WO2025195791A1

WO2025195791A1 - Systems and methods for robotically manipulating elongate surgical tools

Info

Publication number: WO2025195791A1
Application number: PCT/EP2025/056166
Authority: WO
Inventors: Yossi Bar
Original assignee: Lem Surgical Ag
Current assignee: Lem Surgical Ag
Priority date: 2024-03-21
Filing date: 2025-03-06
Publication date: 2025-09-25
Anticipated expiration: 2026-09-21

Abstract

A surgical robot for axially translating an elongate surgical tool includes first and second robotic surgical arms. Each robotic surgical arm has a "gripper" mounted on a distal end thereof, where each gripper is configured to controllably grip the elongate surgical tool or other object. A robotic controller configured to grasp the elongate surgical tool with (i) a first gripper at a first location on the outer surface of the elongate surgical tool and (ii) a second gripper at a second location on the outer surface of the elongate surgical tool, wherein the second location is axially spaced-apart from the first location. The elongate surgical tool is axially translated by (i) tightening the grasp of the first gripper and pulling the elongate surgical tool with the first gripper in a first direction while the grasp of the second gripper is relaxed and (ii) tightening the grasp of the second gripper and pushing the elongate surgical tool with the second gripper in the first direction while the grasp of the first gripper is relaxed.

Description

SYSTEMS AND METHODS FOR ROBOTICALLY MANIPULATING ELONGATE

SURGICAL TOOLS

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Application No. 63/568,102 filed March 21 , 2024, the full disclosure of which is incorporated herein by reference.

BACKGROUND

Field

[0002] The disclosed technology relates generally to medical devices and methods. More particularly, the disclosed technology relates to robotic surgical systems which advance and manipulate elongate surgical objects in robotic surgical procedures.

[0003] Robot-assisted surgery, commonly referred to as robotic surgery, refers to any type of open, minimally invasive, percutaneous vascular, or other surgery that is performed using a surgical robot. Surgical robots can take many different forms and can be configured to manipulate many different types of surgical tools and other objects, depending on the surgical procedure being performed.

[0004] Of particular relevance to the disclosed technologies, surgical robots have been used to advance and manipulate various elongate surgical tools in numerous procedures, such as catheters in vascular and neurovascular procedures; cannulated instruments in bronchial, urological, gynecological, orthopedic, and other procedures; and endoscopic tools in bronchoscopic, laparoscopic, thoracoscopic, and other minimally invasive procedures.

[0005] Robotic manipulation of elongate surgical tools can be challenging. In contrast to manipulation of short tools and probes, such as tissue graspers, tissue cutters, short cannulas, and the like, the manipulation of long flexible and other surgical tool bodies is difficult. For example, advancing a 100 cm catheter or endoscope can require moving the distal end of a robot arm by a distance approaching one meter. The difficulty is exacerbated when two or more robotic surgical arms hold the elongate surgical tool and must be moved in unison for advancement or retraction of the tool.

[0006] In contrast to robotically assisted open surgical procedures which typically have a direct line-of-sight for a camera or the user, the advancement and manipulation of an elongate tool in a procedure with limited or no visibility can be very difficult. Not only is physical control of an elongate instrument more difficult, particularly when the elongate tool is a flexible catheter or has a flexible shaft, the active end of the elongate tool will typically be invisible to the user or robotic camera, making positioning complicated. [0007] There is thus a need for robotic surgical systems and methods that can accurately, precisely, and repeatedly manipulate and position flexible and other elongate surgical tools and devices in a wide variety of robotic surgical procedures. Such robotic surgical systems and methods should be useful in a wide variety of robotic surgical procedures, including but not limited to vascular procedures, such as percutaneous coronary intervention (PCI) procedures, neurovascular interventional (NVI) procedures, and peripheral vascular interventional (PVI) procedures; laparoscopic procedures; thoracoscopic procedures; gastrointestinal procedures; gynecological procedures; orthopedic procedures; and the like. Surgical tools to be positioned and manipulated should include but not be limited to catheters, including balloon catheters, ablation catheters, cutting catheters, drug delivery catheters, and the like; flexible and rigid laparoscopes, thoracoscopes, bronchoscopes, and other endoscopic tools; and the like. At least some of these objectives will be met by the technologies disclosed herein.

Background Art

[0008] W02020/069080, W02020/061240, W02020/079596, and W02008/101228 describe surgical robots configured to manipulate elongated surgical tools.

