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Telerobotic, telesurgical, and/or surgical robotic devices, systems, and methods employ surgical robotic linkages that may have more degrees of freedom than an associated surgical end effector n space. A processor can calculate a tool motion that includes pivoting of the tool about an aperture site.

Telerobotic, telesurgical, and/or surgical robotic devices, systems, and methods employ surgical robotic linkages that may have more degrees of freedom than an associated surgical end effector n space. A processor can calculate a tool motion that includes pivoting of the tool about an aperture site. Linkages movable along a range of configurations for a given end effector position may be driven toward configurations which inhibit collisions. Refined robotic linkages and method for their use are also provided.

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1. A tele-surgical method for use with a tele-surgical system having a manipulator configured to support a surgical instrument, the surgical instrument having a distal end effector, the manipulator and instrument together having a plurality of driven joints and being configured to provide sufficient

1. A tele-surgical method for use with a tele-surgical system having a manipulator configured to support a surgical instrument, the surgical instrument having a distal end effector, the manipulator and instrument together having a plurality of driven joints and being configured to provide sufficient degrees of freedom to allow a range of joint states of the plurality of driven joints for a state of the end effector while the instrument passes through an access site, the method comprising: receiving a movement command input at an input device to effect a desired movement of the end effector within a surgical workspace in a patient;determining first calculated movements of the plurality of driven joints, with a processor coupling the manipulator to the input device, in response to the movement command input, the calculated movements being calculated so as to move the end effector with the desired movement by pivoting the instrument about a pivotal center of the instrument;determining second calculated movements of the plurality of driven joints, with the processor, the second calculated movements being calculated so as to pivot the instrument at a dynamic pivotal center location during the desired movement of the end effector to maintain the pivotal center of the instrument adjacent the access site in response to a changing location of the access site; anddriving the plurality of joints according to the calculated first and second movements. 2. The tele-surgical method of claim 1, further comprising: tracking changes in a location of the pivotal center of the instrument, the dynamic pivotal center location being calculated based at least in part on the tracked changes of the location of the pivotal center. 3. The tele-surgical method of claim 2, wherein the tracked changes of the location of the pivotal center of the instrument is induced by at least one of cyclical physiological movement, patient movement, and movement of a surgical table supporting the patient. 4. The tele-surgical method of claim 2, wherein the tracked changes of the location of the pivotal center of the instrument is induced by movement of a surgical table supporting the patient and wherein the second calculated movements are calculated so that the dynamic pivotal center location compensates for the tracked changes of the location of the pivotal center of the instrument. 5. The tele-surgical method of claim 1, further comprising: determining changes in a location of the pivotal center of the instrument at least in part from observed pivotal movements of the instrument and calculating the dynamic pivotal center location so as to compensate for changes in the location of the pivotal center of the instrument. 6. The tele-surgical method of claim 1, wherein the second calculated movements are calculated so that the dynamic pivotal center location moves within an acceptable range. 7. The tele-surgical method of claim 1, further comprising: determining forces associated with pivoting of the instrument about the access site such that the dynamic pivotal center location of the second calculated movement is calculated based in part on the determined forces. 8. The tele-surgical method of claim 1, further comprising: determining a cyclical movement of the pivotal center of the instrument, the cyclical movement being associated with a physiological activity of the patient. 9. The tele-surgical method of claim 8, wherein the physiological activity comprises breathing of the patient. 10. The tele-surgical method of claim 8, wherein the physiological activity comprises heartbeats of the patient. 11. The tele-surgical method of claim 1, wherein the second calculated movements are calculated so as to change a compliance or stiffness associated with the dynamic pivotal center location within a range extending from a passive pivot point location to a fixed pivot point location. 12. The tele-surgical method of claim 1, wherein the second calculated movements are calculated so as to inhibit movement of a location of the pivotal center of the instrument in response to a port stiffness factor. 13. The tele-surgical method of claim 1, wherein the second calculated movements are calculated partly in response to an external manual articulation of the manipulator so as to maintain the pivotal center of the instrument at the calculated dynamic pivotal center location when the manipulator is manually articulated. 14. A tele-surgical method comprising: receiving a command to effect a desired movement of a distal end effector supported by a manipulator assembly having a plurality of driven joints configured to tele-operatively move the distal end effector relative to a proximal base while a shaft supporting the end effector extends through a minimally invasive access site;calculating first movements of the plurality of driven joints, with a processor of the manipulator assembly, that effect the desired movement of the distal end effector by pivoting the shaft about a pivotal center;calculating a dynamic pivotal center location and associated second movements of the plurality of driven joints, with the processor, that pivot the shaft at the dynamic pivotal center location while maintaining the pivotal center of the shaft adjacent the access site; andconforming the manipulator assembly with an external articulation of the manipulator assembly when the external articulation exceeds a threshold so that movement of at least one joint of the plurality of driven joints is determined in part in response to the threshold-exceeding external articulation, the external articulation effecting movement of the shaft by movement of the access site. 15. The tele-surgical method of claim 14, wherein the external articulation is induced by a change in a surgical table supporting a patient with the access site, the change comprising a reorientation or a motion of the surgical table. 