slave links from the link to an angle such that the angulation slave link and a slave link in the slave console proximal to the angulation slave link remain stationary during operation of the telemanipulator. Thus, under the angle of the angled slave link, the distal end of the slave console allows the end effector to perform a surgical procedure in a hemispherical surgical workspace that is inclined at an angle that is substantially parallel to the angle of the angled slave link.

According to another aspect of the invention, the master console has a master controller and the slave console has a slave controller, such that the master controller can execute instructions based on the movement sensed at the handle and transmit signals to the slave controller based on the movement. Thus, the slave controller may receive signals and execute instructions to move at least one of the plurality of slave links and/or the end effector based on the signals transmitted from the master controller. For example, the slave console may include a right slave remote manipulator, a right slave controller, a left slave remote manipulator, and a left slave controller, and the master console may include a right master remote manipulator, a left master remote manipulator, and a master controller, such that in a forward surgical workspace configuration, the master controller communicates with the right slave controller to cause the right slave remote manipulator to move in response to movement of the right master remote manipulator, and the master controller communicates with the left slave controller to cause the left slave remote manipulator to move in response to movement of the left master remote manipulator. Additionally, according to some embodiments, in the reverse surgical workspace configuration, the master controller communicates with the left slave controller to cause the left slave remote manipulator to move in response to movement of the right master remote manipulator, and the master controller communicates with the right slave controller to cause the right slave remote manipulator to move in response to movement of the left master remote manipulator.

Accordingly, the distal end of the right slave telemanipulator may be rotated about the alpha axis of the right angled slave link of the plurality of right slave links, and the distal end of the left slave telemanipulator may be rotated about the alpha axis of the left angled slave link of the plurality of left slave links, such that the distal ends of the right and left slave telemanipulators may be positioned in a manner that allows a user to move from the master console to manually perform a laparoscopic routine on a patient undergoing a surgical procedure. Additionally, the right handle may be removably coupled to the right master remote manipulator and the left handle may be removably coupled to the left master remote manipulator.

According to yet another aspect of the present invention, a system for remote manipulation to perform a surgical procedure is provided. The system includes a patient console having a plurality of patient links coupled to a base and a surgical instrument coupled to the patient console. A distal region of a surgical instrument may be inserted into a patient at a surgical site to perform a robotic surgical procedure. The system also includes a controller that executes instructions to: in a surgical mode, at least one of the plurality of patient links is moved in response to movement applied at a handle of a surgeon console operably coupled to the patient console to move the surgical instrument to perform the robotic surgery, and the patient console is transitioned from the surgical mode to a laparoscopic mode in which the plurality of patient links are retracted from the patient while a base of the patient console remains stationary to expose the surgical site to allow the surgeon to perform the non-robotic surgery at the surgical site without interference from the plurality of patient links.

In addition, the controller may execute the instructions to determine that the surgical instrument has been removed from the patient at the surgical site, such that the controller transitions the patient console from the surgical mode to the laparoscopic mode only if the surgical instrument has been removed. For example, the controller may determine that the surgical instrument has been removed from the patient by determining that the surgical instrument has been decoupled from the patient console. Further, the controller may transition the patient console from the surgical mode to the laparoscopic mode in response to a user input received at the patient console. Further, the handle may be removably coupled to the surgeon console such that the handle is sterile during the surgical procedure and sterilizable when removed for additional surgical procedures. The system may also include a display coupled to the surgeon console to allow the surgeon to visualize the surgical instrument during operation of the system.

In addition, the controller can also execute instructions to, in a surgical mode, move at least one of the plurality of patient links in response to a movement applied at a handle of the surgeon console at the scaled degree. For example, the controller may execute instructions to cause scaled micro-movements at the surgical instrument in micro-degrees of freedom in response to corresponding movements applied at a handle of the surgeon console in the surgical mode. The micro-movements applied at the surgical instrument may be independently scalable for each of the micro-degrees of freedom such that the scaled micro-movements at the micro-degrees of freedom are at a different scale than the second scaled micro-movements at the surgical instrument at the second micro-degrees of freedom. Further, the surgeon console may include a clutch to prevent micro-movement at the surgical instrument in response to micro-movement applied at a handle of the surgeon console when the clutch is actuated.