[0009] Relevant commonly owned publications and applications include International Application No. PCT/IB2022/052297 (WO2022/195460); International Application No. PCT/IB2022/058986 (WO2023/067415); International Application No. PCT/IB2022/058972 (WO2023/118984); International Application No. PCT/IB2022/058982 (WO2023/118985); International Application No. PCT/IB2022/058978 (WO2023/144602); International Application No. PCT/IB2022/058980 (WO2023/152561); International Application No. PCT/IB2023/055047 (WO2023/223215); International Application No. PCT/IB2022/058988 (WO2023/237922); International Application No. PCT/IB2023/055439; International Application No. PCT/IB2023/056911; International Application No. PCT/IB2023/055662; International Application No. PCT/IB2023/055663; US Provisional App. No. 63/524,911; and US Provisional App. No. 63/532,753, the full disclosures of each of which are incorporated herein by reference in their entirety.

SUMMARY

[0010] In a first aspect, the disclosed technology provides a surgical robot for axially translating an elongate surgical object. The elongate surgical object typically has an axis, a distal portion configured to be positioned in a patient’s body, and a proximal portion configured to be positioned outside the patient’s body, and the surgical robot comprises at least first and second robotic surgical arms. Each robotic surgical arm has a “gripper” fixedly or detachably mounted on a distal end thereof, where each gripper is configured to controllably grip an outer surface of the proximal portion of elongate surgical object. Suitable grippers are described in commonly owned PCT Publication WO/2023/223215 and presently pending US Provisional Patent Application 63/602367, filed on November 22, 2023, the full disclosures of which are incorporated herein by reference.

[0011] As used herein and in the claims, the phrase “surgical object,” refers to any surgical tool, implant, or assembly, that can be deployed or otherwise utilized in a robotic surgical procedure. Exemplaiy elongate surgical objects include, but are not limited to, catheters in vascular and neurovascular procedures; cannulated instruments in bronchial, urological, gynecological, orthopedic, and other procedures; and endoscopic tools in bronchoscopic, laparoscopic, thoracoscopic, and other minimally invasive procedures. The terms “tool” and “surgical tool” will be used interchangeably with the more general phrase “elongate surgical object” which is intended to include all elongate objects and assemblies (including for example implants and implant drivers) that may be handled and advanced by robotic surgical systems. [0012] The surgical robots of the disclosed technology further comprise a robotic controller configured to grasp the elongate surgical object with (i) a first gripper at a first location on the outer surface of the elongate surgical object and (ii) a second gripper at a second location on the outer surface of the elongate surgical object, wherein the second location is axially spaced-apart from the first location. The elongate surgical object is axially translated by (i) tightening the grasp of the first gripper and pulling the elongate surgical object with the first gripper in a first direction while the grasp of the second gripper is relaxed and (ii) tightening the grasp of the second gripper and pushing the elongate surgical object with the second gripper in the first direction while the grasp of the first gripper is relaxed.

[0013] In some instances, the controller is further configured to axially translate the elongate surgical object in a direction opposite to the first direction by alternately (i) tightening the grasp of the first gripper and pushing the elongate surgical object with the first gripper in the second direction while the grasp of the second gripper is relaxed and (ii) tightening the grasp of the second gripper and pulling the elongate surgical object with the second gripper in the opposite direction while the grasp of the first gripper is relaxed. In this way, the elongate surgical object can be moved back-and-forth within or in-and-out of a surgical space, such as a common surgical robotic coordinate space as described hereinafter.

[0014] In some instances, the controller is still further configured to perform steps (i) and (ii) in any order with or without repeating steps.

[0015] In some instances, the controller is still further configured to perform any or all of steps (i) and (ii) in response to user input. [0016] In some instances, the controller is still further configured to perform any or all of steps (i) and (ii) automatically.

[0017] In some instances, the controller is still further configured to perform any or all of steps (i) and (ii) automatically in response to user input.

[0018] In some instances, the first and second robotic arms are mounted on a common platform that defines a common surgical robotic coordinate space. In such instances, the controller is typically further configured to kinematically position the robotic surgical arms in the common surgical robotic coordinate space.

[0019] In some instances, the surgical robots further comprise a third robotic surgical arm configured to carry a camera and the controller is further configured to position the robotic surgical arms in response to images from the camera.

