# US 11,896,330 B2 · Robotic medical system having multiple medical instruments > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,896,330 B2 - Document ID: US11896330B2 - Status: Granted - Kind: B2 - Application number: 16/994,397 - Filed: 2020-08-14 - Published: 2021-02-18 - Granted: 2024-02-13 - Earliest claimed: 2019-08-15 - Assignees: Auris Health, Inc. - Applicants: Auris Health, Inc. - Inventors: Andre J. Castillo; Akira Bryan Ueda; Adrian Tyler Hairrell; Nikhil S. Joshi - Web page: https://patentgrep.com/patent/US11896330B2 ## CPC - A61B 34/35: for telesurgery - A61B 34/37: Leader-follower robots (A61B34/35 takes precedence) - A61B 34/71: {Manipulators operated by drive cable mechanisms} - B25J 9/0087: {Dual arms (double SCARA arms B25J9/043)} - B25J 9/06: characterised by multi-articulated arms - B25J 9/1689: {Teleoperation} - B25J 15/0066: {with different types of end effectors, e.g. gripper and welding gun (B25J15/0057 and B25J15/0061 take precedence)} - A61B 17/221: Gripping devices in the form of loops or baskets {for gripping calculi or similar types of obstructions (surgical snare instruments A61B17/32056)} - A61B 18/20: using laser - A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)} - 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 2034/715: {Cable tensioning mechanisms for removing slack} - 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}) ## Abstract Certain aspects relate to robotic medical instrument systems. Such a system can include first and second medical instruments. The first medical instrument can include an instrument base and an elongate shaft extending from the instrument base, and a robotic drive input. The first medical instrument may include an instrument inlet. The second medical instrument may include an instrument base and an elongate shaft that extends through the instrument inlet. The second medical instrument can include a robotic drive input that is coupled to a rotating element in the second medical instrument. The robotic medical instrument system can include a robotic arm that has first and second robotic drive outputs. The first robotic drive output can drive the robotic drive input of the first medical instrument, and the second robotic drive output can drive the robotic drive input of the second medical instrument. ## Claims ### Claim 1 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. ### Claim 2 (depends on 1) The robotic system of claim 1, wherein the second elongate shaft extends from a proximal portion of the second instrument base of the second medical instrument. ### Claim 3 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. ### Claim 4 (depends on 3) The robotic system of claim 3, wherein the second medical instrument further comprises a linear actuator associated with the coupling element, the linear actuator being configured to manipulate the second elongate shaft longitudinally. ### Claim 5 (depends on 1) The robotic system of claim 1, wherein the second medical instrument comprises at least one of a laser tool or a basketing tool. ### Claim 6 (depends on 1) The robotic system of claim 1, wherein a first actuator of the second instrument base controls a longitudinal position of at least a portion of the second elongate shaft. ### Claim 7 (depends on 6) The robotic system of claim 6, wherein a second actuator of the second instrument base controls an activation of a distal portion of the second elongate shaft. ### Claim 8 (depends on 1) The robotic system of claim 1, wherein the second robotic drive input is coupled to a sheath of the second elongate shaft of the second medical instrument. ### Claim 9 (depends on 1) The robotic system of claim 1, wherein the second medical instrument further comprises a third robotic drive input, wherein the third robotic drive input is coupled to an inner portion of the second elongate shaft of the second medical instrument. ### Claim 10 (depends on 1) The robotic system of claim 1, wherein the second elongate shaft forms a service loop. ### Claim 11 (depends on 10) The robotic system of claim 10, wherein the service loop extends at least 45 degrees between the instrument inlet of the first medical instrument and the second instrument base of the second medical instrument. ### Claim 12 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. ### Claim 13 (depends on 12) The medical system of claim 12, wherein the working channel instrument comprises an instrument base including a coupling element configured to allow removable coupling of the instrument base to the endoscope base. ### Claim 14 (depends on 12) The medical system of claim 12, wherein: the endoscope further comprises a first rotating element that is configured to articulate a distal end of the elongate shaft of the endoscope in a first dimension; and the first manual actuator is configured to cause manual rotation of the first rotating element. ### Claim 15 (depends on 12) The medical system of claim 12, wherein the working channel instrument further comprises an instrument base coupled to the instrument shaft, the instrument shaft extending from a proximal portion of the instrument base. ### Claim 16 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. ### Claim 17 (depends on 16) The medical system of claim 16, wherein the working channel instrument further comprises a linear actuator to associated with the coupling element, the linear actuator configured to move the instrument shaft of the working channel instrument longitudinally. ### Claim 18 (depends on 12) The medical system of claim 12, wherein the working channel instrument comprises at least one of a laser tool or a basketing tool. ### Claim 19 (depends on 12) The medical system of claim 12, wherein the second robotic drive input controls a longitudinal position of at least a portion of the instrument shaft. ### Claim 20 (depends on 12) The medical system of claim 12, wherein the second manual actuator controls articulation of a distal portion of the instrument shaft. ### Claim 21 (depends on 12) The medical system of claim 12, wherein the second robotic drive input is coupled to a sheath of the instrument shaft. ### Claim 22 (depends on 12) The medical system of claim 12, wherein the instrument shaft forms a service loop between an inlet of the endoscope base and an instrument base of the working channel instrument. ### Claim 23 (depends on 12) The medical system of claim 12, wherein the working channel instrument comprises a coupling element configured to couple the instrument shaft to the second robotic drive input. ### Claim 24 (depends on 23) The medical system of claim 23, wherein the working channel instrument further comprises a linear actuator associated with the coupling element, the linear actuator being configured to move the instrument shaft of the working channel instrument longitudinally. ### Claim 25 (depends on 12) The medical system of claim 12, wherein the second robotic drive input of the working channel instrument is operatively coupled to the instrument shaft at a point distal to a proximal portion of a base of the working channel instrument. ### Claim 26 (depends on 25) The medical system of claim 25, wherein the second robotic drive input is operatively coupled to the instrument shaft at a point distal to a proximal portion of the instrument base. ### Claim 27 (depends on 12) The medical system of claim 12, wherein the second manual actuator is a linear actuator. ### Claim 28 (depends on 12) The medical system of claim 12, wherein the second manual actuator is associated with a base of the working channel instrument. ### Claim 29 (depends on 28) The medical system of claim 28, further comprising a third manual actuator associated with the base of the working channel instrument and configured to be manually actuated to cause movement of a component of the working channel instrument, the third manual actuator being independently movable relative to the second manual actuator.