According to another aspect of the present invention, a method for remotely performing a surgical procedure is provided. The method can comprise the following steps: coupling a surgical instrument to a patient console, the patient console including a plurality of patient links coupled to a base; inserting a distal region of a surgical instrument into a patient at a surgical site to perform a robotic surgical procedure; in a surgical mode, moving at least one of the plurality of patient links in response to movement imparted at a handle of a surgeon console operably coupled to the patient console, thereby moving the surgical instrument to perform the robotic surgical procedure; and transitioning the patient console from a surgical mode to a laparoscopic mode in which the plurality of patient links are retracted from the patient while the base of the patient console remains stationary to expose the surgical site to allow the surgeon to perform the non-robotic surgery at the surgical site without interference from the plurality of patient links.

According to yet another aspect of the present invention, another system for remote manipulation to perform a surgical procedure is provided. The system may include a patient console having an alignment joint and a plurality of patient links coupled to a base, and a surgical instrument coupled to the patient console. A distal region of a surgical instrument may be inserted into a patient at a surgical site to perform a robotic surgical procedure. The system may also include a controller that executes instructions to: setting a virtual center of motion based on the alignment of the alignment joint and the surgical site; and moving at least one of the plurality of patient links in response to movement applied at a handle of a surgeon console operably coupled to the patient console to move the surgical instrument to perform the robotic surgery, wherein movement of the surgical instrument is constrained near the virtual remote center of motion to maintain alignment of the patient joint with the surgical site during the surgical procedure.

The system may also include a cut-out indicator that may be removably coupled to the alignment joint to allow the alignment joint to be aligned with the surgical site. For example, the incision indicator may be removably coupled to the alignment joint via a magnetic attachment. In addition, the system can include a trocar positioned within the patient at the surgical site such that the virtual center of motion is set based on the alignment of the alignment joint and the trocar.

According to another aspect of the present invention, another method for remotely performing a surgical procedure is provided. The method can comprise the following steps: aligning one of a plurality of patient joints of a patient console with a trocar insertion site, the plurality of patient joints interconnected by a plurality of patient links, the patient console operably coupled to a surgeon console and configured to move in response to movement applied at a handle of the surgeon console; setting a virtual remote center of motion based on alignment of the patient joint with the trocar insertion site; and moving at least one of the plurality of patient links in response to movement applied at the handle to move a surgical instrument coupled to the patient console to perform the surgical procedure, wherein movement of the surgical instrument is constrained near the virtual remote center of motion to maintain alignment of the patient joint with the trocar insertion site during the surgical procedure.

According to yet another aspect of the present invention, another system for remote manipulation to perform a surgical procedure is provided. The system may include a patient console having an alignment joint and a plurality of patient links coupled to a base, and a surgical instrument coupled to the patient console. A distal region of a surgical instrument may be inserted into a patient at a surgical site to perform a robotic surgical procedure. The system may also include a controller that, in a surgical mode, causes scaled micro-movement at the surgical instrument in the micro-degree of freedom in response to a corresponding movement applied at the handle of the surgeon console, wherein the scaled micro-movement at the surgical instrument in the micro-degree of freedom is greater than the corresponding movement applied at the handle of the surgical console. The micro-movements applied at the surgical instrument may be independently scalable for each of the micro-degrees of freedom such that the scaled micro-movements at the first micro-degree of freedom are at a different scale than the second scaled micro-movements at the surgical instrument at the second micro-degree of freedom.

Further, the surgeon console may include a clutch that, when actuated, prevents micro-movement at the surgical instrument in response to micro-movement applied at a handle of the surgeon console. For example, the surgeon may articulate the instrument end effector via the handle to a certain position (e.g., using roll, pitch, and/or yaw degrees of freedom of the end effector), then actuate the clutch, move the handle back to a more ergonomic position while the instrument end effector remains stationary, and then release the clutch to continue relative micro-movement from the handle to the instrument end effector.