[0020] In some instances, the controller is configured to position the robotic surgical arms and in response to user input based upon images from the camera. In such instances, the controller is typically configured to automatically position the robotic surgical arms in response to the images from the camera.

[0021] In some instances, all surgical arms are mounted on a common chassis. In such instances, the chassis may comprise surgical bed frame. More usually, in such instances, the chassis may comprise a mobile cart, wherein the mobile cart is often configured to extend beneath and across a full width of a surgical bed to position the first and second robotic surgical arms on opposite sides of the bed.

[0022] In some instances, a tracking component is coupled to or incorporated into the mobile cart, wherein the tracking component is configured to track or image the patient to locate the distal portion of the elongate surgical object when the mobile cart is positioned beneath and across the full width of the surgical bed. In such instances, the imaging component comprises any one of an ultrasound imaging component, a fluoroscopic imaging component, an MRI imaging component, and an electromagnetic (EM) tracking component.

[0023] In a second aspect, the disclosed technology provides a robotic method for axially translating an elongate surgical object having an axis, a distal portion configured to be positioned in a patient’s body, and a proximal portion configured to be positioned outside the patient’s body. The method comprises (a) grasping a first location on an outer surface of the proximal portion of the elongate surgical object with a first gripper of a surgical robot and (b) grasping a second location on an outer surface of the proximal portion of the elongate surgical object with a second gripper of a surgical robot, where the second location is axially spacedapart from the first location. The elongate surgical obj ect can then be advanced over a first incremental length by tightening a grasp of the first gripper and then pulling with the first gripper in a first direction while the grasp of the second gripper is relaxed. The elongate surgical object can then be advanced over a second incremental length by tightening the grasp of the second gripper and pushing the elongate surgical object with the second gripper in the first direction while the grasp of the first gripper is relaxed. These alternating steps can be repeated as necessary to fully advance the elongate object over a desired total length.

[0024] In addition to advancing the elongate surgical object in a first direction, the disclosed technology can be configured to retract the elongate surgical object in an opposite direction by tightening the grasp of the first gripper and pushing the elongate surgical object with the first gripper in the opposite (second) direction while the grasp of the second gripper is relaxed. Further incremental retraction can be effected by tightening the grasp of the second gripper and pulling the elongate surgical object with the second gripper in the opposite direction while the grasp of the first gripper is relaxed. These alternating steps can be repeated as necessary to fully retract the elongate object over a desired total length.

[0025] In some instances, grasping the first and second locations on an outer surface of the proximal portion of the elongate surgical object comprises (1) controlling the first and second robotic arms of the surgical robot with a robotic controller to position the first and second grippers at the first and second locations on the outer surface of the proximal portion of the elongate surgical object and (2) controlling the grippers to tighten and relax grasp of the elongate surgical object with the robotic controller. In such instances, at least a portion of controlling the first and second surgical arms and controlling the grippers is typically performed by the robotic controller in response to user input, e.g., through an interface such as ajoystick, track pad, haptic glove, or remote workstation control interface. Alternatively, at least a portion of controlling the first and second surgical arms and controlling the grippers may be performed automatically by the robotic controller, e.g. in response to preprogrammed or real-time control algorithms performed partially or fully independently by the controller.

[0026] In some instances, the robotic methods of the disclosed technology further comprise imaging or sensing a position of the distal portion of the elongate surgical object in the patient’s body with a robotically controlled sensor while the elongate surgical object is being axially translated by the surgical robot. In such instances, the first and second robotic surgical arms and the sensor may be located on a common chassis. For example, the common chassis may be positioned beneath and across a surgical table so that the first robotic surgical arm is on one side of the table and the second robotic surgical arm is on the opposite side of the table. Typically, the sensor will be positioned on a midsection of the common chassis beneath the patient.

