Robotic medical system having multiple medical instruments

A robotic system comprising:

• a first medical instrument comprising a first instrument base and a first elongate shaft extending from the first instrument base, the first instrument base including a first robotic drive input and a first rotating element coupled to the first robotic drive input, wherein the first robotic drive input is configured to articulate a distal end of the first elongate shaft, the first medical instrument further comprising an instrument inlet providing access to a working channel of the first medical instrument, wherein the first rotating element comprises a tensioning ratchet configured to allow for tensioning of a pull wire coupled to the first rotating element;
• a second medical instrument comprising a second instrument base and a second elongate shaft configured to extend through the instrument inlet and at least partially within the first elongate shaft of the first medical instrument, the second medical instrument including a second robotic drive input;
• and
• a robotic end effector comprising first and second robotic drive outputs, the first robotic drive output configured to drive the first robotic drive input of the first medical instrument, and the second robotic drive output configured to drive the second robotic drive input of the second medical instrument;
• wherein:
• the second elongate shaft extends from a proximal portion of the second instrument base of the second medical instrument;
• and
• the second medical instrument comprises a coupling element operatively coupling the second elongate shaft to the second robotic drive input, wherein the second robotic drive input is operatively coupled to the second elongate shaft at a point distal to the proximal portion of the second instrument base.

A medical system, comprising:

• an endoscope comprising an endoscope base having an elongate shaft extending from the endoscope base, the endoscope base including a first robotic drive input and a first manual actuator;
• and
• a working channel instrument having an instrument shaft configured to extend within the elongate shaft of the endoscope, the working channel instrument including a second robotic drive input and a second manual actuators;
• wherein:
• the first and second robotic drive inputs are configured to couple to corresponding first and second robotic drive outputs of a robotic end effector;
• the first manual actuators is configured to be manually actuated to cause articulation of the elongate shaft of the endoscope when the first robotic drive inputs is decoupled from the first robotic drive output of the robotic end effector;
• and
• the second manual actuator is configured to be manually actuated to cause movement of one or more components of the working channel instrument when the second robotic drive input is decoupled from the second robotic drive output.

A medical system comprising:

• an endoscope comprising an endoscope base having an elongate shaft extending from the endoscope base, the endoscope base including a first robotic drive input and a first manual actuator;
• and
• a working channel instrument having an instrument base and an instrument shaft configured to extend within the elongate shaft of the endoscope, the instrument base including a second robotic drive input and a second manual actuator;
• wherein:
• the first and second robotic drive inputs are configured to couple to corresponding first and second robotic drive outputs of a robotic end effector,
• the first and second manual actuators are configured to be manually actuated when the first and second robotic drive inputs are decoupled from the first and second robotic drive outputs, respectively;
• and
• the working channel instrument comprises a coupling element configured to couple the instrument shaft to the second robotic drive input, wherein the second robotic drive input of the working channel instrument is operatively coupled to the instrument shaft of the working channel instrument at a point distal to a proximal portion of the instrument base.