# US 10,117,714 B2 · Software center and highly configurable robotic systems for surgery and other uses > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,117,714 B2 - Document ID: US10117714B2 - Status: Granted - Kind: B2 - Application number: 15/488,173 - Filed: 2017-04-14 - Published: 2017-08-03 - Granted: 2018-11-06 - Earliest claimed: 2005-05-19 - Assignees: Intuitive Surgical Operations, Inc. - Applicants: Intuitive Surgical Operations, Inc. - Inventors: William C. Nowlin; Paul W. Mohr; Bruce M. Schena; David Q. Larkin; Gary S. Guthart - Web page: https://patentgrep.com/patent/US10117714B2 ## CPC - A61B 34/35: for telesurgery - A61B 34/30: Surgical robots - A61B 34/37: Leader-follower robots (A61B34/35 takes precedence) - A61B 34/71: {Manipulators operated by drive cable mechanisms} - A61B 34/77: {Manipulators with motion or force scaling} - A61B 90/37: {Surgical systems with images on a monitor during operation} - B25J 3/00: Manipulators of leader-follower type, i.e. both controlling unit and controlled unit perform corresponding spatial movements - B25J 9/1682: {Dual arm manipulator; Coordination of several manipulators} - B25J 9/1689: {Teleoperation} - A61B 90/361: {Image-producing devices, e.g. surgical cameras} - A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes} - A61B 2034/302: {specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities} - A61B 2034/305: {Details of wrist mechanisms at distal ends of robotic arms} - A61B 2090/065: {for measuring contact or contact pressure} - G05B 2219/39135: For multiple manipulators operating at same time, avoid collision - G05B 2219/39212: Select between autonomous or teleoperation control - G05B 2219/39322: Force and position control - G05B 2219/40184: Compliant teleoperation, operator controls motion, system controls contact, force - G05B 2219/45117: Medical, radio surgery manipulator - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - B25J: MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES ({manipulators specially adapted for use in surgery A61B34/70; manipulators used in cleaning hollow articles B08B9/04}; manipulators associated with rolling mills B21B39/20; manipulators associated with forging machines B21J13/10; {manipulators associated with picking-up and placing mechanisms B23P19/007}; means for holding wheels or parts thereof B60B30/00; {vehicles with ground-engaging propulsion means, e.g. walking members B62D57/02, B62D57/032; devices for picking-up and depositing articles or materials between conveyors B65G47/90, B65G47/91; manipulators with gripping or holding means for transferring packages B65H67/065}; cranes B66C; {manipulators used in the protection or supervision of pipe-line installations F17D5/00; walking equipment adapted for nuclear steam-generators F22B37/006}; manipulators specially adapted for, or associated with, nuclear reactors G21C; {apparatus used for handling wafers during manufacture or treatment of semiconductor H10P72/50}) - G05B: CONTROL OR REGULATING SYSTEMS IN GENERAL; FUNCTIONAL ELEMENTS OF SUCH SYSTEMS; MONITORING OR TESTING ARRANGEMENTS FOR SUCH SYSTEMS OR ELEMENTS (systems for controlling or regulating non-electric variables G05D; systems for regulating electric or magnetic variables G05F; control devices or systems insofar as characterised by mechanical features only G05G) ## Abstract Telerobotic, telesurgical, and/or surgical robotic devices, systems, and methods employ surgical robotic linkages that may have more degrees of freedom than an associated surgical end effector in space. A processor can calculate a tool motion that includes pivoting of the tool about an aperture site. Linkages movable along a range of configurations for a given end effector position may be driven toward configurations which inhibit collisions. Refined robotic linkages and methods for their use are also provided. ## Claims ### Claim 1 A medical system comprising: a manipulator assembly having a plurality of links extending between an instrument holder and a proximal base, the instrument holder being configured to support an instrument extending through an access site of a patient, the manipulator assembly being configured for moving the instrument relative to the proximal base when the instrument is supported by the instrument holder, wherein the plurality of links are interconnected by a plurality of joints; and a processor operably coupled with the manipulator assembly, wherein the processor is configured to: determine a first set of joint movements of the plurality of joints that maintains the instrument at or adjacent the access site during movement of the access site, and determine, in response to detected movement of the access site, a second set of joint movements of the plurality of joints that, when combined with the first set of joint movements, maintains an orientation or position of at least a portion of the instrument or a distal portion of the manipulator assembly during the movement of the access site, and cause movement of the plurality of joints of the manipulator assembly in accordance with the second set of joint movements, such that the second set of joint movements occur in combination with the first set of joint movements during the movement of the access site. ### Claim 2 (depends on 1) The medical system of claim 1, wherein the plurality of joints provide sufficient degrees of freedom to allow a range of joint states for a given state of the instrument when the instrument is supported by the instrument holder. ### Claim 3 (depends on 1) The medical system of claim 1, wherein the manipulator assembly comprises a plurality of joint sensors, and wherein the processor is configured to determine the first set of joint movements of the plurality of joints by: allowing the movement of the access site; and using the plurality of joint sensors to sense the first set of joint movements during the movement of the access site. ### Claim 4 (depends on 1) The medical system of claim 1, wherein the processor is configured to determine the first set of joint movements based on the movement of the access site as determined from one or more sensed joint states, and wherein the processor is further configured to cause movement of the manipulator assembly in accordance with the first set of joint movements during the movement of the access site. ### Claim 5 (depends on 1) The medical system of claim 1, wherein the processor is further configured to allow the movement of the access site in response to sensing a force on the manipulator assembly exceeding a threshold value. ### Claim 6 (depends on 5) The medical system of claim 5, wherein sensing the force comprises sensing a force applied by a body wall of the patient at or adjacent the access site. ### Claim 7 (depends on 1) The medical system of claim 1, wherein the processor is further configured to cause movement of the plurality of joints of the manipulator assembly in accordance with the first set of joint movements while moving the plurality of joints of the manipulator assembly in accordance with the