[0027] In a third aspect, the disclosed technology provides a mobile surgical robot having improved on-board imaging and tracking capabilities. The mobile surgical robot typically includes a mobile chassis, such as a wheeled or other mobile cart adapted to be moved, as needed, into and out of proximity with a surgical table having a head, a foot, and first and second lateral sides. The mobile surgical robot typically comprises a mobile chassis having a longitudinal axis, a first longitudinal end, and a second longitudinal end, where the mobile chassis defines a robotic surgical coordinate space. A first robotic surgical arm is mounted on the first longitudinal end of the mobile chassis, and a second robotic surgical arm is mounted on the second longitudinal end of the mobile chassis. A location or imaging sensor is disposed on a midsection of mobile chassis at a known location in the robotic surgical coordinate space, and a controller is configured to kinematically position the first and second robotic surgical arms in the robotic surgical coordinate space. The mobile chassis is typically configured to be advanced in a lateral direction beneath the surgical table so that the first robotic surgical arm is positioned along the first lateral side of the surgical table, the second robotic surgical arm is positioned along the second lateral side of the surgical table, and the location or imaging sensor is positioned beneath the table and directed upwardly to sense or image a patient when lying on the table. The location or imaging sensor can thus be positioned to percutaneously monitor and track a location of a distal end of an elongate surgical object that is being used in a surgical procedure being performed by the surgical robot.

[0028] In many instances, the location or imaging sensor will be fixedly mounted on the mobile chassis. For example, the location or imaging sensor may be fixedly mounted on an upper surface of the mobile cart at a position midway between the first and second robotic surgical arms. Alternatively, the location or imaging sensor may be movably mounted on the mobile chassis.

[0029] In many instances, the location or imaging sensor may comprise any one of an ultrasound imaging component, a fluoroscopic imaging component, an MRI imaging component, and an electromagnetic (EM) tracking component.

[0030] In a fourth aspect, the disclosed technology provides a method for performing robotic surgery on a patient lying on a surgical table. The surgical table has first and second lateral sides, and a mobile chassis is advanced in a lateral direction beneath the surgical table so that a first robotic surgical arm is positioned along the first lateral side of the surgical table and a second robotic surgical arm is positioned along the second lateral side of the surgical table. At least one of the first and second robotic surgical arms is manipulated to percutaneously position a surgical object internally in the patient, and a location of a distal portion of the surgical object is imaged or sensed within the patient using a location or imaging sensor disposed on the mobile chassis so that the sensor is positioned underneath the patient when the mobile chassis is positioned beneath and across the surgical table. [0031] In some instances, the manipulating and imaging steps may be performed at least in part by a user interfacing with a robotic controller. In other instances, the manipulating and imaging steps may be performed at least in part automatically by a robotic controller. In other instances, the manipulating and imaging steps are performed in part by a user interfacing with a robotic controller and in part automatically by the robotic controller.

[0032] In some instances, imaging or sensing comprises any one of an ultrasound imaging, fluoroscopic imaging, MRI imaging, and an electromagnetic (EM) tracking.

BRIEF DESCRIPTION OF THE DRAWINGS

[0033] FIG.l shows a surgical robot having adjustable grippers and on-board patient imaging capability configured to perform the methods of the disclosed technology, in accordance with some embodiments.

[0034] FIG. 2 illustrates a representative robotic surgical arm arrangement for performing methods according to the disclosed technology, in accordance with some embodiments.

[0035] FIG. 3 is a detailed, enlarged view of the internal mechanisms of the adjustable grippers of the surgical robot of FIG. 1, in accordance with some embodiments.

[0036] FIGS. 4A and 4B are schematic illustrations of the internal mechanisms of FIG. 2 shown in a relaxed configuration and a tightened configuration, respectively, in accordance with some embodiments.

[0037] FIGS. 5A to 5C illustrates how the grippers of the surgical robot of FIGS. 1 and 4 are manipulated to advance an elongate surgical object in accordance with the principles of the disclosed technology, in accordance with some embodiments.

DETAILED DESCRIPTION OF THE TECHNOLOGY

[0038] An exemplary robotic surgical system 100 intended particularly for use in the methods of the disclosed technology is shown in FIG. 1. The robotic surgical system 100 may comprise a chassis 102, typically a single, ngid frame which provides a base or platform for three robotic arms 106, 108 and 110 that are placed relatively far apart on the chassis on opposite longitudinal ends thereof, typically approximately one meter apart, thus allowing for desirable attributes such as reachability, maneuverability, and an ability to apply significant force. In the illustrated embodiment, robotic surgical arms 108 and 110 are on a first end 102a of the chassis 102 and robotic surgical arm 106 is on a second end 102b of the chassis. The chassis may be mobile, e.g. being in the form of a mobile cart as described in commonly owned WO2022/195460, previously incorporated herein by reference. In other embodiments and implementations, the surgical arms 106, 108 and 110 can be mounted on a base or other structure of a surgical table. For performing elongate tool advancement in accordance with the disclosed technology, the robotic surgical arms can be located on a stable platform that allows the arms to be moved within a common robotic coordinate system under the control of a surgical robotic controller, typically an on-board controller having a user interface, such as display screen 120.

