# US 11,992,188 B2 · Systems and methods for detecting environmental forces on an elongate device > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,992,188 B2 - Document ID: US11992188B2 - Status: Granted - Kind: B2 - Application number: 18/308,906 - Filed: 2023-04-28 - Published: 2023-08-24 - Granted: 2024-05-28 - Earliest claimed: 2017-10-13 - Assignees: Intuitive Surgical Operations, Inc. - Applicants: Intuitive Surgical Operations, Inc. - Inventors: Nicola Diolaiti; Federico Barbagli; Samuel Y. Chang; Vincent Duindam - Web page: https://patentgrep.com/patent/US11992188B2 ## CPC - A61B 1/0051: {with controlled bending of insertion part} - A61B 1/005: Flexible endoscopes - A61B 1/009: {with bending or curvature detection of the insertion part} - A61B 1/2676: {Bronchoscopes} - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback} - A61B 2017/0011: {piezoelectric} - A61B 2017/00115: {with audible or visual output} - A61B 2017/00296: {mounted on an endoscope} - A61B 2034/2048: {using an accelerometer or inertia sensor} - A61B 2034/2061: {using shape-sensors, e.g. fiber shape sensors with Bragg gratings} - A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes} - A61B 2090/065: {for measuring contact or contact pressure} - A61B 2562/0261: Strain gauges - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A medical system includes a flexible elongate instrument and a control unit. The control unit is configured to determine a force exerted by the flexible elongate instrument on tissue of a patient, determine a driving state of the flexible elongate instrument, set a force threshold based on the driving state, and provide feedback to an operator in response to the determined force being higher than the force threshold. Different driving states are associated with different force thresholds. ## Claims ### Claim 1 A medical system comprising: a flexible elongate instrument; and a control unit configured to: determine a force exerted by the flexible elongate instrument on tissue of a patient; determine a driving state of the flexible elongate instrument; set a force threshold based on the driving state, wherein different driving states are associated with different force thresholds; and provide feedback to an operator in response to the determined force being higher than the force threshold. ### Claim 2 (depends on 1) The medical system of claim 1, further comprising an actuator for inserting and retracting the flexible elongate instrument. ### Claim 3 (depends on 2) The medical system of claim 2, wherein the control unit determines the force based on one or more of: a shape of the flexible elongate instrument; a force being exerted by the actuator; or an amount of force being applied at a proximal end of the flexible elongate instrument. ### Claim 4 (depends on 3) The medical system of claim 3, wherein the control unit determines the shape of the flexible elongate instrument using a shape sensor. ### Claim 5 (depends on 3) The medical system of claim 3, wherein to determine the force exerted by the actuator the control unit determines a current used to drive the actuator. ### Claim 6 (depends on 1) The medical system of claim 1, wherein the control unit is further configured to: determine a plurality of force thresholds for the medical system; and provide an alert to the operator, the alert depending on which of the plurality of force thresholds the force exerted by the flexible elongate instrument on the tissue of the patient is higher than and which of the plurality of force thresholds the force exerted by the flexible elongate instrument on the tissue of the patient is lower than, the alert indicating an alert level regarding the force exerted by the flexible elongate instrument on the tissue of the patient. ### Claim 7 (depends on 1) The medical system of claim 1, wherein the driving state includes insertion. ### Claim 8 (depends on 7) The medical system of claim 7, wherein when the driving state includes insertion, the control unit further provides the feedback to the operator when a change in force over a change in insertion distance is higher than a threshold. ### Claim 9 (depends on 1) The medical system of claim 1, wherein the driving state includes retraction. ### Claim 10 (depends on 9) The medical system of claim 9, wherein when the driving state includes retraction, the force threshold is a fixed threshold. ### Claim 11 A method of operating a medical system, the method comprising: determining a force exerted by a flexible elongate instrument on tissue of a patient; determining a driving state of the flexible elongate instrument; setting a force threshold based on the driving state, wherein different driving states are associated with different force thresholds; and providing feedback to an operator in response to the determined force being higher than the force threshold. ### Claim 12 (depends on 11) The method of claim 11, further comprising determining a shape of the flexible elongate instrument using a shape sensor. ### Claim 13 (depends on 11) The method of claim 11, further comprising determining a force exerted on the flexible elongate instrument by an actuator by determining a current used to drive the actuator. ### Claim 14 (depends on 11) The method of claim 11, wherein determining the force exerted by the flexible elongate instrument on the tissue of the patient comprises: determining one or more of: a mass of the flexible elongate instrument; an acceleration of a proximal end of the flexible elongate instrument; an amount of friction in the medical system; or an effect of gravity on the medical system and the flexible elongate instrument; and applying a mechanical model of the medical system. ### Claim 15 (depends on 14) The method of claim 14, wherein determining the amount of friction comprises using a friction model of the medical system. ### Claim 16 (depends on 11) The method of claim 11, further comprising determining an amount of force being applied to a proximal end of the flexible elongate instrument using a force sensor located proximal to the proximal end of the flexible elongate instrument. ### Claim 17 (depends on 11) The method of claim 11, wherein setting the force threshold is further based on one or more of a model of the medical system, a model of the flexible elongate instrument, a size of passageways through which the flexible elongate instrument is being navigated, a desired target location for a distal end of the flexible elongate instrument, a type of tissue through which the flexible elongate instrument is being navigated, a type of procedure being performed, or an operator preference. ### Claim 18 (depends on 11) The method of claim 11, further comprising determining the force threshold based on one or more of an insertion depth of the flexible elongate instrument within one or more passageways, a branch depth of the flexible elongate instrument within the one or more passageways, a diameter or cross-sectional area of the one or more passageways near a distal end of the flexible elongate instrument, whether the distal end is being inserted toward a wall of the one or more passageways, or a curvature of the flexible elongate instrument. ### Claim 19 (depends on 11) The method of claim 11, further comprising: determining a plurality of force thresholds for the medical system; and providing an alert to the operator, the alert depending on which of the plurality of force thresholds the force exerted by the flexible elongate instrument on the tissue of the patient is higher than and which of the plurality of force thresholds the force exerted by the flexible elongate instrument on the tissue of the patient is lower than, the alert indicating an alert level regarding the force exerted by the flexible elongate instrument on the tissue of the patient. ### Claim 20 A non-transitory machine-readable medium comprising a plurality of machine-readable instructions which when executed by one or more processors associated with a device are adapted to cause the one or more processors to perform a method comprising: determining a first force exerted by a flexible elongate instrument on tissue of a patient; determining a driving state of the flexible elongate instrument; setting a force threshold based on the driving state, wherein different driving states are associated with different force thresholds; and providing feedback to an operator in response to the determined first force being higher than the force threshold.