second set of joint movements. ### Claim 8 (depends on 1) The medical system of claim 1, wherein the processor is further configured to: allow external articulation of a first joint of the plurality of joints during the movement of the access site; and cause movement of at least one other joint of the plurality of joints in response to the external articulation of the first joint so as to maintain the instrument at or adjacent the access site with the external articulation. ### Claim 9 (depends on 1) The medical system of claim 1, wherein the processor is configured to determine a location at which the instrument is maintained at or adjacent the access site. ### Claim 10 (depends on 1) The medical system of claim 1 wherein the movement of the access site corresponds to movement of a medical table on which the patient is supported. ### Claim 11 (depends on 10) The medical system of claim 10 wherein the processor is further configured to control the movement of the medical table on which the patient is supported. ### Claim 12 (depends on 10) The medical system of claim 10 wherein the processor is configured to determine the first set of joint movements based on the movement of the access site. ### Claim 13 (depends on 10) The medical system of claim 10 wherein the movement of the medical table corresponds to a desired repositioning of the patient. ### Claim 14 (depends on 10) The medical system of claim 10 wherein the processor controls the movement of the medical table to compensate for a movement of the patient. ### Claim 15 (depends on 14) The medical system of claim 14 wherein the movement of the patient comprises cyclical physiological movements. ### Claim 16 (depends on 15) The medical system of claim 15 wherein the cyclical physiological movements comprise breathing or beating of a heart of the patient. ### Claim 17 (depends on 1) The medical system of claim 1, further comprising: an input device, wherein, in response to the input device receiving a movement command to effect a desired movement of the instrument in a manipulation mode, the processor causes motion of the plurality of joints to effect the desired movement. ### Claim 18 (depends on 1) The medical system of claim 1, wherein the medical system is a tele-surgical system, the instrument is a surgical instrument, and the access site is a minimally invasive access site of the patient. ### Claim 19 (depends on 1) The medical system of claim 1, wherein the processor is configured such that the first set of joint movements is determined in response to a commanded movement received by an input device to perform a desired movement of the instrument or manipulator assembly. ### Claim 20 (depends on 1) The medical system of claim 1, wherein the at least the portion of the instrument or the distal portion of the manipulator assembly comprises an end effector of the instrument. ### Claim 21 A robotic method for robotically moving a distal link of a manipulator assembly relative to a proximal base, the manipulator assembly having a plurality of links extending between the proximal base and the distal link, the plurality of links interconnected by a plurality of joints, the method comprising: receiving a movement command to move the manipulator assembly or an instrument supported by the manipulator assembly according to a desired movement; determining, with a processor of the manipulator assembly and in response to receiving the movement command, a first set of joint movements of the plurality of joints, wherein the first set of joint movements effects the desired movement while maintaining the distal link at or adjacent an access site; determining, with the processor and in response to detecting movement of the access site, a second set of joint movements of the plurality of joints, wherein the second set of joint movements combined with the first set of joint movements maintain an orientation or position of at least a portion of the instrument or a distal portion of the manipulator assembly during movement of the access site while the distal link is maintained at or adjacent the access site; and robotically moving the manipulator assembly according to the first set of joint movements combined with the second set of joint movements to effect the desired movement and maintain the orientation or position of the instrument or the distal portion of the manipulator assembly during the movement of the access site. ### Claim 22 (depends on 21) The robotic method of claim 21, wherein the plurality of joints provides sufficient degrees of freedom to allow a range of joint states for a given state of the instrument when the instrument is supported by the distal link. ### Claim 23 (depends on 21) The robotic method of claim 21, wherein the manipulator assembly comprises a plurality of joint sensors, and the method further comprises: determining the first set of joint movements of the plurality of joints by: allowing the movement of the access site and using the plurality of joint sensors to sense the first set of joint movements during the movement of the access site. ### Claim 24 (depends on 21) The robotic method of claim 21, further comprising: determining the first set of joint movements, with the processor, based on the movement of the access site, and moving the manipulator assembly, with the processor, in accordance with the first set of joint movements during the movement of the access site. ### Claim 25 (depends on 21) The robotic method of claim 21, further comprising: allowing the movement of the access site in response to sensing a force on the manipulator assembly exceeding a threshold value. ### Claim 26 (depends on 21) The robotic method of claim 21, wherein the processor is further configured to: allow external articulation of a first joint of the plurality of joints during the movement of the access site; and cause movement of at least one other joint of the plurality of joints in response to the external articulation of the first joint so as to maintain the instrument at or adjacent the access site with the external articulation. ### Claim 27 (depends on 21) The robotic method of claim 21, further comprising: determining a location at which the instrument is maintained at or adjacent the access site. ### Claim 28 (depends on 21) The robotic method of claim 21, further comprising: robotically moving a table on which a subject defining the access site is supported to achieve a desired repositioning of the subject. ### Claim 29 (depends on 21) The robotic method of claim 21, further comprising: robotically moving a table on which a subject defining the access site is supported to compensate for a cyclical movement of the subject. ### Claim 30 (depends on 29) The robotic method of claim 29 further comprising: determining the first set of joint movements based on the movement of the access site. ### Claim 31 (depends on 29) The robotic method of claim 29, wherein the at least the portion of the instrument or the distal portion of the manipulator assembly comprises an end effector of the instrument.