[0039] The single, rigid chassis of the disclosed technology can comprise, consist of, or consist essentially of a single mobile cart, as disclosed for example in commonly owned WO2022/195460, the full disclosure of which has been previously incorporated herein by reference. In other instances, however, the single, rigid chassis may comprise separate modules, platforms, or components, that are assembled at or near the surgical table, as described for example in commonly owned PCT Application PCT/EP2024/052353, entitled Integrated MultiArm Mobile Surgical Robotic System, fded on January 29, 2024, the full disclosure of which is incorporated herein by reference. The single, rigid chassis may provide a stable base for all the surgical arms so that they may be accurately and precisely kinematically and/or optically navigated, positioned and tracked by the surgical robotic controller in a single surgical robotic coordinate space.

[0040] The chassis 102 of the robotic surgical system 100 may be configured to be temporarily placed under a surgical table 130 when performing the robotic surgical procedure, allowing the robotic surgical system 100 to be stored remotely before and after the procedure. The robotic arms 106, 108 and 110 may optionally be configured to be retracted into the chassis 102 of the robotic surgical system, allowing the system to be moved into or out of the surgical field in a compact configuration. The first robotic arm 106 may hold a first gripper 112 configured to removably and adjustably hold an elongate tool 150 (FIGS. 2 and 5A-5C). The second robotic arm 108 may hold a second gripper 114 also configured to removably and adjustably hold the elongate tool 150.

[0041] The chassis 102 may carry an imaging or sensing component 118 configured to visualize or track a position of a percutaneously positioned portion of an elongated surgical object used in performing a robotic or robotically assisted procedure using the surgical robot. The imaging or sensing component 118 may be located on an upper surface 104 of the chassis 102 between the robotic surgical arms 106, 108, and 110 at each end 102a and 102b of the chassis. As the chassis 102 may be configured to be selectively located beneath the surgical table, a user can locate the cart so the imaging or sensing component 118 is properly aligned with a patient anatomy when the patient is lying on the bed. The imaging or sensing component 118 is often an ultrasonic imaging array which together with the surgical bed 130 may be configured to allow upward imaging while the patient lies on the bed. In other instances, the imaging or sensing component 118 can be a fluoroscopic imaging or sensing component, an MRI imaging component, and an electromagnetic (EM) tracking component, or the like. In some instances, further structure or component(s) (not illustrated) might be needed to complete the imaging or sensing capability, e g., an overhead X-Ray source when the imaging or sensing component 118 is an X-ray detector.

[0042] As shown in FIG. 2, a draped patient P may be positioned on the surgical table 130 with a target anatomy TA, such as the patient’s lungs, positioned over the imaging or sensing component 118 (not visible in FIG. 2). The elongate tool 150, for example a bronchoscope (pulmonary endoscope), may be held by the first and second grippers 112 and 114 which are axially aligned with the patient’s superior-inferior axis which is oriented from a head 132 to a foot 134 of the surgical table 130. In this alignment, the first and second grippers 112 and 114 can be used to incrementally advance and retract the elongate tool 150 as described in detail with reference to FIGS. 5A to 5C below. As shown in FIG. 2, the elongate surgical object 150 may be a bronchoscope being orally advanced into a patient’s lungs.

[0043] The first and second grippers 112 and 114 can be configured to grasp and center a wide variety of elongate surgical objects 150, including but not limited to catheters in vascular and neurovascular procedures; cannulated instruments in bronchial, urological, gynecological, orthopedic, and other procedures; and endoscopic tools in bronchoscopic, laparoscopic, thoracoscopic, and other minimally invasive procedures. Usually, the elongate surgical objects 150 have a generally circular cross-section with a diameter that may be constant or may vary over its length. The grippers 112 and 114 can adjust a gripping force with which any elongate surgical object 150 being held in order to allow each gripper to be able to both (1) tightly grip the elongate object to allow pushing or pulling with a single gripper and (2) hold the object with a relaxed or loosened grip to allow the elongate object to slide through the gripper while the other gripper is advancing or retracting the object. In this way, two grippers can be used to align and stabilize the elongate object 150 while the grippers can alternate in pushing and pulling the object for advancement or retraction.

