Abstract: A combined teleoperative-cooperative controllable robotic system includes a robotic actuator assembly, a control system adapted to communicate with the robotic actuator assembly, and a teleoperation unit adapted to communicate with the control system. The control system is configured to control at least a first portion of the robotic actuator assembly in response to at least one of a force or a torque applied to at least a second portion of the robotic actuator assembly by a first user for cooperative control. The control system is further configured to control at least a third portion of the robotic actuator assembly in response to input by a second user from the teleoperation unit for teleoperative control.

Abstract: A system and method for determining at least one new treatment plan for at least one new patient, comprising: providing at least one representation of the at least one new patient's at least one organ at risk relative to at least one target; searching for at least one prior treatment plan for at least one prior patient with at least one similar representation; and reviewing the at least one prior treatment plan for the at least one prior patient in order to determine whether the at least one new treatment plan can be improved based on information in the at least one prior treatment plan.

Abstract: A system and method for tool exchange during surgery for cooperatively controlled robots comprises a tool holder for receiving a surgical tool adapted to be held by a robot and a surgeon, a tool holding element for constraining downward motion of the tool while allowing low force removal of the surgical tool from the holder, a first sensor for detecting if the surgical tool is docked within the tool holder, and a selector for automatically selecting different movements or actions of the tool holder to be performed based upon information detected by the first sensor. The system and method of the present invention provides an advantage to an often slow moving cooperative robot, by increasing the speed by which the tool holder may move in the direction away from the patient.

Abstract: A tracking and navigation system is provided. The system includes an imaging or treatment device, a tracker device, and a fiducial marker. At least part of the imaging or treatment device is movable relative to a patient. The tracker device is mounted on the imaging or treatment device and is movable therewith relative to the patient. The fiducial marker may be fixed relative to the patient to define a patient coordinate system. The fiducial marker is detectable by the tracker device to substantially maintain registration between the tracker device and the patient coordinate system.

Abstract: A system and method for cooperative control of surgical tool includes a tool holder for receiving a surgical tool adapted to be held by a robot and a surgeon, a sensor for detecting a force based on operator input and/or tool tip forces, a controller for limiting robot velocity based upon the force detected so as to provide a haptic feedback, a selector for automatically selecting one level of a multi-level audio feedback based upon the detected force applied, the audio feedback representing the relative intensity of the force applied, and an audio device for providing the audio feedback together with the haptic feedback. The audio feedback provides additional information to the surgeon that allows lower forces to be applied during the operation.

Abstract: An optical coherence tomography (OCT) system for real-time surgical guidance includes an optical source, an optical fiber configured to be optically coupled to the optical source, a plurality of OCT sensor heads configured to be optically coupled to the optical fiber, an optical detector configured to be optically coupled to the optical fiber, a signal processor configured to communicate with the optical detector to receive detected signals therefrom, and a display system configured to receive OCT image signals from the signal processor and to display an OCT image of at least a portion of a surgical region of interest in real time to provide surgical guidance.

Abstract: A method and system for micro-force guided cooperative control that assists the operator in manipulating tissue in the direction of least resistance. A tool holder receives a surgical tool adapted to be held by a robot and a surgeon. A first sensor measures interaction forces between a tip of the surgical tool and tissue of a region of interest. A second sensor measures interaction forces between the surgeon and a handle to the surgical tool. A data processor is configured to perform an algorithm to actively guide the surgical tool by creating a bias towards a path of least resistance and limit directional tool forces of the surgical tool as a function of handle input forces and tip forces. This function offers assistance to challenging retinal membrane peeling procedures that require a surgeon to delicately delaminate fragile tissue that is susceptible to hemorrhage and tearing due to undesirable forces.

Abstract: A novel sensing system and methods for preventing damage to the cochlea during cochlear implant surgery are disclosed, using optical sensing to determine the distance of a stylet or the end of the implant itself from the interior wall of the scalar tympani. A variety of feedback methods are proposed to enable the surgeon to perform the procedure safely without damage to the basilar membrane or other delicate anatomic structures. Although a number of embodiments are disclosed, one preferred embodiment comprises a robotically manipulated end-effector.

Abstract: An autofocusing endoscope includes an objective lens, a relay optical system arranged to relay an image between the objective lens and a proximal end of the autofocusing endoscope, an optical fiber arranged with a distal end proximate the objective lens, a light source arranged to couple light into the optical fiber, an optical detection system arranged to receive and detect light from the optical fiber, and a data processor constructed to communicate with the optical detection system while in operation. The data processor is configured to determine a distance of a surface to be imaged through the objective lens and provide instructions for adjusting a focus of the autofocusing endoscope of the surface.

Abstract: In one embodiment of the invention, a method for a minimally invasive surgical system is disclosed. The method includes capturing and displaying camera images of a surgical site on at least one display device at a surgeon console; switching out of a following mode and into a masters-as-mice (MaM) mode; overlaying a graphical user interface (GUI) including an interactive graphical object onto the camera images; and rendering a pointer within the camera images for user interactive control. In the following mode, the input devices of the surgeon console may couple motion into surgical instruments. In the MaM mode, the input devices interact with the GUI and interactive graphical objects. The pointer is manipulated in three dimensions by input devices having at least three degrees of freedom. Interactive graphical objects are related to physical objects in the surgical site or a function thereof and are manipulatable by the input devices.

