Surgical instrument with distal visualization and proximal optical fiducials

A surgical system, comprising:

• a surgical instrument comprising:
• an elongated body extending from a proximal region to a distal working region and defining a distal working point;
• a vision module carried by the elongated body at a position proximal to the distal working point, the vision module comprising at least one camera and at least one light source;
• a fiducial assembly mounted to the proximal region of the elongated body, the fiducial assembly comprising a support structure carrying a plurality of optical tracking elements arranged in a predefined geometry;
• and
• one or more reference features defined by the fiducial assembly and the elongated body and configured to establish a repeatable spatial relationship between a fiducial coordinate frame associated with the fiducial assembly and at least one of a camera coordinate frame of the vision module and a distal-working-point coordinate frame associated with the distal working point;
• an external optical navigation system configured to detect the optical tracking elements and determine a pose of the fiducial assembly in a navigation coordinate frame;
• and
• a data processing system comprising at least one processor and memory storing instructions that, when executed by the at least one processor, cause the data processing system to:
• receive image data from the at least one camera;
• receive or derive the pose of the fiducial assembly from the external optical navigation system;
• apply a stored transform corresponding to the repeatable spatial relationship to derive a pose of at least one of the at least one camera and the distal working point from the pose of the fiducial assembly;
• determine a confidence state for tracked guidance based on at least one of (i) a visible subset of the optical tracking elements, (ii) a pose-estimation residual or fit quality, and (iii) consistency between the derived pose and image-derived information from the image data;
• and
• generate a guidance output based at least in part on the derived pose and the confidence state.

A method for operating a surgical navigation system with a surgical instrument, the surgical instrument comprising an elongated body extending from a proximal region to a distal working region and defining a distal working point, a vision module carried by the elongated body at a position proximal to the distal working point, the vision module comprising at least one camera and at least one light source, and a fiducial assembly mounted to the proximal region of the elongated body, the fiducial assembly comprising a support structure carrying a plurality of optical tracking elements arranged in a predefined geometry and one or more reference features configured to establish a repeatable spatial relationship between a fiducial coordinate frame associated with the fiducial assembly and at least one of a camera coordinate frame of the vision module and a distal-working-point coordinate frame associated with the distal working point, the method comprising:

• retrieving or determining a transform corresponding to the repeatable spatial relationship;
• detecting the optical tracking elements with an external optical navigation system and determining a pose of the fiducial assembly in a navigation coordinate frame;
• receiving image data from the at least one camera;
• applying the transform to derive a pose of at least one of the at least one camera and the distal working point from the pose of the fiducial assembly;
• determining a confidence state for tracked guidance based on at least one of (i) a visible subset of the optical tracking elements, (ii) a pose-estimation residual or fit quality, and (iii) consistency between the derived pose and image-derived information from the image data;
• and
• responsive to the confidence state, selectively (a) presenting a first guidance output, (b) presenting a warning output, or (c) suppressing at least part of the guidance output and initiating a re-verification routine or a recalibration routine.