[0044] Suitable grippers include but are not limited to those described in commonly owned PCT Publication WO2023/223215, and pending US provisional application 63/602367, filed on November 22, 2023, the full disclosures of which are incorporated herein by reference. Referring now to FIGS. 3, 4A and 4B, an exemplary gripper mechanism 200 as generally described in PCT Publication WO2023/223215 and pending US provisional application 63/602367 will be described. An upper pair of opposed “shutters” 204a and 204b and a lower pair of opposed “shutters” 206a and 206b (upper and lower are with reference to the orientation in FIG. 3) can be mounted to counter-rotate when driven by drive shaft 210. A distal gear 212 on the drive shaft 210 can rotate a gear 214 which in turn rotates a vertical shaft 216 having upper and lower worm gears (not visible in FIG. 3). The worm gears in turn can counter-rotate upper gears 220a and 220b and lower gears 222a and 222b, linked to the opposed upper “shutters” 204a and 204b and lower pair “shutters” 206a and 206b, respectively.

[0045] Each of the shutters 204a/b and 206a/b can have a tapered groove 226a/b and 228a/b formed in an outer, cylindrical surface thereof. As shown in FIG. 4A, rotating drive shaft 210 in a first direction causes an “object-holding” periphery 232a defined by the surfaces of tapered grooves 226a and 226b to increase. In contrast, as shown in FIG. 4B, rotating drive shaft 210 in an opposite direction causes an “obj ect-holding” periphery 232b defined by the surfaces of tapered grooves 226a and 226b to decrease. The center 230 of the peripheral envelope can remain fixed relative to the gripper regardless of the rotational orientation of the opposed shutters 204a/b. In this way, tools of widely varying widths and diameters can be accommodated by gross adjustment of the periphery while the tightness of the grip can be increased or decreased by fine adjustment of the periphery.

[0046] Referring now to FIGS. 5 A to 5C, a specific protocol using first and second grippers 112 and 114 to advance the elongate surgical tool 150 will be described. Initially, the first and second grippers 112 and 114 can be closely spaced-apart in an axial direction along a length of the elongate surgical tool 150, as shown in FIG. 5 A. A “grasp” (holding force) of the first gripper 112 is then tightened by counter-rotating the upper opposed “shutters 204a/b and lower opposed “shutters” 206a/b to constrict the periphery 232b, as shown in FIG. 4B. Conversely, the “grasp” of the second gripper 114 can be loosened by counter-rotating the upper opposed “shutters” 204a/b and lower opposed “shutters” 206a/b to open the periphery 232a, as shown in FIG. 4A, allowing the robotic controller 120 to move the robot arm 106 to cause the surgical first gripper 112 to pull the elongate surgical tool 150 in the direction of arrow 302, with the trailing portion of the tool sliding through the second gripper 114.

[0047] After advancing the first gripper 112 to pull the elongate tool 150 forward, as shown in FIG. 5B, the grasp of the second gripper 114 can be tightened and the grasp of the first gripper can be loosened, allowing the controller 120 to move robot arm 106 to return the first gripper 112 to its initial position relative to the second gripper, as shown in FIG. 5C. After reversing the grasps of both the first and second grippers 112 and 114, the robotic system 100 is ready to again pull the elongate surgical tool 150 forward for a second incremental advancement. It will be appreciated that any number of incremental advances may be achieved by repeating the steps just described. Moreover, incremental retraction of the elongate surgical tool 150 can be accomplished by using the second gripper 114 to pull the elongate surgical tool in the opposite direction while the grasp of the first gripper 112 is loosened.

[0048] Reference number used herein are in the TABLE below:

[0049] While some embodiments have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the scope of the invention. It should be understood that various alternatives to the embodiments described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the disclosed technology and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims

CLAIMS WHAT IS CLAIMED IS:

1. A surgical robot for axially translating an elongate surgical object having an axis, a distal portion configured to be positioned in a patient’s body, and a proximal portion configured to be positioned outside the patient’s body, said surgical robot comprising: a first robotic surgical arm; a first gripper mounted on a distal end of the first robotic surgical arm, said first gripper configured to controllably grip an outer surface of the proximal portion of elongate surgical object; a second robotic surgical arm; a second gripper mounted on a distal end of the second robotic surgical arm, said second gripper configured to controllably grip an outer surface of the proximal portion of the elongate surgical object; and a controller configured to: grasp the elongate surgical object with (i) the first gripper at a first location on the outer surface of the elongate surgical object and (ii) the second gripper at a second location on the outer surface of the elongate surgical object, wherein the second location is axially spaced-apart from the first location; and axially translate the elongate surgical object by (i) tightening the grasp of the first gripper and pulling the elongate surgical object with the first gripper in a first direction while the grasp of the second gripper is relaxed and (ii) tightening the grasp of the second gripper and pushing the elongate surgical object with the second gripper in the first direction while the grasp of the first gripper is relaxed.