16. The tele-surgical method of claim 14, wherein conforming the manipulator assembly with an external articulation of the manipulator assembly comprises: determining changes in a location of the pivotal center of the shaft at least in part from observed pivotal movements of the shaft and calculating the dynamic pivotal center location so as to compensate for movement of the location of the pivotal center of the shaft. 17. A tele-surgical method comprising: tele-operatively moving a tool holder of a manipulator relative to a proximal base of the manipulator while a shaft of a tool supported by the tool holder extends from the tool holder distally through an aperture to an end effector of the tool;calculating movements of at least one driven joint of a plurality of driven joints of the manipulator according to a calculated movement, the calculated movement being calculated with a processor of the manipulator in response to manual articulation of the manipulator so that the tool holder pivots about a pivotal center disposed along an axis of the shaft distal of the tool holder; andcalculating a dynamic pivotal center location with the processor, wherein the calculated movements of the plurality of driven joints pivot the tool at the dynamic pivotal center location to maintain the pivotal center of the shaft adjacent the aperture in response to a changing location of the aperture. 18. A tele-surgical method for use with a tele-surgical system having a manipulator supporting a surgical instrument having a distal end effector suitable for insertion into a patient, the manipulator and instrument together having a plurality of driven joints having sufficient degrees of freedom to allow a range of joint states for a state of the end effector while a shaft of the surgical instrument passes through an access site, the method comprising: receiving a movement command from a user input to effect a desired movement of the end effector within a surgical workspace;calculating movements of the plurality of driven joints, with a processor of the tele-surgical system, in response to the movement command, that moves the end effector with the desired movement by pivoting the instrument about a pivotal center of the instrument that is at or adjacent the access site while the shaft extends through the access site; andmoving the pivotal center within an acceptable range according to calculated movements of the driven joints calculated by the processor to avoid imposing excessive lateral forces on a tissue of the patient when the tissue along the access site moves. 19. The tele-surgical method of claim 18, further comprising: determining forces associated with moving the pivotal center according to the calculated movements. 20. The tele-surgical method of claim 18, wherein calculating the movements of the plurality of driven joints comprises: changing a stiffness associated with a location of the pivotal center. 21. A tele-surgical method for use with a tele-surgical system having a manipulator configured to support a surgical instrument, the surgical instrument having a proximal end, a distal end effector suitable for insertion into a patient, and an intermediate portion extending between the end effector and the proximal end, the manipulator and instrument together having a plurality of driven joints that are configured to provide sufficient degrees of freedom to allow a range of joint states for a state of the end effector while the intermediate portion passes through an access site, the method comprising: receiving a movement command from a user input to effect a desired movement of the end effector within a surgical workspace;calculating movements of the plurality of driven joints, with a processor of the tele-surgical system, in response to the movement command, to move the end effector with the desired movement by pivoting the instrument about a pivotal center of the instrument while the intermediate portion is within the access site;determining a cyclical movement of the pivotal center, with the processor, the cyclical movement being associated with a physiological activity of the patient, so as to maintain the pivotal center adjacent the access site; andmoving the pivotal center, with the processor, according to the determined cyclical movement such that the pivotal center remains adjacent the access site. 22. The tele-surgical method of claim 21, wherein the physiological activity comprises breathing of the patient. 23. The tele-surgical method of claim 21, wherein the physiological activity comprises heartbeats of the patient. 24. A tele-surgical method for use with a tele-surgical system having a manipulator configured to support a surgical instrument having a proximal end, a distal end effector, and an intermediate portion extending between the end effector and the proximal end, the manipulator and instrument together having a plurality of driven joints with sufficient degrees of freedom to allow a range of joint states of the plurality of driven joints for a state of the end effector while the intermediate portion passes through an access site, the method comprising: receiving a movement command with a user input to effect a desired movement of the end effector within a surgical workspace;determining, with a processor of the tele-surgical system, a dynamic pivotal center location that remains adjacent the access site during movement of the access site; anddetermining calculated movements of the plurality of driven joints in response to the movement command and in response to a changing location of the access site so as to: move the end effector with the desired movement,pivot the instrument about a pivotal center of the instrument, andmove the pivotal center of the instrument toward the dynamic pivotal center location, or maintain the pivotal center of the instrument at the dynamic pivotal center location, to maintain the pivotal center of the instrument adjacent the access site during the desired movement of the end effector. 25. A tele-surgical method for use with a tele-surgical system having a tele-operated manipulator configured to support a surgical instrument having a proximal end mounted on the manipulator, a distal end effector, an intermediate portion between the proximal end and the end effector, the manipulator and the instrument together having a plurality of driven joints with sufficient degrees of freedom to allow a range of states of the plurality of driven joints for an individual position of the end effector in a surgical site as the intermediate portion extends through an access site, a method comprising: determining calculated movements of the plurality of driven joints that pivot the instrument about a pivotal center defined at a position on the intermediate portion of the instrument and that move the pivotal center of the instrument toward a dynamic pivotal center location calculated to remain adjacent to the access site as the access site moves, or maintain the pivotal center of the instrument at the dynamic pivotal center location;moving the end effector using the calculated movements so as to pivot the surgical instrument about the pivotal center of the instrument in response to an operator input command as the access site moves; andin the absence of the operator input command, using the calculated movements to keep the end effector stationary in relation to the surgical site as the access site moves.