Abstract: A device includes first and second sheets of first and second elastic materials, respectively, and a control wire. The first sheet has a first thickness and a first length and is shaped to have a first cross-section having a first inner periphery and a first outer periphery. The second sheet has a second thickness and a second length and is shaped to have a second cross-section having a second inner periphery and a second outer periphery. One of the first sheet and the second sheet has a spacing disposed in along one of the first length and the second length, respectively. The first outer periphery is less than or equal to the second inner periphery. The second sheet surrounds the first sheet. The control wire has an end constrained to one of the first sheet the first material and the second sheet. The control wire is disposed within the spacing.

Abstract: A surgical tool system according to an embodiment of the current invention includes a surgical tool, and an interferometry system optically coupled to the surgical tool. The surgical tool includes a body section, a sensor section at least one of attached to or integral with the body section, and a surgical section at least one of attached to or integral with the sensor section at an opposing end of the sensor section from the body section. The sensor section comprises an interferometric optical sensor defining a reference distance that changes in response to at least one of a force or a torque when applied to the surgical section of the surgical tool.

Abstract: A motion-compensating surgical tool system includes a surgical tool that includes a hand piece and a moveable component, a drive assembly connecting the moveable component to the hand piece such that the moveable component is movable in an axial direction relative to the hand piece by the drive assembly. The motion-compensating surgical tool system also includes an optical detection system that includes an optical fiber attached to the moveable component with an end at a fixed distance to a distal-most portion of the moveable component. The optical detection system is configured to output a signal for the determination of a distance of the distal-most portion of the moveable component to a target during surgery.

Abstract: An endoscope manipulation adapter includes a support frame having a first end configured to be rigidly fixed relative to a handpiece of a flexible endoscope, and a manipulation assembly arranged at a second end of the support frame. The manipulation assembly defines a channel for at least one of a flexible endoscope shaft or a flexible endoscope insertion component to traverse through in an axial direction to assist in manipulating the at least one of the flexible endoscope shaft or the flexible endoscope insertion component during use of the flexible endoscope.

Abstract: In one embodiment of the invention, a method for a minimally invasive surgical system is disclosed. The method includes capturing and displaying camera images of a surgical site on at least one display device at a surgeon console; switching out of a following mode and into a masters-as-mice (MaM) mode; overlaying a graphical user interface (GUI) including an interactive graphical object onto the camera images; and rendering a pointer within the camera images for user interactive control. In the following mode, the input devices of the surgeon console may couple motion into surgical instruments. In the MaM mode, the input devices interact with the GUI and interactive graphical objects. The pointer is manipulated in three dimensions by input devices having at least three degrees of freedom. Interactive graphical objects are related to physical objects in the surgical site or a function thereof and are manipulatable by the input devices.

Abstract: An illumination system includes a light source, an optical waveguide that has a proximal end and a distal end such that the proximal end is arranged to receive light from the light source and the distal end is suitable to illuminate an object of interest; and an optical coupler constructed and arranged to couple light from the light source into the optical waveguide. The optical coupler includes a reflective surface that reflects at least some light diverging from the light source to be coupled into the optical waveguide.

Abstract: Featured are systems, devices and apparatuses for use in minimally invasive surgical, diagnostic or therapeutic methods and/or techniques, in particular methods and/or techniques for a mammalian throat. In particular embodiments, a dexterity apparatus including one or more dexterity devices is featured, where each of the dexterity devices comprises surgical tools and each is configured and arranged with end-tip dexterity for enhanced manipulation. A portion of the dexterity devices is snake like, which is re-configurable (i.e., can be bent) so as to in effect maneuver the surgical tool and put the tool in a desired position with respect to the surgical site. Another portion of the dexterity device includes the surgical tool thereby providing the capability of performing surgical actions such as sewing, gripping, soft tissue manipulation, cutting and suction of saliva, blood and other materials from the surgical site.

Abstract: A method for guiding a surgical cannula having a plurality of overlapping flexible tubes includes determining a desired cannula path; selecting the plurality of flexible tubes, wherein each of the flexible tubes within the plurality has a pre-formed curvature and a flexibility; determining a final overlap configuration of the plurality of flexible tubes such that a resulting curvature of the overlap configuration substantially corresponds to the desired cannula path; and determining a plurality of intermediate overlap configurations of the plurality of flexible tubes. Each of the intermediate configurations correspond to the desired cannula path.

Abstract: A visual tracking and annotation system for surgical intervention includes an image acquisition and display system arranged to obtain image streams of a surgical region of interest and of a surgical instrument proximate the surgical region of interest and to display acquired images to a user; a tracking system configured to track the surgical instrument relative to the surgical region of interest; a data storage system in communication with the image acquisition and display system and the tracking system; and a data processing system in communication with the data storage system, the image acquisition and display system and the tracking system. The data processing system is configured to annotate images displayed to the user in response to an input signal from the user.

Abstract: A sensing system for implant surgery includes an insertion device for moving an implant into a narrow cavity in a patient's body. A sensor measures the distance from an end of the insertion device to anatomic surfaces at a distance from the end of the insertion device. An optical coherence tomography (OCT) system integrates the sensor and produces OCT images, which can be quantified to distance measurements. The system is particularly useful for cochlear implant surgery.