2. The surgical robot of claim 1, wherein the controller is further configured to: axially translate the elongate surgical object in a direction opposite to the first direction by alternately (i) tightening the grasp of the first gripper and pushing the elongate surgical object with the first gripper in the second direction while the grasp of the second gripper is relaxed and (ii) tightening the grasp of the second gripper and pulling the elongate surgical object with the second gripper in the opposite direction while the grasp of the first gripper is relaxed.

3. The surgical robot of claim 2, wherein the controller is further configured to perform steps (i) and (ii) in any order with or without repeating steps.

4. The surgical robot of claim 2 or 3, wherein the controller is further configured to perform any or all of steps (i) and (ii) in response to user input.

5. The surgical robot of claim 2 or 3, wherein the controller is further configured to perform any or all of steps (i) and (ii) automatically.

6. The surgical robot of claim 2 or 3, wherein the controller is further configured to perform any or all of steps (i) and (ii) automatically in response to user input.

7. The surgical robot of any one of claims 1 to 6, wherein the first and second robotic arms are mounted on a common platform that defines a common surgical robotic coordinate space.

8. The surgical robot of claim 7, wherein the controller is further configured to kinematically position the robotic surgical arms in the common surgical robotic coordinate space.

9. The surgical robot of any one of claims 1 to 8, further comprising a third robotic surgical arm configured to carry a camera, wherein the controller is further configured to position the robotic surgical arms in response to images from the camera.

10. The surgical robot of claim 9, wherein the controller is configured to position the robotic surgical arms and in response to user input based upon images from the camera.

11. The surgical robot of claim 9, wherein the controller is configured to automatically position the robotic surgical arms in response to the images from the camera.

12. The surgical robot of any one of claims 1 to 11, wherein all surgical arms are mounted on a common chassis.

13. The surgical robot of claim 12, wherein the chassis comprises surgical bed frame.

14. The surgical robot of claim 12, wherein the chassis comprises a mobile cart.

15. The surgical robot of claim 14, wherein the mobile cart is configured to extend beneath and across a full width of a surgical bed to position the first and second robotic surgical arms on opposite sides of the bed.

16. The surgical robot of claim 15, further comprising a tracking component coupled to or incorporated into the mobile cart, wherein the tracking component is configured to track or image the patient to locate the distal portion of the elongate surgical obj ect when the mobile cart is positioned beneath and across the full width of the surgical bed.

17. The surgical robot of claim 16, wherein the imaging component comprises any one of an ultrasound imaging component, a fluoroscopic imaging component, an MRI imaging component, and an electromagnetic (EM) tracking component.

18. The surgical robot of any one of claims 1 to 17, wherein the first and second grippers are configured to center the elongate surgical object to align with an axis of the gripper regardless of diameter.

19. A robotic method for axially translating an elongate surgical object having an axis, a distal portion configured to be positioned in a patient’s body, and a proximal portion configured to be positioned outside the patient’s body, said method comprising: grasping a first location on an outer surface of the proximal portion of the elongate surgical object with a first gripper of a surgical robot; grasping a second location on an outer surface of the proximal portion of the elongate surgical object with a second gripper of a surgical robot, wherein the second location is axially spaced-apart from the first location; tightening the grasp of the first gripper and pulling the elongate surgical object with the first gripper in a first direction while the grasp of the second gripper is relaxed; and tightening the grasp of the second gripper and pushing the elongate surgical object with the second gripper in the first direction while the grasp of the first gripper is relaxed.

20. The robotic method as in claim 19, further comprising: tightening the grasp of the first gripper and pushing the elongate surgical object with the first gripper in the second direction while the grasp of the second gripper is relaxed; and tightening the grasp of the second gripper and pulling the elongate surgical object with the second gripper in the opposite direction while the grasp of the first gripper is relaxed.

