MINIMALLY INVASIVE SURGICAL INSTRUMENT ADVANCEMENT

1 . A minimally invasive surgical instrument system comprising:

a flexible guide probe;

a flexible guide tube;

a surgical instrument comprising a distal end effector; and

a telemanipulation control system;

wherein the telemanipulation control system outputs control signals that advance the guide probe from an entry port in a patient, past an intermediate tissue structure, towards a surgical site;

wherein the guide probe is lockable to maintain a flexed position after a distal end of the guide probe is past the intermediate tissue structure;

wherein the guide tube is coaxially advancable over the locked guide probe;

wherein the guide tube is lockable to maintain a flexed position corresponding to the locked flexed position of the guide probe after a distal end of the advanced guide tube is at the surgical site; and

wherein the surgical instrument is insertable through the locked guide tube to position the end effector at the surgical site after the guide probe is withdrawn from the guide tube.

2 . The system of claim 1 , wherein the guide probe comprises an image capture device positioned at a distal end of the guide probe.

3 . The system of claim 1 , wherein the telemanipulation control system advances the guide probe in accordance with a preoperative image of a path between the entry port and the surgical site.

4 . The system of claim 1 , wherein the telemanipulation control system advances the guide probe in accordance with a real time image of a path between the entry port and the surgical site.

5 . The system of claim 1 , wherein the control system automatically propagates a curve from a distal portion of the guide probe to a proximal portion of the guide probe as the guide probe advances.

6 . The system of claim 1 , wherein the intermediate tissue is in the head of the patient.

7 . The system of claim 1 , wherein the intermediate tissue blocks a straight path between the entry port and the surgical site.

8 . The system of claim 1 , wherein the telemanipulation control system outputs second control signals that move a distal portion of the surgical instrument after the end effector is at the surgical site.

9 . The system of claim 1 , wherein the telemanipulation control system outputs second control signals that move a distal portion of the guide tube after the end effector is at the surgical site.

10 . A minimally invasive surgical method comprising:

generating telemanipulative control signals that advance a guide probe from an entry port in a patient, past an intermediate tissue structure, towards a surgical site;

locking the guide probe in a flexed position after a distal end of the guide probe is past the intermediate tissue structure;

coaxially advancing a guide tube over the locked guide probe;

locking the guide tube after a distal end of the guide tube is at the surgical site;

withdrawing the guide probe from the locked guide tube; and

advancing a surgical instrument through the locked guide tube to position an end effector of the surgical instrument at the surgical site.

11 . The method of claim 10 , wherein at least a portion of the control signals are based on a preoperative image of a path between the entry port and the surgical site.

12 . The method of claim 10 , wherein at least a portion of the control signals are based on a real time image of a path between the entry port and the surgical site.

13 . The method of claim 10 further comprising generating second telemanipulative control signals that move a distal portion of the surgical instrument after the end effector is at the surgical site.

14 . The method of claim 10 further comprising generating second telemanipulative control signals that move a distal portion of the guide tube after the end effector is at the surgical site.

15 . The method of claim 10 further comprising capturing an image with an image capture component of the guide probe.

16 . The method of claim 10 , wherein the intermediate tissue blocks a straight path between the entry port and the surgical site.

17 . A surgical system comprising:

a guide probe that is telemanipulatively advanced from an entry port in a patient, past an intermediate tissue structure, towards a surgical site, wherein the intermediate tissue structure blocks a direct line path between the entry point and the surgical site;

a guide tube that is coaxially advanced over the telemanipulatively advanced guide probe; and

a surgical instrument that is inserted through the coaxially advanced guide tube after the guide probe is removed from the advanced guide tube.

18 . The surgical system of claim 17 further comprising:

an image capture component at a distal end of the guide probe.