21. The robotic method as in claim 19 or 20, wherein grasping the first and second locations on an outer surface of the proximal portion of the elongate surgical object comprises (1) controlling the first and second robotic arms of the surgical robot with a robotic controller to position the first and second grippers at the first and second locations on the outer surface of the proximal portion of the elongate surgical object and (2) controlling the grippers to tighten and relax grasp of the elongate surgical object with the robotic controller.

22. The robotic method as in claim 21, wherein at least a portion of controlling the first and second surgical arms and controlling the grippers is performed by the robotic controller in response to user input.

23. The robotic method as in claim 21, wherein at least a portion of controlling the first and second surgical arms and controlling the grippers is performed automatically by the robotic controller.

24. The robotic method as in any one of claims 19 to 23, further comprising imaging or sensing a position of the distal portion of the elongate surgical object in the patient’s body with a robotically controlled sensor while the elongate surgical object is being axially translated by the surgical robot.

25. The robotic method as in claim 24, wherein the first and second robotic surgical arms and the sensor are located on a common chassis.

26. The robotic method as in claim 25, wherein the common chassis is positioned beneath and across a surgical table so that the first robotic surgical arm is on one side of the table and the second robotic surgical arm is on the opposite side of the table

27. The robotic method as in claim 26, wherein the sensor is positioned on a midsection of the common chassis beneath the patient.

28. The robotic method of any one of claims 19 to 27, wherein the first and second grippers center the elongate surgical object to align with an axis of the gripper regardless of diameter.

29. A mobile surgical robot for use with a surgical table having a head, a foot, and first and second lateral sides, said surgical robot comprising: a mobile chassis having a longitudinal axis, a first longitudinal end, and a second longitudinal end, wherein the mobile chassis defines a robotic surgical coordinate space; a first robotic surgical arm mounted on the first longitudinal end of the mobile chassis; a second robotic surgical arm mounted on the second longitudinal end of the mobile chassis; a location or imaging sensor disposed on a midsection of mobile chassis at a known location in the robotic surgical coordinate space; and a controller configured to kinematically position the first and second robotic surgical arms in the robotic surgical coordinate space; wherein the mobile chassis is configured to be advanced in a lateral direction beneath the surgical table so that the first robotic surgical arm is positioned along the first lateral side of the surgical table, the second robotic surgical arm is positioned along the second lateral side of the surgical table, and the location or imaging sensor is positioned beneath the table and directed upwardly to sense or image a patient when lying on the table.

30. The mobile surgical robot of claim 29, wherein the location or imaging sensor is fixedly mounted on the mobile chassis.

31. The mobile surgical robot of claim 30, wherein the location or imaging sensor is fixedly mounted on an upper surface of the mobile cart at a position midway between the first and second robotic surgical arms.

32. The mobile surgical robot of claim 29, wherein the location or imaging sensor is movably mounted on the mobile chassis.

33. The mobile surgical robot of any one of claims 29 to 32, wherein the location or imaging sensor comprises any one of an ultrasound imaging component, a fluoroscopic imaging component, an MRI imaging component, and an electromagnetic (EM) tracking component.

34. A method for performing robotic surgery on a patient lying on a surgical table having first and second lateral sides, said method compnsing: advancing a mobile chassis in a lateral direction beneath the surgical table so that a first robotic surgical arm is positioned along the first lateral side of the surgical table and a second robotic surgical arm is positioned along the second lateral side of the surgical table; manipulating at least one of the first and second robotic surgical arms to percutaneously position a surgical object internally in the patient; and imaging or sensing a location of a distal portion of the surgical object within the patient using a location or imaging sensor disposed on the mobile chassis and positioned underneath the patient when the mobile chassis is positioned beneath and across the surgical table.

35. The method of claim 34, wherein the manipulating and imaging steps are performed at least in part by a user interfacing with a robotic controller.

36. The method of claim 34, wherein the manipulating and imaging steps are performed at least in part automatically by a robotic controller.

37. The method of claim 34, wherein the manipulating and imaging steps are performed in part by a user interfacing with a robotic controller and in part automatically by the robotic controller.

38. The method of any one of claims 34 to 37, wherein imaging or sensing comprises any one of an ultrasound imaging, fluoroscopic imaging, MRI imaging, and an electromagnetic (EM) tracking.